Democratizing Pathology Co-Pilots: An Open Pipeline and Dataset for Whole-Slide Vision-Language Modelling

Vision-language models (VLMs) have the potential to become co-pilots for pathologists. However, most VLMs either focus on small regions of interest within whole-slide images, provide only static slide-level outputs, or rely on data that is not publicly available, limiting reproducibility. Furthermore, training data containing WSIs paired with detailed clinical reports is scarce, restricting progress toward transparent and generalisable VLMs. We address these limitations with three main contributions. First, we introduce Polysome, a standardised tool for synthetic instruction generation. Second, we apply Polysome to the public HISTAI dataset, generating HISTAI-Instruct, a large whole-slide instruction tuning dataset spanning 24,259 slides and over 1.1 million instruction-response pairs. Finally, we use HISTAI-Instruct to train ANTONI-α, a VLM capable of visual-question answering (VQA). We show that ANTONI-α outperforms MedGemma on WSI-level VQA tasks of tissue identification, neoplasm detection, and differential diagnosis. We also compare the performance of multiple incarnations of ANTONI-α trained with different amounts of data. All methods, data, and code are publicly available.

A Multicentric Dataset for Training and Benchmarking Breast Cancer Segmentation in H&E Slides

Automated semantic segmentation of whole-slide images (WSIs) stained with hematoxylin and eosin (H&E) is essential for large-scale artificial intelligence-based biomarker analysis in breast cancer. However, existing public datasets for breast cancer segmentation lack the morphological diversity needed to support model generalizability and robust biomarker validation across heterogeneous patient cohorts. We introduce BrEast cancEr hisTopathoLogy sEgmentation (BEETLE), a dataset for multiclass semantic segmentation of H&E-stained breast cancer WSIs. It consists of 587 biopsies and resections from three collaborating clinical centers and two public datasets, digitized using seven scanners, and covers all molecular subtypes and histological grades. Using diverse annotation strategies, we collected annotations across four classes - invasive epithelium, non-invasive epithelium, necrosis, and other - with particular focus on morphologies underrepresented in existing datasets, such as ductal carcinoma in situ and dispersed lobular tumor cells. The dataset's diversity and relevance to the rapidly growing field of automated biomarker quantification in breast cancer ensure its high potential for reuse. Finally, we provide a well-curated, multicentric external evaluation set to enable standardized benchmarking of breast cancer segmentation models.