Title: A Multimodal Feature Distillation with CNN-Transformer Network for Brain Tumor Segmentation with Incomplete Modalities

Abstract: Existing brain tumor segmentation methods usually utilize multiple Magnetic Resonance Imaging (MRI) modalities in brain tumor images for segmentation, which can achieve better segmentation performance. However, in clinical applications, some modalities are missing due to resource constraints, leading to severe degradation in the performance of methods applying complete modality segmentation. In this paper, we propose a Multimodal feature distillation with Convolutional Neural Network (CNN)-Transformer hybrid network (MCTSeg) for accurate brain tumor segmentation with missing modalities. We first design a Multimodal Feature Distillation (MFD) module to distill feature-level multimodal knowledge into different unimodality to extract complete modality information. We further develop a Unimodal Feature Enhancement (UFE) module to model the relationship between global and local information semantically. Finally, we build a Cross-Modal Fusion (CMF) module to explicitly align the global correlations among different modalities even when some modalities are missing. Complementary features within and across different modalities are refined via the CNN-Transformer hybrid architectures in both the UFE and CMF modules, where local and global dependencies are both captured. Our ablation study demonstrates the importance of the proposed modules with CNN-Transformer networks and the convolutional blocks in Transformer for improving the performance of brain tumor segmentation with missing modalities. Extensive experiments on the BraTS2018 and BraTS2020 datasets show that the proposed MCTSeg framework outperforms the state-of-the-art methods in missing modalities cases. Our code is available at: this https URL