Adam Cole

Qiyuan Hu, Abbas A. Rizvi, Geoffery Schau et al.

Microsatellite instability-high (MSI-H) is a tumor agnostic biomarker for immune checkpoint inhibitor therapy. However, MSI status is not routinely tested in prostate cancer, in part due to low prevalence and assay cost. As such, prediction of MSI status from hematoxylin and eosin (H&E) stained whole-slide images (WSIs) could identify prostate cancer patients most likely to benefit from confirmatory testing and becoming eligible for immunotherapy. Prostate biopsies and surgical resections from de-identified records of consecutive prostate cancer patients referred to our institution were analyzed. Their MSI status was determined by next generation sequencing. Patients before a cutoff date were split into an algorithm development set (n=4015, MSI-H 1.8%) and a paired validation set (n=173, MSI-H 19.7%) that consisted of two serial sections from each sample, one stained and scanned internally and the other at an external site. Patients after the cutoff date formed the temporal validation set (n=1350, MSI-H 2.3%). Attention-based multiple instance learning models were trained to predict MSI-H from H&E WSIs. The MSI-H predictor achieved area under the receiver operating characteristic curve values of 0.78 (95% CI [0.69-0.86]), 0.72 (95% CI [0.63-0.81]), and 0.72 (95% CI [0.62-0.82]) on the internally prepared, externally prepared, and temporal validation sets, respectively. While MSI-H status is significantly correlated with Gleason score, the model remained predictive within each Gleason score subgroup. In summary, we developed and validated an AI-based MSI-H diagnostic model on a large real-world cohort of routine H&E slides, which effectively generalized to externally stained and scanned samples and a temporally independent validation cohort. This algorithm has the potential to direct prostate cancer patients toward immunotherapy and to identify MSI-H cases secondary to Lynch syndrome.

Adam Cole, Mick Grierson

We present AttentionBender, a tool that manipulates cross-attention in Video Diffusion Transformers to help artists probe the internal mechanics of black-box video generation. While generative outputs are increasingly realistic, prompt-only control limits artists' ability to build intuition for the model's material process or to work beyond its default tendencies. Using an autobiographical research-through-design approach, we built on Network Bending to design AttentionBender, which applies 2D transforms (rotation, scaling, translation, etc.) to cross-attention maps to modulate generation. We assess AttentionBender by visualizing 4,500+ video generations across prompts, operations, and layer targets. Our results suggest that cross-attention is highly entangled: targeted manipulations often resist clean, localized control, producing distributed distortions and glitch aesthetics over linear edits. AttentionBender contributes a tool that functions both as an Explainable AI style probe of transformer attention mechanisms, and as a creative technique for producing novel aesthetics beyond the model's learned representational space.

Adam Cole, Mick Grierson

This paper presents an artistic and technical investigation into the attention mechanisms of video diffusion transformers. Inspired by early video artists who manipulated analog video signals to create new visual aesthetics, this study proposes a method for extracting and visualizing cross-attention maps in generative video models. Built on the open-source Wan model, our tool provides an interpretable window into the temporal and spatial behavior of attention in text-to-video generation. Through exploratory probes and an artistic case study, we examine the potential of attention maps as both analytical tools and raw artistic material. This work contributes to the growing field of Explainable AI for the Arts (XAIxArts), inviting artists to reclaim the inner workings of AI as a creative medium.