Shima Nofallah

Chaitanya Dwivedi, Shima Nofallah, Maryam Pouryahya et al.

In pathology, tissue samples are assessed using multiple staining techniques to enhance contrast in unique histologic features. In this paper, we introduce a multimodal CNN-GNN based graph fusion approach that leverages complementary information from multiple non-registered histopathology images to predict pathologic scores. We demonstrate this approach in nonalcoholic steatohepatitis (NASH) by predicting CRN fibrosis stage and NAFLD Activity Score (NAS). Primary assessment of NASH typically requires liver biopsy evaluation on two histological stains: Trichrome (TC) and hematoxylin and eosin (H&E). Our multimodal approach learns to extract complementary information from TC and H&E graphs corresponding to each stain while simultaneously learning an optimal policy to combine this information. We report up to 20% improvement in predicting fibrosis stage and NAS component grades over single-stain modeling approaches, measured by computing linearly weighted Cohen's kappa between machine-derived vs. pathologist consensus scores. Broadly, this paper demonstrates the value of leveraging diverse pathology images for improved ML-powered histologic assessment.

Tan H. Nguyen, Dinkar Juyal, Jin Li et al.

Differences in staining and imaging procedures can cause significant color variations in histopathology images, leading to poor generalization when deploying deep-learning models trained from a different data source. Various color augmentation methods have been proposed to generate synthetic images during training to make models more robust, eliminating the need for stain normalization during test time. Many color augmentation methods leverage domain labels to generate synthetic images. This approach causes three significant challenges to scaling such a model. Firstly, incorporating data from a new domain into deep-learning models trained on existing domain labels is not straightforward. Secondly, dependency on domain labels prevents the use of pathology images without domain labels to improve model performance. Finally, implementation of these methods becomes complicated when multiple domain labels (e.g., patient identification, medical center, etc) are associated with a single image. We introduce ContriMix, a novel domain label free stain color augmentation method based on DRIT++, a style-transfer method. Contrimix leverages sample stain color variation within a training minibatch and random mixing to extract content and attribute information from pathology images. This information can be used by a trained ContriMix model to create synthetic images to improve the performance of existing classifiers. ContriMix outperforms competing methods on the Camelyon17-WILDS dataset. Its performance is consistent across different slides in the test set while being robust to the color variation from rare substances in pathology images. We make our code and trained ContriMix models available for research use. The code for ContriMix can be found at https://gitlab.com/huutan86/contrimix

Harshith Padigela, Shima Nofallah, Atchuth Naveen Chilaparasetti et al.

Foundation models trained on large-scale pathology image corpora have demonstrated strong transfer capabilities across diverse histopathology tasks. Building on this progress, we introduce PLUTO-4, our next generation of pathology foundation models that extend the Pathology-Universal Transformer (PLUTO) to frontier scale. We share two complementary Vision Transformer architectures in the PLUTO-4 family: a compact and efficient PLUTO-4S model optimized for multi-scale deployment using a FlexiViT setup with 2D-RoPE embeddings, and a frontier-scale PLUTO-4G model trained with a single patch size to maximize representation capacity and stability. Both models are pretrained using a self-supervised objective derived from DINOv2 on a large multi-institutional corpus containing 551,164 WSIs from 137,144 patients across over 50 institutions, spanning over 60 disease types and over 100 stains. Comprehensive evaluation across public and internal benchmarks demonstrates that PLUTO-4 achieves state-of-the-art performance on tasks requiring varying spatial and biological context, including tile classification, segmentation, and slide-level diagnosis. The compact PLUTO-4S provides high-throughput and robust performance for practical deployment, while PLUTO-4G establishes new performance frontiers across multiple pathology benchmarks, including an 11% improvement in dermatopathology diagnosis. These diverse improvements underscore PLUTO-4's potential to transform real-world applications as a backbone for translational research and diagnostic use cases.