Pei Liu

Pei Liu, Luping Ji, Feng Ye et al.

The survival analysis on histological whole-slide images (WSIs) is one of the most important means to estimate patient prognosis. Although many weakly-supervised deep learning models have been developed for gigapixel WSIs, their potential is generally restricted by classical survival analysis rules and fully-supervised learning requirements. As a result, these models provide patients only with a completely-certain point estimation of time-to-event, and they could only learn from the labeled WSI data currently at a small scale. To tackle these problems, we propose a novel adversarial multiple instance learning (AdvMIL) framework. This framework is based on adversarial time-to-event modeling, and integrates the multiple instance learning (MIL) that is much necessary for WSI representation learning. It is a plug-and-play one, so that most existing MIL-based end-to-end methods can be easily upgraded by applying this framework, gaining the improved abilities of survival distribution estimation and semi-supervised learning. Our extensive experiments show that AdvMIL not only could often bring performance improvement to mainstream WSI survival analysis methods at a relatively low computational cost, but also enables these methods to effectively utilize unlabeled data via semi-supervised learning. Moreover, it is observed that AdvMIL could help improving the robustness of models against patch occlusion and two representative image noises. The proposed AdvMIL framework could promote the research of survival analysis in computational pathology with its novel adversarial MIL paradigm.

Pei Liu, Bo Fu, Feng Ye et al.

The cancer prognosis on gigapixel Whole-Slide Images (WSIs) has always been a challenging task. To further enhance WSI visual representations, existing methods have explored image pyramids, instead of single-resolution images, in WSIs. In spite of this, they still face two major problems: high computational cost and the unnoticed semantical gap in multi-resolution feature fusion. To tackle these problems, this paper proposes to efficiently exploit WSI pyramids from a new perspective, the dual-stream network with cross-attention (DSCA). Our key idea is to utilize two sub-streams to process the WSI patches with two resolutions, where a square pooling is devised in a high-resolution stream to significantly reduce computational costs, and a cross-attention-based method is proposed to properly handle the fusion of dual-stream features. We validate our DSCA on three publicly-available datasets with a total number of 3,101 WSIs from 1,911 patients. Our experiments and ablation studies verify that (i) the proposed DSCA could outperform existing state-of-the-art methods in cancer prognosis, by an average C-Index improvement of around 4.6%; (ii) our DSCA network is more efficient in computation -- it has more learnable parameters (6.31M vs. 860.18K) but less computational costs (2.51G vs. 4.94G), compared to a typical existing multi-resolution network. (iii) the key components of DSCA, dual-stream and cross-attention, indeed contribute to our model's performance, gaining an average C-Index rise of around 2.0% while maintaining a relatively-small computational load. Our DSCA could serve as an alternative and effective tool for WSI-based cancer prognosis.