Effective and Robust Multimodal Medical Image Analysis
Organizations: Indian Institute of Technology Ropar, Rupnagar, Punjab, India · Deakin University, Melbourne, Victoria, Australia · Queensland University of Technology, Brisbane, QLD, Australia
Abstract
Multimodal Fusion Learning (MFL), leveraging disparate data from various imaging modalities (e.g., MRI, CT, SPECT), has shown great potential for addressing medical problems such as skin cancer and brain tumor prediction. However, existing MFL methods face three key limitations: a) they often specialize in specific modalities, and overlook effective shared complementary information across diverse modalities, hence limiting their generalizability for multi-disease analysis; b) they rely on computationally expensive models, restricting their applicability in resource-limited settings; and c) they lack robustness against adversarial attacks, compromising reliability in medical AI applications. To address these limitations, we propose a novel Multi-Attention Integration Learning (MAIL) network, incorporating two key components: a) an efficient residual learning attention block for capturing refined modality-specific multi-scale patterns and b) an efficient multimodal cross-attention module for learning enriched complementary shared representations across diverse modalities. Furthermore, to ensure adversarial robustness, we extend MAIL network to design Robust-MAIL by incorporating random projection filters and modulated attention noise. Extensive evaluations on 20 public datasets show that both MAIL and Robust-MAIL outperform existing methods, achieving performance gains of up to 9.34% while reducing computational costs by up to 78.3%. These results highlight the superiority of our approaches, ensuring more reliable predictions than top competitors. Code: https://github.com/misti1203/MAIL-Robust-MAIL.
Figures & tables
| Datasets | D1: Nickparvar | D2: IQ-OTHNCCD | D3: Tuberculosis | D4: BCCD | D5: HAM10000 | D6: SIPaKMeD | D7: CRC | D8: CNMC-2019 | D9: KVASIR | D10: CBIS-DDSM | Cost Analysis | |||||||||||||||||||||
| Models | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | ACC | F1 | AUC | Params | Flops |
| DDA-Net | 96.8 | 96.6 | 97.1 | 98.1 | 97.4 | 98.1 | 98.6 | 97.7 | 98.8 | 98.2 | 98.2 | 98.6 | 92.2 | 91.8 | 92.6 | 92.5 | 92.8 | 91.9 | 93.4 | 92.7 | 93.6 | 92.6 | 91.8 | 93.1 | 90.6 | 90.2 | 91.1 | 92.5 | 91.8 | 91.5 | 12.1 | 1.12 |
| NAT | 95.5 | 95.5 | 95.6 | 97.5 | 97.3 | 97.2 | 98.4 | 96.7 | 98.2 | 98.1 | 97.7 | 98 | 93.1 | 92.6 | 93.3 | 91.1 | 91.1 | 91.5 | 96.8 | 96.7 | 96.8 | 94.1 | 93.7 | 93.4 | 89.3 | 87.6 | 90.1 | 92.0 | 91.7 | 91.9 | 20 | 1.1 |
| POTTER | 95.1 | 94.7 | 94.7 | 97.2 | 96.5 | 97.2 | 97.8 | 97.2 | 98.2 | 96.8 | 96.4 | 96.1 | 91.3 | 91.1 | 91.8 | 92.3 | 92.1 | 92.3 | 95.8 | 95.2 | 96.2 | 93.8 | 93.5 | 92.7 | 91.5 | 90.7 | 90.9 | 91.3 | 91.1 | 90.8 | 12 | 0.95 |
| MFMSA | 98.3 | 98.0 | 98.4 | 99.5 | 99.3 | 99.5 | 98.9 | 97.4 | 98.6 | 98.3 | 98.5 | 98.8 | 97.9 | 97.3 | 97.9 | 94.7 | 94.4 | 95.3 | 97.3 | 97.3 | 97.6 | 96.2 | 96.0 | 96.3 | 90.9 | 90.5 | 90.7 | 94.6 | 94.5 | 94.6 | 26.9 | 1.4 |
| Gloria | 98.1 | 97.5 | 97.9 | 98.5 | 98.3 | 98.5 | 98.2 | 97.5 | 98.9 | 98.1 | 97.6 | 98.4 | 93.7 | 93.7 | 94.5 | 94.2 | 94.2 | 94.2 | 96.2 | 95.5 | 95.9 | 93.7 | 93.5 | 93.2 | 89.6 | 89.1 | 90.2 | 92.5 | 91.2 | 91.9 | 30.8 | 1.54 |
| Datasets | D11: PathMNIST | D12: PneumoniaMNIST | D13: RetinaMNIST | D14: BreastMNIST | D15: TissueMNIST | D16: OrganAMNIST | D17: KVASIR | D18: ISIC 2018 | D19: BraTs 2020 | D20: LiTs | Params | Flops | |||||||||||
| Models | ACC | AUC | ACC | AUC | ACC | AUC | ACC | AUC | ACC | AUC | ACC | AUC | Models | DICE | mIOU | DICE | mIOU | DICE | mIOU | DICE | mIOU | ||
| DDA-Net | 92.25 | 99.84 | 90.25 | 97.25 | 67.62 | 78.46 | 86.35 | 90.18 | 68.90 | 94.54 | 95.75 | 99.80 | UNet | 80.55 | 72.60 | 87.32 | 80.24 | 81.79 | 76.54 | 88.80 | 84.64 | 34.5 | 65.5 |
| NAT | 91.80 | 99.78 | 89.95 | 97.12 | 66.58 | 77.60 | 86.24 | 90.10 | 68.42 | 94.39 | 95.70 | 99.80 | UNet++ | 84.37 | 77.48 | 87.30 | 80.25 | 82.55 | 76.37 | 89.45 | 85.08 | 9.2 | 34.7 |
| POTTER | 91.45 | 99.50 | 89.89 | 97.74 | 63.54 | 74.26 | 87.15 | 90.90 | 67.98 | 93.29 | 96.06 | 99.85 | AttnUNet | 83.89 | 77.15 | 87.80 | 80.54 | 82.78 | 76.48 | 86.72 | 84.98 | 34.9 | 66.6 |
| MFMSA | 92.28 | 99.70 | 91.49 | 98.15 | 69.10 | 78.84 | 88.90 | 93.37 | 72.45 | 95.29 | 96.12 | 99.90 | PolypPVT | 91.67 | 85.90 | 90.42 | 83.85 | 86.38 | 79.50 | 93.83 | 88.20 | 25.1 | 5.3 |
| Gloria | 91.94 | 99.78 | 91.25 | 97.88 | 66.89 | 77.55 | 87.52 | 91.07 | 69.88 | 94.72 | 95.68 | 99.80 | TransUNet | 86.45 | 81.37 | 87.28 | 81.20 | 84.90 | 78.24 | 92.12 | 87.85 | 105 | 38.5 |
| Datasets | D5: HAM10000 | D3: Tuberculosis CXR | D10: CBIS-DDSM | D11: PathMNIST | D16: OrganAMNIST | D8: CNMC-2019 | ||||||||||||||||||||||||
| PGD | BIM | MIM | AA | Square | PGD | BIM | MIM | AA | Square | PGD | BIM | MIM | AA | Square | PGD | BIM | MIM | AA | Square | PGD | BIM | MIM | AA | Square | PGD | BIM | MIM | AA | Square | |
| PNI | 51.8 | 55.2 | 53.5 | 60.9 | 63.1 | 74.9 | 76.4 | 74.9 | 80.6 | 81.8 | 47.6 | 49.4 | 47.3 | 59.2 | 56.2 | 39.3 | 40.6 | 39.6 | 49.8 | 48.5 | 39.8 | 38.1 | 37.4 | 49.4 | 46.8 | 70.5 | 72.4 | 70.2 | 77.4 | 77.6 |
| DBN | 48.3 | 50.9 | 48.3 | 57.6 | 59.4 | 72.5 | 74.6 | 73.8 | 78.1 | 79.6 | 40.3 | 45.9 | 40.3 | 58.4 | 56.2 | 38.4 | 39.2 | 38.1 | 47.8 | 43.7 | 38.7 | 39.5 | 38.0 | 45.6 | 45.3 | 69.1 | 73.6 | 70.4 | 74.5 | 72.9 |
| Learn2Perturb | 53.0 | 54.6 | 51.8 | 61.4 | 59.4 | 77.1 | 79.3 | 77.1 | 82.5 | 81.9 | 45.8 | 43.2 | 45.8 | 61.1 | 62.3 | 40.7 | 41.8 | 40.7 | 49.9 | 50.1 | 39.4 | 44.7 | 39.4 | 48.2 | 47.8 | 74.5 | 77.8 | 76.3 | 79.6 | 79.0 |
| RPF | 59.5 | 62.1 | 60.3 | 68.9 | 69.4 | 80.8 | 83.6 | 81.3 | 85.1 | 85.5 | 51.0 | 49.3 | 48.0 | 67.2 | 63.7 | 42.5 | 43.9 | 41.2 | 54.7 | 48.6 | 41.8 | 40.6 | 38.8 | 52.9 | 51.2 | 81.9 | 81.4 | 79.1 | 85.1 | 84.3 |
| CAP | 60.8 | 63.2 | 56.4 | 69.2 | 72.4 | 86.2 | 87.5 | 84.2 | 90.7 | 90.3 | 52.3 | 52.2 | 50.1 | 68.1 | 64.5 | 43.4 | 44.7 | 43.3 | 55.8 | 50.2 | 40.7 | 42.1 | 41.2 | 51.9 | 50.6 | 82.3 | 82.8 | 79.5 | 86.2 | 85.1 |
| Dataset | ERLA | MFIFA | EMSCA | Acc | F1 | Dataset | ERLA | MFIFA | EMSCA | Acc | F1 | Params |
| D5 | 94.9 | 94.7 | D6 | 90.1 | 88.9 | 23.4 | ||||||
| 96.5 | 96.5 | ✓ | 91.9 | 91.4 | 23.7 | |||||||
| 96.9 | 96.8 | 92.3 | 92.3 | 23.9 | ||||||||
| 98.9 | 98.8 | 95.8 | 95.6 | 24.2 | ||||||||
| 95.9 | 95.6 | 91.5 | 91.2 | 9.83 | ||||||||
| 97.7 | 97.7 | 93.6 | 93.4 | 10.2 |
| EMILA | MFIFA | EMSCA | D5 | D6 | Robust-MAIL | D5 | D3 | ||||||||
| MSGDC | CA | MO | DF | MSGDC | CMI | Acc | Acc | Params | RPF@E | RPF | MAN | Acc | Acc | ||
| + | 94.9 | 90.1 | 23.4 | 0 | 2.58 | ||||||||||
| 96.49 | 92.15 | 9.85 | 18.37 | 25.42 | |||||||||||
| 97.78 | 94.79 | 24.2 | 48.27 | 73.39 | |||||||||||
| 97.42 | 93.90 | 10.4 | 46.95 | 70.44 | |||||||||||
| 98.48 | 95.52 | 10.8 | 61.18 | 82.56 | |||||||||||
| Dataset | PFA | CAT | Acc | F1 | Dataset | PFA | CAT | Acc | F1 | Params |
| D5 | 99.1 | 99.0 | D6 | 95.9 | 95.9 | 11.7 | ||||
| 99.4 | 99.4 | 96.3 | 96.3 | 11.7 |
| Dataset | Modality | Task | Classes / Labels | #Samples | Split | Remarks |
| Nickparvar MRI ( Nickparvar, 2021 ) | Brain MRI (T1–weighted) | Classification | Glioma (1621), Meningioma (1645), No Tumor (2000), Pituitary (1757) | 7023 | 80%/10%/10% | Aggregated from Figshare, SARTAJ, BrH35 datasets. |
| IQ-OTHNCCD ( Alyasriy and Muayed, 2020 ) | Chest CT | Classification | Normal, Benign, Malignant | 1098 | 80%/10%/10% | Lung nodule diagnosis. |
| Tuberculosis CXR ( Rahman et al., 2020 ) | Chest X-ray | Classification | Normal vs Tuberculosis | 4200 | 80%/10%/10% | Binary TB screening. |
| BCCD ( Shenggan, 2018 ) | Microscopy (blood smear) | Classification | Eosinophil, Lymphocyte, Monocyte, Neutrophil | 9957 | 80%/10%/10% | Leukocyte subtype recognition. |
| HAM10000 ( Tschandl et al., 2018 ) | Dermoscopy | Classification | 7 skin lesion categories | 10015 | 80%/10%/10% | 50% histopathology-confirmed labels. |
| SIPaKMeD ( Plissiti et al., 2018 ) | Cytology | Classification | 5 epithelial cell types | 4049 | 80%/10%/10% | Pap smear cell classification of cervical cancer. |