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AdaMHF: Adaptive Multimodal Hierarchical Fusion for Survival Prediction

The integration of pathologic images and genomic data for survival analysis has gained increasing attention with advances in multimodal learning. However, current methods often ignore biological characteristics, such as heterogeneity and sparsity, both within and across modalities, ultimately limiting their adaptability to clinical practice. To address these challenges, we propose AdaMHF: Adaptive Multimodal Hierarchical Fusion, a framework designed for efficient, comprehensive, and tailored feature extraction and fusion. AdaMHF is specifically adapted to the uniqueness of medical data, enabling accurate predictions with minimal resource consumption, even under challenging scenarios with missing modalities. Initially, AdaMHF employs an experts expansion and residual structure to activate specialized experts for extracting heterogeneous and sparse features. Extracted tokens undergo refinement via selection and aggregation, reducing the weight of non-dominant features while preserving comprehensive information. Subsequently, the encoded features are hierarchically fused, allowing multi-grained interactions across modalities to be captured. Furthermore, we introduce a survival prediction benchmark designed to resolve scenarios with missing modalities, mirroring real-world clinical conditions. Extensive experiments on TCGA datasets demonstrate that AdaMHF surpasses current state-of-the-art (SOTA) methods, showcasing exceptional performance in both complete and incomplete modality settings.

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