When Fusion Fails: Corruption-Aware Rebalanced Fusion for Multi-Modal Medical Image Segmentation

Multi-modal medical image segmentation leverages complementary diagnostic information, yet fusion can underperform single-modality baselines when spatially aligned inputs differ in quality. Here, "corruption" primarily denotes resolution-induced degradation rather than misalignment or complete modality absence, while synthetic noise is evaluated only as an auxiliary setting. We identify a critical optimization-inference inconsistency: degraded modalities can receive weak training updates yet substantially affect predictions, indicating active interference with fusion. We attribute this failure to resampling-induced feature corruption and optimization bias, where noisy features propagate through skip connections and encourage unreliable modality selection. We therefore propose CoReFuse-Med, a Corruption-aware Rebalanced Fusion framework that suppresses corruption during feature transmission and rebalances modality contributions during high-level fusion. Experiments on EPVS, BraTS, and WMH, including multiple Z-axis slice-retention ratios and an auxiliary noise test, demonstrate improved accuracy and robustness under modality-quality discrepancies. Our code is available at https://github.com/lrever/CoReFuse.