cs.CVJun 29, 2026

Uncertainty Estimation in Pathology Foundation Models via Deep Mutual Learning

Authors: Gbègninougbo Aurel Davy TchokponhoueSevda ÖğütAli IdriDorina ThanouPascal Frossard

Abstract

Pathology foundation models (PFMs) offer generalizable representations for whole-slide image (WSI) analysis, yet their clinical adoption remains limited. Specifically, their predictions lack reliable confidence estimates, and no single PFM is universally best across tasks, which severely undermines trust in medical settings. To overcome this, we propose DICE\mathtt{DICE}, a plug-and-play framework that ensembles KK frozen PFMs and models their disagreement as a proxy for uncertainty estimation. To ensure this proxy yields meaningful estimates, we align the ensemble members via deep mutual learning, and theoretically show that this objective upper-bounds the model uncertainty. Additionally, we demonstrate that the ensemble's consensus localizes abnormalities at the patch level without any explicit supervision. We evaluate DICE\mathtt{DICE} on three challenging WSI benchmarks. Notably, our framework provides reliable uncertainty estimates that accurately flag failure-prone cases under in- and out-of-distribution settings, while matching or outperforming SOTA baselines in classification, calibration, and localization. Overall, DICE\mathtt{DICE} takes a crucial step toward translating PFMs into uncertainty-aware decision-support systems.

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