Local-to-global spatial learning for whole-slide image representation and classification

LESS: Label-efficient multi-scale learning for cytological whole slide image screening

In computational pathology, multiple instance learning (MIL) is widely used to circumvent the computational impasse in giga-pixel whole slide image (WSI) analysis. It usually consists of two stages: patch-level feature extraction and slide-level aggregation. Recently, pretrained models or self-supervised learning have been used to extract patch features, but they suffer from low effectiveness or inefficiency due to overlooking the task-specific supervision provided by slide labels. Here we propose a weakly-supervised Label-Efficient WSI Screening method, dubbed LESS, for cytological WSI analysis with only slide-level labels, which can be effectively applied to small datasets. First, we suggest using variational positive-unlabeled (VPU) learning to uncover hidden labels of both benign and malignant patches. We provide appropriate supervision by using slide-level labels to improve the learning of patch-level features. Next, we take into account the sparse and random arrangement of cells in cytological WSIs. To address this, we propose a strategy to crop patches at multiple scales and utilize a cross-attention vision transformer (CrossViT) to combine information from different scales for WSI classification. The combination of our two steps achieves task-alignment, improving effectiveness and efficiency. We validate the proposed label-efficient method on a urine cytology WSI dataset encompassing 130 samples (13,000 patches) and a breast cytology dataset FNAC 2019 with 212 samples (21,200 patches). The experiment shows that the proposed LESS reaches 84.79%, 85.43%, 91.79% and 78.30% on the urine cytology WSI dataset, and 96.88%, 96.86%, 98.95%, 97.06% on the breast cytology high-resolution-image dataset in terms of accuracy, AUC, sensitivity and specificity. It outperforms state-of-the-art MIL methods on pathology WSIs and realizes automatic cytological WSI cancer screening.

A survey of Transformer applications for histopathological image analysis: New developments and future directions

Transformers have been widely used in many computer vision challenges and have shown the capability of producing better results than convolutional neural networks (CNNs). Taking advantage of capturing long-range contextual information and learning more complex relations in the image data, Transformers have been used and applied to histopathological image processing tasks. In this survey, we make an effort to present a thorough analysis of the uses of Transformers in histopathological image analysis, covering several topics, from the newly built Transformer models to unresolved challenges. To be more precise, we first begin by outlining the fundamental principles of the attention mechanism included in Transformer models and other key frameworks. Second, we analyze Transformer-based applications in the histopathological imaging domain and provide a thorough evaluation of more than 100 research publications across different downstream tasks to cover the most recent innovations, including survival analysis and prediction, segmentation, classification, detection, and representation. Within this survey work, we also compare the performance of CNN-based techniques to Transformers based on recently published papers, highlight major challenges, and provide interesting future research directions. Despite the outstanding performance of the Transformer-based architectures in a number of papers reviewed in this survey, we anticipate that further improvements and exploration of Transformers in the histopathological imaging domain are still required in the future. We hope that this survey paper will give readers in this field of study a thorough understanding of Transformer-based techniques in histopathological image analysis, and an up-to-date paper list summary will be provided at https://github.com/S-domain/Survey-Paper .