HistoLoop: Iterative Contextual Inference with a Looped Transformer for Histology-Based Spatial Gene Expression Prediction

Predicting spatial gene expression from standard H&E images could extend molecular analysis to tissues without spatial transcriptomic measurements. A standard Transformer applies self-attention over spots but ignores where each spot sits in the tissue, whereas a spot's molecular state depends on tissue context at multiple spatial scales. Building on this insight, we introduce MIST, a Multi-context Spatial Transformer that augments the self-attention backbone with two context pathways applied in every layer: a coordinate-invariant local pathway that attends over spatial k-nearest-neighbor spots, and a slide pathway that broadcasts a whole-slide summary to every spot; the model predicts all spots in a single forward pass. Because coordinates enter only through pairwise distances, the local pathway is invariant to translations, rotations, and reflections when image features are fixed. In intra-cohort evaluation across six human organ cohorts from HEST-1k, MIST improves mean Pearson correlation over the strongest evaluated baseline by 9.7%, 11.6%, and 11.4% for 10-, 50-, and 100-gene panels, respectively, with the lowest average MSE and MAE. MIST further improves leave-one-organ-out transfer by 6.0% over the next strongest baseline, attains the best expression-derived domain recovery (highest mean ARI and NMI at every clustering resolution, and higher NMI than the closest baseline on 84% of held-out slides), and reproduces spatial expression patterns of selected cancer-marker genes. Together, these results show that adding local and slide context to a vanilla Transformer backbone is an effective approach to spatial gene expression prediction from histology.

Predicting spatial gene expression from routine hematoxylin and eosin (H&E) images provides a practical complement to experimental spatial transcriptomics. Existing approaches focus on local or multi-scale visual features and often treat pretrained gene representations as fixed priors, although the interpretation of local morphology and the relevance of gene priors depend on tissue context. We propose HistoGPA, a context-conditioned gene-prior attention framework that uses a shared slide-level representation in two parallel pathways: one modulates local morphological features, whereas the other conditions pretrained gene embeddings and retrieves gene-prior information through cross-attention. This design enables each spatial location to retrieve context-adapted gene-prior information using its local morphology, position, and slide context. Across ten cancer types in HEST-1k, HistoGPA achieves the highest macro-averaged gene-wise Pearson correlation coefficient among the compared methods under the same evaluation protocol for both the top-50 and top-1,500 highly variable gene sets. Additional analyses show that HistoGPA better recovers the spatial expression patterns of cancer-associated genes and yields greater agreement between clusters derived independently from predicted and ground-truth expression profiles. Together, these findings motivate a context-dependent view of histology-to-expression prediction, in which local morphological representations and gene priors are jointly adapted to the broader tissue context.

Spatial transcriptomics provides spatially resolved molecular profiling, but its cost, limited throughput and experimental complexity hinder routine large-scale use. Predicting spatial gene expression from hematoxylin-and-eosin-stained histology images offers a scalable alternative, yet remains challenging because histology provides only an indirect morphological view of molecular activity. Existing methods typically decode expression from visual features in a single stage, even when enhanced with spatial aggregation, retrieval or multi-resolution fusion. This formulation is restrictive because spot-level expression reflects not only local morphology but also cellular identity, neighborhood composition and tissue-level organization. We propose BCARP, a Biology-guided Context-Aware Residual Propagation framework for histology-guided spatial transcriptomics prediction. Instead of directly predicting gene expression from histology embeddings, BCARP treats them as morphology visual priors and progressively refines spot representations in a transcriptomics-oriented latent space. Each refinement step integrates nuclei-guided local cellular context with prototype-guided global context propagation, enabling information exchange across both neighboring and spatially distant spots. A pattern-scale decoder further separates spatial expression into pattern prediction from raw expression with scale calibration. Evaluated on three ST datasets and ten HEST-1k cohorts, BCARP achieves the highest mean correlation-based performance against other baselines. Numerical results support biology-guided local-global residual propagation as an effective alternative to visual decoding for histology-to-transcriptomics prediction.