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A Multimodal Foundation Model of Spatial Transcriptomics and Histology for Biological Discovery and Clinical Prediction

arXiv:2604.0363069.51 citationsh-index: 10
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This work addresses the problem of high costs and low throughput in spatial transcriptomics for biomedical researchers and clinicians by providing a scalable framework for spatially informed discovery and clinical precision medicine, representing a novel method for a known bottleneck.

The researchers tackled the challenge of integrating costly spatial transcriptomics with widely available histology images by developing STORM, a foundation model trained on 1.2 million profiles across 18 organs, which outperforms existing methods in predicting spatial gene expression from H&E images across 11 tumor types and improves immunotherapy response prediction in 7,245 patients.

Spatial transcriptomics (ST) enables gene expression mapping within anatomical context but remains costly and low-throughput. Hematoxylin and eosin (H\&E) staining offers rich morphology yet lacks molecular resolution. We present \textbf{\ours} (\textbf{S}patial \textbf{T}ranscriptomics and hist\textbf{O}logy \textbf{R}epresentation \textbf{M}odel), a foundation model trained on 1.2 million spatially resolved transcriptomic profiles with matched histology across 18 organs. Using a hierarchical architecture integrating morphological features, gene expression, and spatial context, STORM bridges imaging and omics through robust molecular--morphological representations. STORM enhances spatial domain discovery, producing biologically coherent tissue maps, and outperforms existing methods in predicting spatial gene expression from H\&E images across 11 tumor types. The model is platform-agnostic, performing consistently across Visium, Xenium, Visium HD, and CosMx. Applied to 23 independent cohorts comprising 7,245 patients, STORM significantly improves immunotherapy response prediction and prognostication over established biomarkers, providing a scalable framework for spatially informed discovery and clinical precision medicine.

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