Abstract:Foundation models with visual question answering capabilities for digital pathology are emerging. Such unprecedented technology requires independent benchmarking to assess its potential in assisting pathologists in routine diagnostics. We created DALPHIN, the first multicentric open benchmark for pathology AI copilots, comprising 1236 images from 300 cases, spanning 130 rare to common diagnoses, 6 countries, and 14 subspecialties. The DALPHIN design and dataset are introduced alongside a human performance benchmark of 31 pathologists from 10 countries with varying expertise. We report results for two general-purpose (GPT-5, Gemini 2.5 Pro) and one pathology-specific copilot (PathChat+) for sequential and independent answer generation. We observed no statistically significant difference from expert-level performance in four of six tasks for PathChat, 2/6 tasks for Gemini, and 1/6 tasks for GPT. DALPHIN is publicly released with sequestered, indirectly accessible ground truth to foster robust and enduring benchmarking. Data, methods, and the evaluation platform are accessible through dalphin.grand-challenge.org.




Abstract: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.



Abstract: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.