Single-Stage Hierarchical Rectification for Weakly Supervised Histopathology Segmentation
Authors: Duc T. Nguyen, Hoang-Long Nguyen, Thanh-Ha DO, Huy-Hieu Pham
Organizations: College of Engineering & Computer Science, VinUniversity, Hanoi, Vietnam · VinUni-Illinois Smart Health Center, VinUniversity, Hanoi, Vietnam · The Computer Vision and Medical AI Lab, VinUniversity, Hanoi, Vietnam · Posts and Telecommunications Institute of Technology, Hanoi, Vietnam
Abstract
Existing weakly supervised semantic segmentation (WSSS) methods in computational pathology rely on a multi-stage paradigm: class activation map (CAM) generation, offline pseudo-mask refinement, and fully supervised retraining. While established, this decoupled approach presents fundamental limitations. The multi-stage process not only incurs high computational training costs but also suffers from error propagation: local texture biases in shallow CNN layers generate false-positive artifacts that subsequent refinement steps often fail to correct. To address these persistent challenges through a simple yet highly effective approach, we propose the Single-Stage Hierarchical Rectification (SSHR) framework. Rather than passively refining CAMs post-hoc, our method proactively purifies intermediate feature representations during the forward pass. We introduce a Hierarchical Feature Rectification Module (HFRM) that utilizes deep global semantic context to filter out local anomalies in shallow layers. This mechanism generates high-fidelity activation maps directly within a single training loop. Experiments on the LUAD-HistoSeg and BCSS datasets demonstrate that SSHR outperforms state-of-the-art multi-stage methods. Furthermore, SSHR reduces training duration by 2 to 5 times. This efficiency minimizes computational overhead and accelerates clinical translation for large-scale histopathology workflows. The code is available at: https://github.com/trongduc-nguyen/SSHR
Weakly supervised semantic segmentation enables histopathology tissue segmentation from image-level annotations, avoiding costly pixel-level labeling by expert pathologists. However, CAM-based methods often localize only highly discriminative regions and remain unreliable near tissue interfaces. We propose ProBAG, a stage-1 pseudo-mask generator that combines dataset-specific visual prototypes with pathology-aligned CONCH text prototypes over multi-scale frozen UNI features. ProBAG introduces two complementary mechanisms: class-wise power recalibration that reshapes inter-class competition while preserving the total foreground activation mass at each pixel, and one-step graph diffusion in which feature affinities are penalized by a late-transformer attention-context discrepancy used as a soft structural boundary cue. The resulting stage-1 pseudo-masks require neither CRF nor an external segmentation model; for complete two-stage comparison, they additionally supervise a downstream Phikon-FPN segmenter. Experiments on BCSS-WSSS and LUAD-HistoSeg show consistent gains over recent WSSS approaches, while ablations indicate that pathology-aligned text semantics provide the largest improvement and graph refinement provides a smaller complementary gain. The code is available at: https://github.com/wterrr/WSSS
Whole-slide images (WSIs) provide rich tissue-level and cellular-level information, but storing and transmitting high-magnification pathology data is resource-intensive. Moreover, annotating WSIs at the pixel level is labor-intensive and time-consuming. Therefore, it is important to investigate whether low-magnification pathology images with limited annotations (i.e., image-level instead of pixel-level labels) can achieve performance comparable to high-magnification images. This paper presents a systematic benchmark study on weakly supervised histopathological image segmentation under different low-resolution storage settings. Starting from high-resolution image patches, we simulate lower-magnification inputs and reconstruct them to the original size using interpolation and deep learning-based reconstruction methods before applying the weakly-supervised segmentation pipeline. This framework enables a quantitative evaluation of how weakly supervised methods respond to different levels of resolution degradation. Experimental results show that reconstruction quality metrics alone are insufficient to predict downstream segmentation performance. In particular, the study identifies a critical degradation point where the localization of small-scale structures declines significantly. These findings provide practical guidance for designing efficient digital pathology storage systems while maintaining reliable automated analysis. Code is available at https://github.com/Dung-Dx/LowMagWSS
Histopathological tissue segmentation is essential for computer-aided diagnosis, yet weakly supervised methods often suffer from noisy pseudo-labels generated by Class Activation Mapping (CAM). Existing CAM approaches tend to focus on staining-driven appearance cues rather than true causal tissue morphology, resulting in spurious localization and poor structural consistency. To address this issue, we propose C2RM-Seg, a two-stage framework that integrates causal pseudo-label refinement with structure-aware semantic enhancement. For classification, we introduce a Causal Counterfactual Reasoning Module (C2RM) that decomposes features into latent factors and performs counterfactual intervention via a learned causal structure matrix, suppressing confounding context and producing morphology-aligned CAMs. For segmentation, we design a Dual-Path Structural-Semantic Architecture that combines fine-grained structural features from ResNeSt with global semantic priors from a frozen DINOV3 foundation model. A cross-path gating mechanism adaptively regulates semantic injection using local structural cues to preserve boundary fidelity. To further mitigate residual pseudo-label noise, we propose an Uncertainty-Gated Margin (UGM) loss, which dynamically balances margin enforcement and confidence learning based on prediction uncertainty. Extensive experiments on two public histopathological tissue datasets show that C2RM-Seg achieves state-of-the-art performance.