AINet: Anchor Instances Learning for Regional Heterogeneity in Whole Slide Image

Whole Slide Image (WSI) analysis has been widely studied for cancer diagnosis. Conventionally, a gigapixel WSI is divided into small patches and processed by Multiple Instance Learning (MIL) models. However, existing MIL models typically process all patches, many of which contain redundant or non-informative tissue patterns. Although recent approaches have focused on instance selection to identify discriminative patches and reduce redundancy, these selection modules still require additional training. In this work, we propose Test-Time Instance Selection (TTIS), a training-free, plug-and-play framework that selects compact yet representative patches during inference. TTIS further incorporates a multi-view ensemble strategy to integrate distinct facets of tissue morphology, enhancing robustness. Importantly, TTIS can be seamlessly integrated into existing MIL models without retraining or architectural changes, enabling flexible deployment. Extensive evaluations across multiple benchmarks demonstrate that our approach improves or matches baseline MIL performance across a range of classification and subtyping tasks. Our implementation code is available at https://github.com/QuIIL/TTIS

Attention-based multiple instance learning (MIL) has emerged as a powerful framework for whole slide image (WSI) diagnosis, leveraging attention to aggregate instance-level features into bag-level predictions. Despite this success, we find that such methods exhibit a new failure mode: unstable attention dynamics. Across four representative attention-based MIL methods and two public WSI datasets, we observe that attention distributions oscillate across epochs rather than converging to a consistent pattern, degrading performance. This instability adds to two previously reported challenges: overfitting and over-concentrated attention distribution. To simultaneously overcome these three limitations, we introduce attention-stabilized multiple instance learning (ASMIL), a novel unified framework. ASMIL uses an anchor model to stabilize attention, replaces softmax with a normalized sigmoid function in the anchor to prevent over-concentration, and applies token random dropping to mitigate overfitting. Extensive experiments demonstrate that ASMIL achieves up to a 6.49% F1 score improvement over state-of-the-art methods. Moreover, integrating the anchor model and normalized sigmoid into existing attention-based MIL methods consistently boosts their performance, with F1 score gains up to 10.73%. All code and data are publicly available at https://github.com/Linfeng-Ye/ASMIL.

Whole slide image (WSI) analysis heavily relies on multiple instance learning (MIL). While recent methods benefit from large-scale foundation models and advanced sequence modeling to capture long-range dependencies, they still struggle with two critical issues. First, directly applying frozen, task-agnostic features often leads to suboptimal separability due to the domain gap with specific histological tasks. Second, relying solely on global aggregators can cause over-smoothing, where sparse but critical diagnostic signals are overshadowed by the dominant background context. In this paper, we present ReconMIL, a novel framework designed to bridge this domain gap and balance global-local feature aggregation. Our approach introduces a Latent Space Reconstruction module that adaptively projects generic features into a compact, task-specific manifold, improving boundary delineation. To prevent information dilution, we develop a bi-stream architecture combining a Mamba-based global stream for contextual priors and a CNN-based local stream to preserve subtle morphological anomalies. A scale-adaptive selection mechanism dynamically fuses these two streams, determining when to rely on overall architecture versus local saliency. Evaluations across multiple diagnostic and survival prediction benchmarks show that ReconMIL consistently outperforms current state-of-the-art methods, effectively localizing fine-grained diagnostic regions while suppressing background noise. Visualization results confirm the models superior ability to localize diagnostic regions by effectively balancing global structure and local granularity.