BMDS-Net:Deployment-aware multi-modal brain tumor segmentation with adaptive fusion,decoder regularization,and Bayesian calibration

Multi-modal MRI enables detailed brain tumor sub-region segmentation, but clinical deployment remains affected by missing sequences,boundary errors, and overconfident predictions. We present BMDS-Net, a two-stage Swin UNETR framework that combines adaptivemodality fusion, boundary-aware decoder regularization, and efficient Bayesian calibration. The deterministic stage adds zero-initializedmultimodal contextual fusion (MMCF) and residual-gated deep decoder supervision (DDS) to modulate modality contributions andregularize hierarchical boundary reconstruction. The second stage replaces only the final convolutional layer with a Bayesian layer,enabling Monte Carlo uncertainty estimates with limited additional training cost. On BraTS 2021 (1,251 cases), BMDS-Net achieved Dice scores of 0.9293, 0.9098, and 0.8675 for WT, TC, and ET, with HD95 values of 2.27, 2.22, and 3.27 mm. Configuration comparisons showed that auxiliary supervision favored complete-input segmentation, whereas the complete MMCF+gated-DDS configuration was most robust under single-modality removal. Bayesian BMDS-Net achieved an expected calibration error of 0.0037, close to a three-model ensemble (0.0035) at approximately 60% lower training cost. On BraTS 2020, the same protocol preserved the leading internal ranking of the complete configuration among five Swin UNETR-controlled variants. The implementation code is available at https://github.com/RyanZhou168/BMDS-Net.