F3-Net: Foundation Model for Full Abnormality Segmentation of Medical Images with Flexible Input Modality Requirement

Abstract: F3-Net is a foundation model designed to overcome persistent challenges in clinical medical image segmentation, including reliance on complete multimodal inputs, limited generalizability, and narrow task specificity. Through flexible synthetic modality training, F3-Net maintains robust performance even in the presence of missing MRI sequences, leveraging a zero-image strategy to substitute absent modalities without relying on explicit synthesis networks, thereby enhancing real-world applicability. Its unified architecture supports multi-pathology segmentation across glioma, metastasis, stroke, and white matter lesions without retraining, outperforming CNN-based and transformer-based models that typically require disease-specific fine-tuning. Evaluated on diverse datasets such as BraTS 2021, BraTS 2024, and ISLES 2022, F3-Net demonstrates strong resilience to domain shifts and clinical heterogeneity. On the whole pathology dataset, F3-Net achieves average Dice Similarity Coefficients (DSCs) of 0.94 for BraTS-GLI 2024, 0.82 for BraTS-MET 2024, 0.94 for BraTS 2021, and 0.79 for ISLES 2022. This positions it as a versatile, scalable solution bridging the gap between deep learning research and practical clinical deployment.