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A review of multimodal medical image fusion: Developments in traditional, model-based and learning-based approaches

Zhaopeng Zhou1, Jiaen Wu1, Jiaxun Jiang1, Miao Zhou2, Wenhui Guo3, Yongchu Hu4


1School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China. 2Jiangsu Cancer Hospital, Nanjing 213164, Jiangsu Province, China. 3The Department of Anesthesiology,  Naval Medical University, Shanghai 200433, China. 4The Department of Anesthesiology, Second Affiliated Hospital of Navy Medical University, Shanghai 200003, China.


Address correspondence to: Yongchu Hu, The Department of Anesthesiology, Second Affiliated Hospital of Navy Medical University, No. 415 Fengyang Road, Shanghai 200003, China. E-mail: liuyang1268@smmu.edu.cn.


DOI: https://doi.org/10.61189/617079irudnn


Received April 10, 2025; Accepted July 11, 2025; Published December 31, 2025


Highlights

● Significant Advantages of Multimodal Fusion: Multimodal medical image fusion enhances diagnostic accuracy and medical value by integrating multi-source data such as CT, MRI, and PET images, outperforming singlemodality technologies. 

● Benefits of Deep Learning: Deep learning technologies significantly advance multimodal medical image fusion, enabling more efficient and accurate fusion results. 

● Perioperative clinical significance: Multimodal image fusion can provide important support for perioperative preoperative planning, intraoperative guidance, and postoperative evaluation, thereby improving surgical accuracy and patient safety. 

● Future Research Directions: Future research should focus on improving model interpretability, enhancing modality alignment, and achieving breakthroughs in practicality, applicability, and efficiency.

Abstract

Multimodal medical image fusion technology optimizes image content by integrating images from diverse modalities, such as Computed Tomography (CT), Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI), and Single Photon Emission Computed Tomography (SPECT), while retaining critical information. With the rapid advancements in medical imaging technology, single-modal approaches have limitations in capturing comprehensive anatomical or functional characteristics. As a result, researchers are increasingly turning to multimodal fusion methods to enhance diagnostic accuracy and provide richer data for classification, detection, and segmentation tasks. In particular, during the perioperative period, multimodal image fusion plays a crucial role in surgical planning, intraoperative navigation, and postoperative evaluation, enabling precise localization of  lesions and improving clinical decision-making. This paper presents a survey of the latest literature on medical image fusion, covering three major approaches: traditional methods, model-based methods, and learning-based  methods. It discusses the advantages and limitations of each approach, with a particular emphasis on traditional image processing techniques, model-based fusion methods, and the integration of emerging deep learning (DL) technologies. Comparative experimental analysis highlights performance differences among these methods in terms of information retention, computational efficiency, and clinical applicability. Finally, the paper reviews performance evaluation metrics for multimodal fusion and provides recommendations for future research to further promote the widespread adoption of this technology in clinical diagnostics and intelligent healthcare.

Keywords: Multimodal medical image fusion, multimodal database, perioperative period, deep learning, evaluation metrics

Cite

Zhou ZP, Wu JE, Jiang JX, Zhou M, Guo WH, Hu YC. A review of multimodal medical image fusion: Developments in traditional, model-based and learning-based approaches. Perioper Precis Med. 2025 Dec; 3 (4): 152-167. doi: 10.61189/617079irudnn

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