Timing Is Everything: Finding the Optimal Fusion Points in Multimodal Medical Imaging

Multimodal deep learning harnesses diverse imaging modalities, such as MRI sequences, to enhance diagnostic accuracy in medical imaging. A key challenge is determining the optimal timing for integrating these modalities-specifically, identifying the network layers where fusion modules should be inserted. Current approaches often rely on manual tuning or exhaustive search, which are computationally expensive without any guarantee of converging to optimal results. We propose a sequential forward search algorithm that incrementally activates and evaluates candidate fusion modules at different layers of a multimodal network. At each step, the algorithm retrains from previously learned weights and compares validation loss to identify the best-performing configuration. This process systematically reduces the search space, enabling efficient identification of the optimal fusion timing without exhaustively testing all possible module placements. The approach is validated on two multimodal MRI datasets, each addressing different classification tasks. Our algorithm consistently identified configurations that outperformed unimodal baselines, late fusion, and a brute-force ensemble of all potential fusion placements. These architectures demonstrated superior accuracy, F-score, and specificity while maintaining competitive or improved AUC values. Furthermore, the sequential nature of the search significantly reduced computational overhead, making the optimization process more practical. By systematically determining the optimal timing to fuse imaging modalities, our method advances multimodal deep learning for medical imaging. It provides an efficient and robust framework for fusion optimization, paving the way for improved clinical decision-making and more adaptable, scalable architectures in medical AI applications.