Adapting Frozen Mono-modal Backbones for Multi-Modal Registration via Contrast-Agnostic Instance Optimization

Abstract

Deformable image registration remains a central challenge in medical image analysis, particularly under multi-modal scenarios where intensity distributions vary significantly across scans. While deep learning methods provide efficient feed-forward predictions, they often fail to generalize robustly under distribution shifts at test time. A straightforward remedy is full network fine-tuning, yet for modern architectures such as Transformers or deep U-Nets, this adaptation is prohibitively expensive in both memory and runtime when operating in 3D. Meanwhile, the naive fine-tuning struggles more with potential degradation in performance in the existence of drastic domain shifts. In this work, we propose a registration framework that integrates a frozen pretrained mono-modal registration model with a lightweight adaptation pipeline for multi-modal image registration. Specifically, we employ style transfer based on contrast-agnostic representation generation and refinement modules to bridge modality and domain gaps with instance optimization at test time. This design is orthogonal to the choice of backbone mono-modal model, thus avoids the computational burden of full fine-tuning while retaining the flexibility to adapt to unseen domains. We evaluate our approach on the Learn2Reg 2025 LUMIR validation set and observe consistent improvements over the pretrained state-of-the-art mono-modal backbone. In particular, the method ranks second on the multi-modal subset, third on the out-of-domain subset, and achieves fourth place overall in Dice score. These results demonstrate that combining frozen mono-modal models with modality adaptation and lightweight instance optimization offers an effective and practical pathway toward robust multi-modal registration.