Multimodal medical image fusion (MMIF) extracts the most meaningful information from multiple source images, enabling a more comprehensive and accurate diagnosis. Achieving high-quality fusion results requires a careful balance of brightness, color, contrast, and detail; this ensures that the fused images effectively display relevant anatomical structures and reflect the functional status of the tissues. However, existing MMIF methods have limited capacity to capture detailed features during conventional training and suffer from insufficient cross-modal feature interaction, leading to suboptimal fused image quality. To address these issues, this study proposes a two-stage diffusion model-based fusion network (DM-FNet) to achieve unified MMIF. In Stage I, a diffusion process trains UNet for image reconstruction. UNet captures detailed information through progressive denoising and represents multilevel data, providing a rich set of feature representations for the subsequent fusion network. In Stage II, noisy images at various steps are input into the fusion network to enhance the model's feature recognition capability. Three key fusion modules are also integrated to process medical images from different modalities adaptively. Ultimately, the robust network structure and a hybrid loss function are integrated to harmonize the fused image's brightness, color, contrast, and detail, enhancing its quality and information density. The experimental results across various medical image types demonstrate that the proposed method performs exceptionally well regarding objective evaluation metrics. The fused image preserves appropriate brightness, a comprehensive distribution of radioactive tracers, rich textures, and clear edges. The code is available at https://github.com/HeDan-11/DM-FNet.

This paper has been accepted by IEEE Transactions on Multimedia (TMM) in March 2025