cs.CVOct 29, 2026

Sparse Autoencoders for Expert-Assisted Interpretation of Histopathology Foundation Model Embeddings

Authors: Šimon Šmída, Wanda Benesova

Organizations: Czech Technical University, Prague, Czech Republic

Abstract

Histopathology foundation models learn rich embedding representations, but their internal structure remains difficult to inspect. Concept-level interpretability is particularly relevant in computational pathology because pathologists reason through recurring morphological and tissue-level patterns, including tissue architecture, cellular morphology, staining variation, and artifacts. In this work, we investigate whether sparse autoencoders (SAEs) can decompose embeddings from histopathology foundation models into sparse latent features suitable for expert-assisted interpretation. We train vanilla and Batch-TopK SAE variants on NCT-CRC embeddings, using CONCH as the primary foundation model and UNI2-h as an additional robustness evaluation, and characterize the resulting latent features through reconstruction fidelity, sparsity, coherence, label enrichment, and downstream class-signal preservation. The learned sparse representations preserve most downstream tissue-class information, and their latent features retrieve more coherent and label-concentrated patch groups than raw embedding dimensions or PCA components. Discussions with pathology experts further motivated a WSI-level latent visualization workflow that places feature activations into larger tissue context. Overall, the additional UNI2-h evaluation suggests that the observed behavior is not specific to CONCH, supporting the use of sparse autoencoders for expert-assisted analysis of histopathology foundation-model embeddings, while emphasizing that latent features should be treated as candidate concepts requiring pathological assessment rather than automatically validated histopathological concepts.

Figures & tables

Appendix figures & tables15 assets

Supplementary material from the paper’s appendix.

Appendix

Explore similar work

Mar 24, 2026

Sparse Autoencoders for Interpretable Medical Image Representation Learning

Vision foundation models (FMs) achieve state-of-the-art performance in medical imaging. However, they encode information in abstract latent representations that clinicians cannot interrogate or verify. The goal of this study is to investigate Sparse Autoencoders (SAEs) for replacing opaque FM image representations with human-interpretable, sparse features. We train SAEs on embeddings from BiomedParse (biomedical) and DINOv3 (general-purpose) using 909,873 CT and MRI 2D image slices from the TotalSegmentator dataset. We find that learned sparse features: (a) reconstruct original embeddings with high fidelity (R2 up to 0.941) and recover up to 87.8% of downstream performance using only 10 features (99.4% dimensionality reduction), (b) preserve semantic fidelity in image retrieval tasks, (c) correspond to specific concepts that can be expressed in language using large language model (LLM)-based auto-interpretation. (d) bridge clinical language and abstract latent representations in zero-shot language-driven image retrieval. Our work indicates SAEs are a promising pathway towards interpretable, concept-driven medical vision systems. Code repository: https://github.com/pwesp/sail.
Aug 28, 2026

EXPOSE: Explainable and Domain-Robust Embeddings from Pathology Vision Foundation Models using Sparse Autoencoders

Vision Foundation Models (VFMs) are widely used in computational pathology but remain sensitive to domain shifts arising from variations in staining, tissue preparation, and scanner hardware. A key limitation is that VFM embeddings entangle biological with domain-specific information, hindering cross-domain generalization. We propose Explainable Probing of Cross-Domain Sparse Embeddings (EXPOSE), a framework that uses Sparse Autoencoders (SAEs) as an explainable bottleneck to identify and suppress domain-specific components in VFM embeddings. We train a sparse representation of VFM features, use a linear classifier to identify domain-specific latent dimensions, and mask these features prior to downstream relapse prediction without retraining the backbone model. Experiments on a large prostate cancer dataset with multiple acquisition domains show that SAE features capture both domain- and task-specific information, which are partially disentangled in the latent space. Removing domain-specific features improves cross-domain performance and increases embedding robustness as measured by the Domain Robustness Index (DoRI). Code is available at https://github.com/imsb-uke/expose .
Apr 13, 2026

Sparse Autoencoder Decomposition of Clinical Sequence Model Representations: Feature Complexity, Task Specialisation, and Mortality Prediction

Sparse autoencoders (SAEs) have been applied to large language models and protein language models, but not systematically to electronic health record (EHR) foundation models. We train TopK SAEs on FlatASCEND, a 14.5-million-parameter autoregressive clinical sequence model, at all 10 residual stream extraction points on INSPECT (outpatient) and MIMIC-IV (ICU). SAE decomposition reveals progressive abstraction across transformer depth: layer-0 features are near-perfect token detectors (45.7% singleton), while layer-6 features span approximately 30 token types across multiple clinical categories (0.5% singleton). Under full-sequence simple linear probes, SAE features outperform dense representations for discrete event prediction (mortality) while dense representations outperform for continuous magnitude prediction (length of stay) - a probe-level representational phenomenon that does not extend to clinically relevant leakage-safe windows, where dense representations match or exceed SAE features across all tested settings (eICU-CRD 48-hour AUC: SAE 0.871 versus dense 0.880; base model zero-shot, SAE dictionaries trained on eICU activations; MIMIC-IV: 0.836 versus 0.914; INSPECT 1-year/3-year: 0.697 versus 0.800). A delta-mode intervention method reduces SAE perturbation noise by 86x, enabling cleaner feature-level experiments, though the resulting perturbation effects are larger than random controls in 3 of 4 conditions but not formally significant. Feature reproducibility across random seeds is 21%, and individual features should be interpreted as illustrative rather than stable.