TMFormer: Token Merging Transformer for Brain Tumor Segmentation with Missing Modalities

Numerous techniques excel in brain tumor segmentation using multi-modal magnetic resonance imaging (MRI) sequences, delivering exceptional results. However, the prevalent absence of modalities in clinical scenarios hampers performance. Current approaches frequently resort to zero maps as substitutes for missing modalities, inadvertently introducing feature bias and redundant computations. To address these issues, we present the Token Merging transFormer (TM-Former) for robust brain tumor segmentation with missing modalities. TMFormer tackles these challenges by extracting and merging accessible modalities into more compact token sequences. The architecture comprises two core components: the Uni-modal Token Merging Block (UMB) and the Multi-modal Token Merging Block (MMB). The UMB enhances individual modality representation by adaptively consolidating spatially redundant tokens within and outside tumor-related regions, thereby refining token sequences for augmented representational capacity. Meanwhile, the MMB mitigates multi-modal feature fusion bias, exclusively leveraging tokens from present modalities and merging them into a unified multi-modal representation to accommodate varying modality combinations. Extensive experimental results on the BraTS 2018 and 2020 datasets demonstrate the superiority and efficacy of TMFormer compared to state-of-the-art methods when dealing with missing modalities.