NeuroMesh: A Bottleneck Topology Controller for Missing-Modality Brain Tumor Segmentation - A Mechanistic Pilot Study on BraTS

Abstract

Deep segmentation networks can degrade sharply when an expected MRI sequence is unavailable at inference. We present NeuroMesh, a bottleneck controller that combines a gated recurrent unit (GRU) with a graphconvolutional edge-activation mask, designed to adapt a U-Net-style segmentation backbone to missing input. We evaluate NeuroMesh in a pilot study using a 30-patient subset of the BraTS 2020 benchmark (22 training, 4 validation, and 4 held-out test patients) under a prespecified frozentest protocol. On the frozen test set, NeuroMesh has higher tumor-core and enhancing-tumor Dice than a plain U-Net in most evaluated missing-modality conditions, but wholetumor Dice falls from 0.596 to 0.108 when FLAIR is missing, compared with 0.604 to 0.545 for the plain U-Net. Direct analysis of the predicted edge-activation mask shows negligible change across modality-availability conditions. A parameter-light static-gating control reproduces the FLAIR failure mode without recurrence, a failure-signal input, or graph-structured machinery. These results do not support the intended interpretation that the trained controller performs input-conditional topology rewiring at the scale of this pilot. Instead, they expose a discrepancy between architectural intent and realized behavior and identify a specific missing-modality failure mode that warrants further investigation. Given the small validation and test sets, the findings are descriptive and do not establish clinical or population-level generalization.