Gene Expression Prediction from Histopathology Images

Gastric Adenocarcinoma is a leading cause of cancer mortality. Although "Inflamed/Non-Inflamed" subtypes have been proposed to predict immunotherapy response, their identification relies on a costly 10-gene RNA signature. We propose a Cross-modal Contrastive Multiple Instance Learning (CCMIL) framework for cross-modal retrieval, imputing these molecular signatures directly from standard Hematoxylin & Eosin (H&E) slides. By leveraging a supervised contrastive objective, CCMIL aligns visual morphological patterns with molecular phenotypes into a shared latent space. This establishes an interpretable search-by-case retrieval engine, enabling pathologists to query a whole slide image to surface transcriptomically coherent neighbors and approximate RNA signatures without genomic sequencing at inference. Our results demonstrate that this retrieval-first approach captures the continuous phenotypic spectrum of tumor inflammation and yields clinically interpretable attention heatmaps. Furthermore, the learned representation also supports competitive downstream classification, providing a practical molecular pre-screening strategy.

Spatial transcriptomics enables spatially resolved gene expression analysis from slide-level images while preserving morphological features, providing valuable information for studying disease mechanisms and developing treatments. However, spatial gene expression profiling typically requires expensive and time-consuming tests. While existing image-based prediction optimizations mostly revolve around including positional embeddings and further image-based changes, text-based optimizations remain relatively unexplored. We present GATE-ST, which incorporates text-based inputs into image-based spatial gene expression predictions. With this approach, generated text descriptions of genes are utilized to better spatial transcriptomics prediction results. Gene summaries are put through a text encoder, generating embeddings that integrate with image embeddings through cross-attention layers to align with morphological features. We demonstrate the effectiveness of such text inputs by benchmarking performance against random gene embeddings and multiple other image-text fusion architectures, and show that GATE-ST outperforms these alternatives. Our results demonstrate the effectiveness of GATE-ST in pathology imaging, which may greatly reduce the time and cost of accurate spatial transcriptomic predictions, proving the potential of text-guided spatial gene expression prediction.

Predicting gene expression from H&E-stained histology images offers a scalable alternative to costly spatial transcriptomics, yet most existing methods operate at the spot level, where signals from multiple cells are aggregated and critical cellular heterogeneity is obscured. Extending this paradigm to single-cell resolution is non-trivial. Naively applying pathology foundation models faces a scale mismatch: their patch-level representations mix multiple cells, whereas per-cell cropping or resizing distorts morphology and removes local context. Conversely, segmentation-based models without strong pretrained visual encoders often lack the morphological representation capacity needed for accurate molecular prediction and inherit errors from imperfect cell boundary masks. Here, we present CELLO, an efficient end-to-end framework that performs a single pathology foundation model forward pass per image and uses grid sampling to extract location-specific features for all cells simultaneously. We further introduce a distance-decay cross-attention module that refines each cell representation using spatially biased local morphological context. Using 52 public Xenium-H&E pairs from HEST-1k that span 12 organs and approximately 10 million cells, CELLO improves the average predictive accuracy over the evaluated baselines while reducing the mean whole-slide inference time compared to DeepSpot2Cell, a 14.0x speed-up on average that excludes upstream cell segmentation. Our work establishes a scalable foundation for single-cell gene expression prediction from H&E images.

Predicting molecular profiles from histopathology remains challenging because whole-slide images contain spatially organized, heterogeneous tissue patterns, while gene expression comprises thousands of correlated targets. We introduce MoSPR (Morpho-Spatial Program Regression), a linear framework that couples an adjacency-informed histology representation with a low-rank molecular basis. MoSPR clusters frozen patch embeddings into morphology microstates, aggregates their spatial adjacencies across the training cohort, and groups microstates with similar adjacency patterns into shared macrostates. Each slide is then represented by global morphology and macrostate-specific deviations, which are linearly mapped to coefficients of a training-derived low-rank gene-expression basis. Across three cancer cohorts from The Cancer Genome Atlas, MoSPR achieves the highest mean gene-expression prediction scores among all evaluated methods. Without pathway-level supervision, pathway scores derived from its predicted expression profiles rank first in eight of nine comparisons across three pathway collections. Ablation studies on the breast cancer cohort show complementary gains from adjacency-derived macrostate representation and low-rank molecular prediction. Moreover, with half of the training data on this cohort, MoSPR exceeds the full-data gene-prediction score of the strongest competing baseline. Finally, its linear formulation enables exact decomposition of each predicted expression profile into global and macrostate-specific molecular contributions, providing an interpretable link between spatially coherent macrostate regions and their associated molecular programs. Our code is available at https://github.com/Radisen-Panthera/MoSPR.

Predicting spatial gene expression from histology images could scale spatial transcriptomics (ST) to image-only cohorts, but conventional histology-based ST prediction is trained and evaluated mainly by per-gene spatial-profile reconstruction. This objective is misaligned with a key downstream use of ST: differentially expressed gene (DEG) discovery, where genes are ranked for a biological or morphology-defined contrast by evidence of between-group expression differences. We formulate image-based differential expression ranking (IDER), which asks whether predicted expression profiles preserve the contrast-specific ranked gene list obtained from measured profiles. IDER compares gene rankings induced by differential-expression statistics, rather than raw expression magnitudes or per-gene spatial correlations. We further introduce a differentiable IDER objective that aligns these statistics across genes and can be trained with morphology-derived proxy contrasts without predefined biological group labels. Experiments on public ST datasets show improved DEG-ranking agreement and pathway-enrichment overlap over conventional reconstruction objectives, including morphology-derived and pathologist-annotated tissue-region evaluations.

Spatial transcriptomics (ST) profiles gene expression within tissue architecture, but its cost and experimental complexity limit routine use. Predicting spatial expression from routinely available hematoxylin and eosin (HE) images therefore offers a scalable alternative. However, conventional methods often fit high-dimensional gene outputs as independent targets, overlooking the biological coordination among genes while remaining vulnerable to high-dimensional noise and overfitting. Existing attempts to address this limitation often rely on computationally heavy graph networks or complex auxiliary supervision. We therefore introduce SpaFactor, a lightweight and efficient low-rank morphology-program-gene factorization framework. At the input, SpaFactor efficiently fuses the visual representation of the central spot with multiscale local and regional neighborhood context, yielding a histologic representation that captures cellular morphology and microenvironmental heterogeneity. For modeling, a residual MLP stably learns a nonlinear mapping from the tissue microenvironment to low-dimensional latent gene programs. These activities are decoded through shared gene loadings into coordinated multi-gene expression predictions. Across five public cohorts, SpaFactor achieves the best aggregate performance, with particularly clear improvements for spatially variable genes, and more faithfully recovers biologically organized spatial patterns. These results demonstrate that lightweight joint modeling of tissue context and gene programs can improve both predictive accuracy and biological fidelity.

Spatial Transcriptomics (ST) has transformed biomedical research by enabling the spatial mapping of gene expression across tissue sections. However, high operational costs, specialized equipment requirements, and sensitivity to experimental noise limit the accessibility and scalability of ST. Recent computer vision approaches aim to overcome these limitations by predicting spatial gene expression directly from histopathology images. While effective, current approaches often suffer from gene expression over-smoothing and overly uniform predictions across tissue regions, suggesting that further progress depends on learning representations that reflect the hierarchical and asymmetric structure of gene regulation and tissue morphology. To address these issues, we propose Hyperbolic Contrastive Learning with Entailment for Spatial Transcriptomics (HyCLoST), a hyperbolic contrastive learning model that captures the intrinsic hierarchical relationships within ST data. By leveraging hyperbolic geometry and a gene-to-image entailment loss, HyCLoST learns structured, biologically grounded representations that improve gene expression prediction accuracy, achieving a 6% reduction in MSE and an 8% increase in PCC across 26 ST datasets, over previous methods. Our source code is publicly available at https://github.com/BCV-Uniandes/HyCLoST

Spatial transcriptomics can resolve gene expression at single-cell resolution, but it is costly, limited to targeted panels of a few hundred to a few thousand genes, and applicable to only a small number of samples. H&E imaging, by contrast, is cheap and collected routinely at scale. This makes predicting single-cell expression directly from morphology a practical way to bring molecular analysis to large tissue archives. We therefore present VOICE, a multimodal foundation model that predicts single-cell gene expression from H&E images using paired Xenium data. VOICE first aligns cell centered H&E morphology from a pathology foundation model with single-cell expression embeddings from a transcriptome foundation model, trained using contrastive learning over 23 million cells. Next it predicts expression through two branches. One branch directly regresses expression from morphology. The other branch retrieves measured expression from similar reference cells, recovering genes that do not have morphological signal. Because genes vary in morphological predictability, VOICE fuses the two branches with a per-gene weight. After training, VOICE generalizes to heldout patients, slides, and partially overlapping gene panels from Xenium, and it consistently outperforms prior single-cell expression prediction methods on seven metrics.

Identifying the Inflamed'' immunophenotype in Gastric Adenocarcinoma predicts immunotherapy response but requires an expensive 10-gene RNA signature. While deep learning on standard H\&E slides offers a scalable alternative, conventional binary classifiers oversimplify continuous RNA data and introduce label noise. To resolve this, we propose VITA (VIrtual Transcriptomic Approximation). By aligning H\&E and RNA into a joint latent space during training, VITA requires only standard H\&E at inference to retrieve morphologically similar historical cases and approximate the continuous RNA signature. Achieving 0.72 classification accuracy and a 0.66 Spearman correlation, VITA provides a cost-effective virtual transcriptomics'' pre-screening tool that preserves the continuous phenotypic spectrum without requiring genomic sequencing.

Predicting spatial gene expression from histopathology images enables large-scale transcriptomic profiling without the cost of direct measurement. Existing methods decode the target gene set as a flat, unstructured vector, ignoring the inter-gene dependencies arising from shared biological pathways and regulatory programs. Without explicit structural guidance, models must infer these dependencies entirely from limited paired data, constraining prediction quality. We propose MSGR (Multi-Scale Gene Refiner), which bridges this gap by incorporating the Gene Ontology (GO), a curated functional hierarchy of genes, as an explicit structural prior. MSGR organizes target genes into a four-level GO tree. Its GO-guided decoder then progressively refines predictions from coarse functional domains to fine individual genes via residual corrections under scale-weighted supervision. Operating solely on the gene side, the GO-guided decoder serves as a seamless plug-in replacement that consistently improves existing architectures without requiring any image-side modifications. Extensive experiments on nine datasets from the HEST-1k benchmark provide empirical evidence for two central claims: GO-structured decoding consistently outperforms flat decoding, even against a state-of-the-art generative baseline, and the gain is attributable to biological ontology structure rather than hierarchical decomposition per se, as confirmed by a +0.027 margin over a structurally equivalent random hierarchy.

Pathology foundation models are reported to encode molecular programmes in tissue morphology, but the evidence is usually a cohort-wide ranked gene list rather than a prediction for a held-out patient. We rebuild such an analysis with the patient as the unit of evidence and ask which pipeline component carries signal. Across 11 frozen backbones, four pre-specified gene programmes and 285 TCGA-BRCA patients with paired slides and RNA-seq (44 cells; GroupKFold by patient, all preprocessing fitted inside the fold), ridge regression on mean-pooled embeddings predicts held-out programme scores at Spearman rho = 0.25-0.56, UNI2 strongest on all four (immune 0.556). A matched permutation null gives raw p ~ 1e-4 at 10,000 permutations for every cell; Holm-adjusted p = 0.0044. The signal is real but not uniformly morphological. Against competing models on the same patients and folds, embeddings beat tissue composition for ER/luminal, proliferation and immune (+0.280, +0.284, +0.479; p <= 0.003) but not basal, where compartment fractions alone reach 0.469 against the embedding's 0.493 (p = 0.77). Fifty-four interpretable cell-count features come within 0.043-0.085 on every programme. The geometric machinery contributes nothing measurable, and we identify why: the geodesic graph selects neighbours by Euclidean nearest-neighbour search and only reweights edges already chosen, so the topology is Euclidean by construction (Riemannian minus Euclidean = +0.0010, 95% CI [-0.0007, +0.0029]). Applied consistently the geometry is worse (-0.0117). Ridge regression beats the graph-and-metric decoder by +0.097 (CI [+0.069, +0.127]). The driver-count metric common in this literature is near-uninformative here: 91.8% of random six-gene panels recover >=5/6 drivers.

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 assays remain costly and technically demanding, restricting transcriptome-wide profiling to specialist settings and preventing routine clinical deployment. Predicting spatially resolved gene expression from H&E histology could close this gap, yet current methods largely ignore the underlying tissue architecture and rarely quantify how their predictions can be trusted. We introduce HierarchicalDAEW, a dual-graph architecture that addresses both gaps. On the spot graph, a Domain-Aware Edge-Weighted convolutional operator learns separate projections for inter-domain, intra-domain, and boundary edges derived from Leiden clustering, allowing the model to treat tissue heterogeneity as an explicit structural signal rather than an implicit one. A second gene-level graph then fuses protein-protein interaction priors from STRING-DB with tissue-specific co-expression through learned attention gating, propagating predictions from a landmark gene set to a broader gene panel. Reliability is handled through evidential uncertainty estimation, which produces far better calibrated confidence intervals than Monte Carlo dropout under identical conditions. Across six human Visium sections spanning breast, colorectal, prostate, and cerebellar tissue, and against thirteen published baselines, HierarchicalDAEW achieves the strongest correlation with ground-truth expression, with gains that hold up under multi-seed reproducibility checks and negative controls that rule out positional shortcuts. Ablations further confirm that both the domain-aware edge typing and the hierarchical depth are necessary to this improvement, and calibrated uncertainty estimates identify low-confidence predictions for pathologist review before clinical action.

Spatial transcriptomics enables profiling of spatial gene expression but is limited by high cost and low throughput, motivating prediction from H&E histopathology images. Existing context-aware methods mainly supervise absolute expression, while relative expression relationships between spots are rarely used explicitly. We propose COAST, a context-aware differential learning framework for spatial gene expression prediction. COAST conditions the local and global context features with type-specific modulation and aggregates the target and context spot tokens using a Transformer encoder to capture both fine-grained local patterns and slide-level structure. It is trained with a joint objective that combines absolute expression regression with signed differential regression between the target and context spots. Experiments on multiple spatial transcriptomics datasets show consistent improvements in correlation- and distribution-based metrics, demonstrating the effectiveness of context-aware differential learning for histology-based spatial gene expression prediction.

Spatial Transcriptomics (ST) measures gene expression while preserving spatial context, but its high cost and low throughput leave public datasets small. Inferring expression directly from widely available Hematoxylin and Eosin (H&E) stained histology offers a cost-effective alternative. However, existing approaches face several limitations: regression methods over-smooth toward the conditional mean, while generative methods are faithful but require slow multi-step inference; most methods treat genes as independent and equally important, ignoring inter-gene dependencies and heterogeneous gene informativeness; and most are tailored to a single resolution, either spot-level or cell-level. To address these issues, we propose DriftST, a unified framework for inferring spatially resolved gene expression from H&E images. DriftST builds on a Cellular Drifting generative model that learns a direct drift from a histology-conditioned source to the expression distribution, retaining generative expressiveness while enabling efficient one-step generation. To capture gene structure, we introduce the STransformer, which combines a co-expression attention module for inter-gene dependencies with a gene residual gate for differential gene importance. Operating on a generic gene-panel representation, DriftST applies directly to both spot-level and cell-level data in one framework, and extensive experiments across diverse tissues and platforms show that it achieves state-of-the-art performance at both resolutions.

H&E-stained whole-slide images offer cohort-scale availability and rich spatial context but lack molecular specificity, whereas bulk RNA-seq provides transcriptome-wide resolution at high cost with limited archival availability. We show that training a lightweight alignment module atop frozen histopathology and RNA-Seq foundation models enables open-vocabulary molecular prompting -- querying H&E slides with gene-set signatures to predict pathway activity without sequencing or end-to-end retraining. Using contrastive learning on a multi-cancer cohort (N=1,720), we achieve a 25-fold improvement in retrieval over baseline methods. Systematic analysis reveals a graduated predictability spectrum: morphologically grounded programs (cell-cycle programs, immune-related) are most reliably predicted (R^2>0.5), while predicting pathways with no morphological footprint remains challenging as expected. We validate clinical utility on the POSEIDON clinical trial: H&E-predicted squamous cell carcinoma scores recapitulate NSCLC subtype identity and predicted IFN-gamma mirror PD-L1 tumor-cell expression groups. Furthermore, genesets describing immune activation and fibrosis predict known tumor microenvironment archetypes from histology alone. We further validate generalization of our approach across unseen cohorts and demonstrate data-efficient domain adaptation, establishing a slide-native framework for molecular analysis on H&E images.

Recent studies have shown that spatial properties of tumors are critical for understanding disease biology and predicting patient outcomes. These spatial properties are increasingly uncovered through complementary modalities: spatial transcriptomics (ST) captures spatially-resolved molecular states, while hematoxylin and eosin-stained whole slide images (HE) reveal tissue morphology. While approaches are emerging to fuse these modalities, effective methods that learn not only joint representations but also incorporate spatial context across modalities are lacking. Here, we present JASPR (Joint Spatial Representation learning), a self-supervised deep learning framework that integrates HE images and ST data through a cross-modal reconstruction objective that incorporates spatial context within HE images and ST profiles. It employs shared modules to capture universal spatial properties across modalities, while modality-specific experts encode features unique to morphological and genomic data. We train and validate JASPR on breast cancer datasets, demonstrating that its learned joint representation substantially improves HE-based prediction of 9,248 genes and provides prognostic value for breast cancer outcomes.

The high cost of spatial transcriptomics (ST) has driven extensive studies into predicting gene expression directly from H&E histology images. However, this prediction task faces an inherent limitation, as tissue morphology alone provides insufficient information to fully resolve underlying gene expression. To address this limitation, a recent study leverages partial gene expression to guide the prediction process alongside histology images. Building on this paradigm, we approach the prediction task as a spatial imputation problem, employing a Masked Autoencoder (MAE) to utilize a small fraction of gene expression as genetic anchors for inferring whole-slide gene expression profiles. Specifically, we propose a bio-saliency score and a learning-to-rank strategy to adaptively identify the most informative spots within the tissue. Based on these identified spots, our framework selects contiguous regions as genetic anchors to ensure suitability for real-world ST profiling hardware. To effectively leverage these anchors, we design a cross-modal joint encoder that integrates visual and genetic modalities. By aligning the selected anchors with their corresponding visual features via contrastive learning, the encoder generates robust joint representations to accurately predict gene expression across the whole slide. Notably, our framework consistently surpasses existing methods in both histology-only prediction and spatial imputation, achieving superior accuracy even without genetic anchors and further excelling with as little as 10% transcriptomic coverage. Our code is available at https://github.com/Kyyle2114/CAMMST.

Spatial transcriptomics (ST) links gene expression with tissue morphology but remains expensive and low-throughput, motivating surrogates that infer expression from routine histology. Whole-slide H&E-to-ST inference pairs a gigapixel image with gene measurements at a sparse, irregular set of locations, making multiscale modeling challenging without incurring dense-grid overhead or quadratic token mixing. We propose HiST, a hierarchical sparse transformer that treats measured locations as a lattice-indexed sparse field and builds a dyadic encoder--decoder directly on the active tissue footprint. HiST combines sparse window attention for local geometric correspondence with resolution-changing operators for rapid multiscale context integration. For a fixed window size, the dominant runtime and memory scale with the number of observed locations rather than the dense slide area. To mitigate slide-specific acquisition variation, HiST adds a bottlenecked global conditioning pathway via a \emph{slide calibration token} that summarizes slide-level context and conditions local representations. On a multi-organ benchmark spanning diverse tissues and acquisition sources, HiST improves predictive performance over recent baselines while reducing runtime and peak memory.

Histology-based single-cell spatial transcriptomics (ST) estimation aims to predict gene expression for individual cells from histopathological images and cell locations, reducing the need for costly single-cell ST measurements. Unlike existing histology-to-ST methods that mainly predict spot-level profiles for local regions containing multiple cells, this task requires modeling cell-to-cell expression variability, which is strongly structured by cell type. We propose Genomics-Guided Cell-Type-Specific Mixture-of-Experts (GC-MoE), which estimates cell-type probabilities with a routing network and softly combines cell-type-specific experts for gene expression prediction. To further encode cell-type-dependent gene programs, we introduce the Cell-Type-Specific Co-Expression-Aware Predictor (CAP), together with a lightweight Cell-to-Cell Interaction Attention (C2CA) module for neighboring-cell context. Experiments and ablations on public single-cell ST datasets show consistent improvements over existing single-cell and adapted spot-level baselines.

Predicting spatial gene expression from routine H&E enables large-scale molecular profiling, yet current models treat this as isolated pointwise tasks, thereby overlooking essential biological structures like gene coordination and spatial distribution. To preserve these relationships, we introduce \textbf{FLAG}, a diffusion-based framework that redefines this task as structured distribution modeling. At the same time, we identify the critical \textbf{Gene Dimension Curse}, where joint modeling gene expression and their spatial interactions fail in high-dimensional spaces, and FLAG solves this challenge by integrating a spatial graph encoder for topological consistency and utilizing Gene Foundation Model (GFM) alignment for gene-gene fidelity in the generation process. To rigorously assess model performance, we propose a set of novel structural evaluation metrics, including Gene Structural Correlation (\textbf{GSC}) and Spatial Structural Correlation (\textbf{SSC}). Our experiments demonstrate that FLAG is highly competitive in traditional accuracy (PCC/MSE) while achieving significantly enhanced structural fidelity in capturing both gene-gene and gene-spatial relationships. The code is available at https://github.com/darkflash03/FLAG.

Histopathology whole-slide images (WSIs) are routinely acquired in clinical practice and contain rich tissue morphology but lack direct molecular architecture and functional programs defining pathological states, whereas RNA sequencing (RNA-seq) provides genome-wide transcriptional profiles at substantial cost, thereby motivating WSI-based genome-wide transcriptomic prediction. Existing approaches for predicting gene expression from WSIs predominantly rely on deterministic regression with one-to-one mapping, limiting their ability to capture biological heterogeneity and predictive uncertainty. We propose RNA-FM, a flow-matching generative framework for genome-wide bulk RNA-seq prediction from WSIs. RNA-FM formulates transcriptomic prediction as a continuous-time conditional transport problem, learning a velocity field that maps a simple prior to the target gene expression distribution conditioned on morphologies. By integrating pathway-level structure, RNA-FM enables scalable and biologically interpretable genome-wide gene expression imputation. Extensive experiments demonstrate that RNA-FM consistently outperforms state-of-the-art approaches while maintaining biological meaningfulness. Code is available at https://github.com/YXSong000/RNA-FM.

Spatial transcriptomics (ST) enables spatially resolved gene profiling but remains expensive and low-throughput, limiting large-cohort studies and routine clinical use. Predicting spatial gene expression from routine hematoxylin and eosin (H&E) slides is a promising alternative, yet under realistic leave-one-slide-out evaluation, existing models often suffer from slide-level appearance shifts and regression-driven over-smoothing that suppress biologically meaningful variation. CHRep is a two-phase framework for robust histology-to-expression prediction. In the training phase, CHRep learns a structure-aware representation by jointly optimizing correlation-aware regression, symmetric image-expression alignment, and coordinate-induced spatial topology regularization. In the inference phase, cross-slide robustness is improved without backbone fine-tuning through a lightweight calibration module trained on the training slides, which combines a non-parametric estimate from a training gallery with a magnitude-regularized correction module. Unlike prior embedding-alignment or retrieval-based transfer methods that rely on a single prediction route, CHRep couples topology-preserving representation learning with post-hoc calibration, enabling stable neighborhood retrieval and controlled bias correction under slide-level shifts. Across the three cohorts, CHRep consistently improves gene-wise correlation under leave-one-slide-out evaluation, with the largest gains observed on Alex+10x. Relative to HAGE, the Pearson correlation coefficient on all considered genes [PCC(ACG)] increases by 4.0% on cSCC and 9.8% on HER2+. Relative to mclSTExp, PCC(ACG) further improves by 39.5% on Alex+10x, together with 9.7% and 9.0% reductions in mean squared error (MSE) and mean absolute error (MAE), respectively.