Multiple Instance Learning

Multi-instance partial-label learning (MIPL) is a weakly supervised framework that extends the principles of multi-instance learning (MIL) and partial-label learning (PLL) to address the challenges of inexact supervision in both instance and label spaces. However, existing MIPL approaches often suffer from poor calibration, undermining classifier reliability. In this work, we propose a plug-and-play calibratable disambiguation loss (CDL) for classification and calibration, which modulates a disambiguation objective by a top-vs-competitor prediction margin. The competitor is instantiated either as the second strongest candidate label or as the strongest non-candidate label, yielding two variants that respectively emphasize candidate-level separation and candidate-vs-non-candidate suppression. Theoretically, we analyze CDL as a margin-modulated momentum-based disambiguation loss (MDL) objective, derive a lower-bound and a pseudo-label confidence-alignment bound for calibration, and show through gradient and momentum analyses how margin shaping affects weight updates. Experimental results on benchmark and real-world MIPL datasets, together with representative PLL adaptation, confirm that our CDL significantly improves both classification accuracy and expected calibration error.

While Vision-Language Models (VLMs) have achieved notable progress in computational pathology (CPath), the gigapixel scale and spatial heterogeneity of Whole Slide Images (WSIs) continue to pose challenges for multimodal understanding. Existing alignment methods struggle to capture fine-grained correspondences between textual descriptions and visual cues across thousands of patches from a slide, compromising their performance on downstream tasks. In this paper, we propose PathFLIP (Pathology Fine-grained Language-Image Pretraining), a novel framework for holistic WSI interpretation. PathFLIP decomposes slide-level captions into region-level subcaptions and generates text-conditioned region embeddings to facilitate precise visual-language grounding. By harnessing Large Language Models (LLMs), PathFLIP can seamlessly follow diverse clinical instructions and adapt to varied diagnostic contexts. Furthermore, it exhibits versatile capabilities across multiple paradigms, efficiently handling slide-level classification and retrieval, fine-grained lesion localization, and instruction following. Extensive experiments demonstrate that PathFLIP outperforms existing large-scale pathological VLMs on four representative benchmarks while requiring significantly less training data, paving the way for fine-grained, instruction-aware WSI interpretation in clinical practice.

The rapid digitization of histopathology slides has opened new opportunities for computational tools in clinical and research workflows. Content-based slide retrieval can help pathologists identify morphologically and semantically related precedent cases, supporting expert diagnosis and example-based education. Effective retrieval of whole-slide images (WSIs), however, remains challenging because gigapixel slides contain abundant irrelevant content, focal diagnostic patterns and slide-level semantic information that must be represented at a practicable search cost. Here we present PathSearch, a retrieval framework that combines fine-grained attentive mosaics with slide-level embeddings aligned through vision-language contrastive learning. Trained on 6,926 slide-report pairs, PathSearch captures both fine-grained morphological cues and high-level semantic patterns to enable accurate and flexible retrieval. The framework supports two key functionalities: (1) mosaic-based image-to-image (I2I) retrieval, ensuring accurate and efficient slide search; and (2) multimodal retrieval, where text queries can directly retrieve relevant slides. PathSearch was evaluated on eight tasks comprising 5,021 evaluation slides, spanning malignancy assessment on frozen and hematoxylin and eosin (H&E)-stained slides, lymph-node metastasis detection, tumor subtyping, mixed-gallery rare-cancer retrieval, and hepatocellular carcinoma (HCC) risk stratification. Internal and external experimental results demonstrate that PathSearch consistently outperforms the strongest existing methods without compromising multimodal accuracy. A multi-center reader study further demonstrated increases in task-level mean diagnostic accuracy, confidence, and inter-observer agreement with PathSearch's support. Together, these results support the effectiveness of PathSearch across diverse retrieval tasks and evaluation settings.

The public often attributes human-like qualities to large language models (LLMs), assuming that they "know" certain things. In reality, LLMs encode information retained during training as internal probabilistic knowledge. This study examines existing methods for probing the veracity of that knowledge and identifies three flawed underlying assumptions. To address these flaws, we introduce sAwMIL (Sparse-Aware Multiple-Instance Learning), a multiclass probing framework that combines multiple-instance learning with conformal prediction. sAwMIL leverages LLMs' internal representations to classify statements as true, false, or neither. We evaluate sAwMIL across 16 open-source LLMs, including default and chat-based variants, using three new curated datasets. Our results show that (1) common probing methods fail to provide a reliable and transferable veracity direction and, in some settings, perform worse than zero-shot prompting; (2) truth and falsehood are not encoded symmetrically; and (3) LLMs encode a third type of signal that is distinct from both true and false.

Weak supervision enables machine learning models to learn from limited or noisy labels, but it introduces challenges in reliability and semantic clarity, particularly in multi-instance partial label learning (MI-PLL), where models must resolve both ambiguous supervision signals and uncertain instance-label mappings. This paper proposes a semantics for a neuro-symbolic framework that integrates inductive logic programming (ILP) to structure MI-PLL through relational constraints. In this formulation, ILP defines a hypothesis space over label transitions, formalizes the semantics of per-instance classifiers and provides a relational scaffold for reasoning about weak supervision. Two inductive tasks are studied in this framework: inferring the transition predicate from the observed and classifier predicates, and inferring instance-level classifier assignments from the observed and transition predicates. This formal semantics facilitates constraint specification, consistency checking and the diagnosis of semantic failure modes that bag-level accuracy alone may conceal.

Cancer survival prediction from whole slide images (WSIs) is a challenging task in computational pathology due to the large size, irregular shape, and high granularity of the WSIs. These characteristics make it difficult to capture the full spectrum of patterns, from subtle cellular abnormalities to complex tissue interactions, which are crucial for accurate prognosis. To address this, we propose CrossFusion, a novel multi-scale feature integration framework that extracts and fuses information from patches across different magnification levels. By effectively modeling both scale-specific patterns and their interactions, CrossFusion generates a rich feature set that enhances survival prediction accuracy. We validate our approach across six cancer types from public datasets, demonstrating significant improvements over existing state-of-the-art methods. Moreover, when coupled with domain-specific feature extraction backbones, our method shows further gains in prognostic performance compared to general-purpose backbones. The source code is available at: https://github.com/RustinS/CrossFusion

Deploying deep learning-based imaging tools across various clinical sites poses significant challenges due to inherent domain shifts and regulatory hurdles associated with site-specific fine-tuning. For histopathology, stain normalization techniques can mitigate discrepancies, but they often fall short of eliminating inter-site variations. Therefore, we present Data Alchemy, an explainable stain normalization method combined with test time data calibration via a template learning framework to overcome barriers in cross-site analysis. Data Alchemy handles shifts inherent to multi-site data and minimizes them without needing to change the weights of the normalization or classifier networks. Our approach extends to unseen sites in various clinical settings where data domain discrepancies are unknown. Extensive experiments highlight the efficacy of our framework in tumor classification in hematoxylin and eosin-stained patches. Our explainable normalization method boosts classification tasks' area under the precision-recall curve(AUPR) by 0.165, 0.545 to 0.710. Additionally, Data Alchemy further reduces the multisite classification domain gap, by improving the 0.710 AUPR an additional 0.142, elevating classification performance further to 0.852, from 0.545. Our Data Alchemy framework can popularize precision medicine with minimal operational overhead by allowing for the seamless integration of pre-trained deep learning-based clinical tools across multiple sites.