Retrieval-Augmented Vision Foundation Models for Robust Leukemia Cell Classification across Multiple Microscopy Datasets
Authors: Carlos Zamora, Hiram Zuniga, Ulises Orozco-Rosas, Kenia Picos
Organizations: CETYS Universidad, Ave. CETYS Universidad No. 4, Fracc. El Lago, C.P. 22210, Tijuana, Baja California, Mexico
Abstract
Leukemia cell image classification is challenged by real-world domain shifts from acquisition, staining, illumination, and site protocols, causing single-dataset models to generalize poorly in real clinical scenarios. This work presents a robust framework for leukemia classification across multiple heterogeneous datasets using a two-stage pipeline with a pretrained vision foundation model. Stage 1 performs binary classification (leukemia vs. non-leukemia) and is trained using 122,167 single-cell images. Stage 2 is conditionally applied to Stage 1 positives to perform subtype classification into Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML), trained using 69,400 single-cell images. Labels are harmonized across five heterogeneous datasets to enable cross-dataset training, and performance is evaluated on a held-out dataset protocol to assess domain-shift generalization. Within this pipeline, three encoders are benchmarked (DinoBloom, pretrained on single-cell images; BiomedCLIP, pretrained on biomedical data; and CLIP as a general-purpose model) under linear probing, Low-Rank Adaptation (LoRA), and a Retrieval-Augmented Classification (RAC) module that retrieves the top-k most similar cell images to provide cytomorphological grounding. The objective is to quantify how much domain-specific pretraining contributes to performance under domain shift, and whether cost-effective adaptation and retrieval can be a viable alternative to expensive domain-specialized pretraining. The held-out protocol additionally serves as a diagnostic tool, revealing when classification performance is attributable to dataset-specific artifacts rather than to cytomorphological features.
Automated classification of acute lymphoblastic leukemia (ALL) from peripheral blood smear images has often reported near-perfect performance on the C-NMC 2019 dataset. We show that such results can be inflated by patient-level data leakage caused by random image-level partitioning, where cells from the same subject may appear in both training and test folds. We establish a leakage-aware benchmark under a strict subject-disjoint protocol, comparing LightGBM, RBF-SVM, EfficientNet-B0, EfficientNet-B1, and ViT-Tiny. Models are developed using three subject-disjoint folds from 73 subjects and evaluated on an external preliminary-phase test set of 1,867 images from 28 unseen subjects with zero patient overlap. Beyond discrimination, we assess calibration using expected calibration error, Brier score, and temperature scaling. Under honest evaluation, EfficientNet-B1 achieves the best performance, with AUROC 0.913, sensitivity 0.87, specificity 0.80, and calibrated ECE 0.024. Frozen-feature classifiers and ViT-Tiny show high sensitivity but poor specificity, indicating a tendency to over-predict the malignant class. A random-versus-subject-disjoint ablation shows that random splitting inflates AUROC by about 0.04 even in the conservative frozen-feature setting. These findings caution against image-level evaluation on C-NMC 2019 and provide a reproducible, calibration-aware benchmark for future work.
Automated white blood cell (WBC) classification is essential for scalable leukaemia screening. However, real-world deployment is challenged by domain shifts caused by staining protocols, scanner characteristics, and inter-laboratory variability, which often degrade model performance. The White Blood Cell Classification Challenge (WBCBench) at ISBI 2026 aims to advance robust WBC recognition, with a focus on accurately identifying blast cells and other clinically critical rare subtypes. We propose a memory-augmented, hierarchical ensemble pipeline for WBC classification under domain shifts, leveraging a feature bank and a DinoBloom backbone fine-tuned with LoRA. Our three-stage inference hierarchy combines k-nearest neighbors (kNN) retrieval at each level, reducing over-reliance on any single decision. Evaluated on the WBCBench dataset, our method ranks within the top ten by macro F1-score in the final testing phase.
Label-free single-cell imaging offers a scalable, non-invasive alternative to fluorescence-based cytometry, yet inferring molecular phenotypes directly from bright-field morphology remains challenging. We present a unified Deep Learning (DL) framework that jointly performs White Blood Cell (WBC) classification and continuous protein-expression regression from label-free Differential Phase Contrast (DPC) images. Our model employs a Hybrid architecture that fuses convolutional fine-grained texture features with transformer-based global representations through a learnable cross-branch gating module, enabling robust morpho-molecular inference from DPC images. To support downstream interpretability, we further incorporate a Large Language Model (LLM) that generates concise, biologically grounded summaries of the predicted cell states. Experiments on the Berkeley Single Cell Computational Microscopy (BSCCM) and Blood Cells Image benchmarks demonstrate strong performance, achieving a 91.3% WBC classification accuracy and a 0.72 Pearson correlation for CD16 expression regression on BSCCM. These results underscore the promise of label-free single-cell imaging for cost-effective hematological profiling, enabling simultaneous phenotype identification and quantitative biomarker estimation without fluorescent staining. The source code is available at https://github.com/saqibnaziir/Single-Cell-Phenotyping.