VLEER: Vision and Language Embeddings for Explainable Whole Slide Image Representation

Recent advances in vision-language models (VLMs) have shown remarkable potential in bridging visual and textual modalities. In computational pathology, domain-specific VLMs, which are pre-trained on extensive histopathology image-text datasets, have succeeded in various downstream tasks. However, existing research has primarily focused on the pre-training process and direct applications of VLMs on the patch level, leaving their great potential for whole slide image (WSI) applications unexplored. In this study, we hypothesize that pre-trained VLMs inherently capture informative and interpretable WSI representations through quantitative feature extraction. To validate this hypothesis, we introduce Vision and Language Embeddings for Explainable WSI Representation (VLEER), a novel method designed to leverage VLMs for WSI representation. We systematically evaluate VLEER on three pathological WSI datasets, proving its better performance in WSI analysis compared to conventional vision features. More importantly, VLEER offers the unique advantage of interpretability, enabling direct human-readable insights into the results by leveraging the textual modality for detailed pathology annotations, providing clear reasoning for WSI-level pathology downstream tasks.

2DMamba: Efficient State Space Model for Image Representation with Applications on Giga-Pixel Whole Slide Image Classification

Efficiently modeling large 2D contexts is essential for various fields including Giga-Pixel Whole Slide Imaging (WSI) and remote sensing. Transformer-based models offer high parallelism but face challenges due to their quadratic complexity for handling long sequences. Recently, Mamba introduced a selective State Space Model (SSM) with linear complexity and high parallelism, enabling effective and efficient modeling of wide context in 1D sequences. However, extending Mamba to vision tasks, which inherently involve 2D structures, results in spatial discrepancies due to the limitations of 1D sequence processing. On the other hand, current 2D SSMs inherently model 2D structures but they suffer from prohibitively slow computation due to the lack of efficient parallel algorithms. In this work, we propose 2DMamba, a novel 2D selective SSM framework that incorporates the 2D spatial structure of images into Mamba, with a highly optimized hardware-aware operator, adopting both spatial continuity and computational efficiency. We validate the versatility of our approach on both WSIs and natural images. Extensive experiments on 10 public datasets for WSI classification and survival analysis show that 2DMamba~improves up to $2.48\%$ in AUC, $3.11\%$ in F1 score, $2.47\%$ in accuracy and $5.52\%$ in C-index. Additionally, integrating our method with VMamba for natural imaging yields $0.5$ to $0.7$ improvements in mIoU on the ADE20k semantic segmentation dataset, and $0.2\%$ accuracy improvement on ImageNet-1K classification dataset. Our code is available at https://github.com/AtlasAnalyticsLab/2DMamba.

GPC: Generative and General Pathology Image Classifier

Deep learning has been increasingly incorporated into various computational pathology applications to improve its efficiency, accuracy, and robustness. Although successful, most previous approaches for image classification have crucial drawbacks. There exist numerous tasks in pathology, but one needs to build a model per task, i.e., a task-specific model, thereby increasing the number of models, training resources, and cost. Moreover, transferring arbitrary task-specific model to another task is still a challenging problem. Herein, we propose a task-agnostic generative and general pathology image classifier, so called GPC, that aims at learning from diverse kinds of pathology images and conducting numerous classification tasks in a unified model. GPC, equipped with a convolutional neural network and a Transformer-based language model, maps pathology images into a high-dimensional feature space and generates pertinent class labels as texts via the image-to-text classification mechanism. We evaluate GPC on six datasets for four different pathology image classification tasks. Experimental results show that GPC holds considerable potential for developing an effective and efficient universal model for pathology image analysis.

CAMP: Continuous and Adaptive Learning Model in Pathology

There exist numerous diagnostic tasks in pathology. Conventional computational pathology formulates and tackles them as independent and individual image classification problems, thereby resulting in computational inefficiency and high costs. To address the challenges, we propose a generic, unified, and universal framework, called a continuous and adaptive learning model in pathology (CAMP), for pathology image classification. CAMP is a generative, efficient, and adaptive classification model that can continuously adapt to any classification task by leveraging pathology-specific prior knowledge and learning taskspecific knowledge with minimal computational cost and without forgetting the knowledge from the existing tasks. We evaluated CAMP on 22 datasets, including 1,171,526 patches and 11,811 pathology slides, across 17 classification tasks. CAMP achieves state-of-theart classification performance on a wide range of datasets and tasks at both patch- and slide-levels and reduces up to 94% of computation time and 85% of storage memory in comparison to the conventional classification models. Our results demonstrate that CAMP can offer a fundamental transformation in pathology image classification, paving the way for the fully digitized and computerized pathology practice.

Towards a text-based quantitative and explainable histopathology image analysis

Recently, vision-language pre-trained models have emerged in computational pathology. Previous works generally focused on the alignment of image-text pairs via the contrastive pre-training paradigm. Such pre-trained models have been applied to pathology image classification in zero-shot learning or transfer learning fashion. Herein, we hypothesize that the pre-trained vision-language models can be utilized for quantitative histopathology image analysis through a simple image-to-text retrieval. To this end, we propose a Text-based Quantitative and Explainable histopathology image analysis, which we call TQx. Given a set of histopathology images, we adopt a pre-trained vision-language model to retrieve a word-of-interest pool. The retrieved words are then used to quantify the histopathology images and generate understandable feature embeddings due to the direct mapping to the text description. To evaluate the proposed method, the text-based embeddings of four histopathology image datasets are utilized to perform clustering and classification tasks. The results demonstrate that TQx is able to quantify and analyze histopathology images that are comparable to the prevalent visual models in computational pathology.