Multimodal graph neural networks in healthcare: a review of fusion strategies across biomedical domains

Graph Neural Networks (GNNs) have transformed multimodal healthcare data integration by capturing complex, non-Euclidean relationships across diverse sources such as electronic health records, medical imaging, genomic profiles, and clinical notes. This review synthesizes GNN applications in healthcare, highlighting their impact on clinical decision-making through multimodal integration, advanced fusion strategies, and attention mechanisms. Key applications include drug interaction and discovery, cancer detection and prognosis, clinical status prediction, infectious disease modeling, genomics, and the diagnosis of mental health and neurological disorders. Various GNN architectures demonstrate consistent applications in modeling both intra- and intermodal relationships. GNN architectures, such as Graph Convolutional Networks and Graph Attention Networks, are integrated with Convolutional Neural Networks (CNNs), transformer-based models, temporal encoders, and optimization algorithms to facilitate robust multimodal integration. Early, intermediate, late, and hybrid fusion strategies, enhanced by attention mechanisms like multi-head attention, enable dynamic prioritization of critical relationships, improving accuracy and interpretability. However, challenges remain, including data heterogeneity, computational demands, and the need for greater interpretability. Addressing these challenges presents opportunities to advance GNN adoption in medicine through scalable, transparent GNN models.