TriFusion-SR: Joint Tri-Modal Medical Image Fusion and SR

Super-resolution (SR) is a severely ill-posed problem with inherent ambiguity, as widely recognized in both empirical and theoretical studies. Although recent semantic-guided and multi-modal SR methods exploit large models or external priors to enhance semantic alignment, the fusion of heterogeneous modalities remains insufficiently understood in practice and theory. In this work, we provide the first theoretical modeling of multi-modal SR, revealing that prior methods are bottlenecked by sub-optimal modality utilization. Our analysis shows that the generalization risk bound can be improved by strengthening the alignment between modality weights and their effective contributions, while reducing representation complexity. This theoretical insight inspires us to propose the novel Multi-Modal Mixture-of-Experts Super-Resolution framework (M$^3$ESR) that employs generalization-oriented dynamic modality fusion for accurate risk control and modality contribution optimization. In detail, we propose a novel spatially dynamic modality weighting module and a temporally adaptive modality temperature scheduling mechanism, enabling flexible and adaptive spatial-temporal modality weighting for effective risk control. Extensive experiments demonstrate that our M$^3$ESR significantly boosts generalization and semantic consistency performances, which confirms our superiority.

Medical image super-resolution (MedSR) is essential for improving diagnostic precision across diverse imaging modalities such as MRI, CT, X-ray, Ultrasound, and Fundus imaging. Despite rapid advances in deep learning, challenges remain in preserving anatomical accuracy, maintaining perceptual quality, and generalizing across medical domains. This paper presents MedSR-Vision, a novel unified deep learning framework for evaluating and comparing super-resolution models across five modalities: Brain MRI, Chest X-ray, Renal Ultrasound, Nephrolithiasis CT, and Spine MRI, at magnification scales of $\times2$, $\times3$, and $\times4$. Three representative models namely SRCNN, SwinIR, and Real-ESRGAN are benchmarked using multiple quantitative metrics encompassing fidelity, perceptual realism, and sharpness. Experimental analysis demonstrates that Real-ESRGAN achieves superior perceptual quality and edge recovery at higher scales, SwinIR excels in preserving structural and diagnostic features, and SRCNN provides efficient and stable performance at lower magnifications. The results establish domain-specific insights and practical guidelines for model selection in clinical imaging workflows, offering a standardized evaluation framework for future medical image super-resolution research and deployment.

Existing image fusion methods struggle to balance visual quality and semantic attributes due to the inherent conflict between their optimization objectives. To address this challenge, we propose an attack-defense semantic reinforcement framework for multi-modal image fusion, termed AD-SRF. By decoupling the optimization of these two aspects and then losslessly reintegrating them, this framework injects rich semantic attributes into the fused image without compromising its visual quality. First, we develop a transformer-based restorative visual fusion network as a strong visual baseline. Equipped with the cross-modal retrieval module and the information restoration-fusion collaborative loss, it produces highly visible fused images even under degraded conditions. Second, we introduce an attack-defense game mechanism to strengthen the semantic attributes of the fused images. The attacker learns perturbation patterns that impair downstream segmentation, whereas the defender restores missing semantics from the original inputs and reintegrates them into the fused image through an imperceptible semantic map. Through iterative adversarial interaction, this mechanism drives the defender to continually strengthen the fused image's semantic attributes, boosting downstream segmentation performance without compromising visual quality. Extensive experiments demonstrate that AD-SRF achieves a win-win performance in both visual quality and semantic attributes. The code is publicly available at https://github.com/HaoZhang1018/AD-SRF.