Tianhang Nan

Tianhang Nan, Hao Quan, Yong Ding et al.

Multiple Instance Learning (MIL) has garnered widespread attention in the field of Whole Slide Image (WSI) classification as it replaces pixel-level manual annotation with diagnostic reports as labels, significantly reducing labor costs. Recent research has shown that bag-level MIL methods often yield better results because they can consider all patches of the WSI as a whole. However, a drawback of such methods is the incorporation of more redundant patches, leading to interference. To extract patches with high diagnostic value while excluding interfering patches to address this issue, we developed an attention-based feature distillation multi-instance learning (AFD-MIL) approach. This approach proposed the exclusion of redundant patches as a preprocessing operation in weakly supervised learning, directly mitigating interference from extensive noise. It also pioneers the use of attention mechanisms to distill features with high diagnostic value, as opposed to the traditional practice of indiscriminately and forcibly integrating all patches. Additionally, we introduced global loss optimization to finely control the feature distillation module. AFD-MIL is orthogonal to many existing MIL methods, leading to consistent performance improvements. This approach has surpassed the current state-of-the-art method, achieving 91.47% ACC (accuracy) and 94.29% AUC (area under the curve) on the Camelyon16 (Camelyon Challenge 2016, breast cancer), while 93.33% ACC and 98.17% AUC on the TCGA-NSCLC (The Cancer Genome Atlas Program: non-small cell lung cancer). Different feature distillation methods were used for the two datasets, tailored to the specific diseases, thereby improving performance and interpretability.

Tianhang Nan, Yong Ding, Hao Quan et al.

Due to the lack of fine-grained annotation guidance, current Multiple Instance Learning (MIL) struggles to establish a robust causal relationship between Whole Slide Image (WSI) diagnosis and evidence sub-images, just like fully supervised learning. So many noisy images can undermine the network's prediction. The proposed Causal Inference Multiple Instance Learning (CI-MIL), uses out-of-distribution generalization to reduce the recognition confusion of sub-images by MIL network, without requiring pixelwise annotations. Specifically, feature distillation is introduced to roughly identify the feature representation of lesion patches. Then, in the random Fourier feature space, these features are re-weighted to minimize the cross-correlation, effectively correcting the feature distribution deviation. These processes reduce the uncertainty when tracing the prediction results back to patches. Predicted diagnoses are more direct and reliable because the causal relationship between them and diagnostic evidence images is more clearly recognized by the network. Experimental results demonstrate that CI-MIL outperforms state-of-the-art methods, achieving 92.25% accuracy and 95.28% AUC on the Camelyon16 dataset (breast cancer), while 94.29% accuracy and 98.07% AUC on the TCGA-NSCLC dataset (non-small cell lung cancer). Additionally, CI-MIL exhibits superior interpretability, as its selected regions demonstrate high consistency with ground truth annotations, promising more reliable diagnostic assistance for pathologists.

Tingting Zheng, Weixing chen, Shuqin Li et al.

The deep neural network is a research hotspot for histopathological image analysis, which can improve the efficiency and accuracy of diagnosis for pathologists or be used for disease screening. The whole slide pathological image can reach one gigapixel and contains abundant tissue feature information, which needs to be divided into a lot of patches in the training and inference stages. This will lead to a long convergence time and large memory consumption. Furthermore, well-annotated data sets are also in short supply in the field of digital pathology. Inspired by the pathologist's clinical diagnosis process, we propose a weakly supervised deep reinforcement learning framework, which can greatly reduce the time required for network inference. We use neural network to construct the search model and decision model of reinforcement learning agent respectively. The search model predicts the next action through the image features of different magnifications in the current field of view, and the decision model is used to return the predicted probability of the current field of view image. In addition, an expert-guided model is constructed by multi-instance learning, which not only provides rewards for search model, but also guides decision model learning by the knowledge distillation method. Experimental results show that our proposed method can achieve fast inference and accurate prediction of whole slide images without any pixel-level annotations.

Hao Quan, Xinjia Li, Dayu Hu et al.

In pathology, the rarity of certain diseases and the complexity in annotating pathological images significantly hinder the creation of extensive, high-quality datasets. This limitation impedes the progress of deep learning-assisted diagnostic systems in pathology. Consequently, it becomes imperative to devise a technology that can discern new disease categories from a minimal number of annotated examples. Such a technology would substantially advance deep learning models for rare diseases. Addressing this need, we introduce the Dual-channel Prototype Network (DCPN), rooted in the few-shot learning paradigm, to tackle the challenge of classifying pathological images with limited samples. DCPN augments the Pyramid Vision Transformer (PVT) framework for few-shot classification via self-supervised learning and integrates it with convolutional neural networks. This combination forms a dual-channel architecture that extracts multi-scale, highly precise pathological features. The approach enhances the versatility of prototype representations and elevates the efficacy of prototype networks in few-shot pathological image classification tasks. We evaluated DCPN using three publicly available pathological datasets, configuring small-sample classification tasks that mirror varying degrees of clinical scenario domain shifts. Our experimental findings robustly affirm DCPN's superiority in few-shot pathological image classification, particularly in tasks within the same domain, where it achieves the benchmarks of supervised learning.