Re-mixing Embeddings for Patient Augmentation in Data Scarce Multiple Instance Learning

Data scarcity is a major bottleneck in medical Multiple Instance Learning (MIL), especially for rare diseases or expensive modalities. We introduce a statistically grounded patient augmentation approach that generates realistic patients directly in embedding space. Using Gaussian Mixture Models as a probabilistic clustering approach on pooled instance embeddings from all patients, our method learns disease-specific "recipes"-statistical distributions of instances across unsupervised clusters. New patients are then generated by sampling embeddings from clusters based on learned recipes. Unlike existing methods that require examples from all categories, our method can generate patients offline by re-mixing pooled embeddings. Generated patients are further selected based on uncertainty quantification to improve MIL performance. We evaluate our method across three clinically relevant scarcity scenarios: (i) cross-dataset transfer, where an entirely missing "healthy" class is generated using statistics from an external cohort; (ii) low-data regimes, where class sizes are extremely limited; and (iii) small-cohort non-image tasks, including single-cell RNA-seq and flow cytometry. Across all experiments, our method improves performance over baseline, often outperforming other bag-mixing strategies. Notably, in the missing-class scenario, a performance comparable to full-dataset training is achieved, demonstrating its potential for rare disease diagnostic and privacy-preserving patient augmentation. The code is available at https://github.com/marrlab/RECIPE

3D Masked Autoencoders are Robust Learners of Volumetric and Multimodal Cellular Representations for Microscopy

Self-supervised learning in fluorescence microscopy often relies on 2D projections, despite the inherently three-dimensional nature of cells. We present a systematic comparison of 2D and 3D masked autoencoders (MAE-2D vs. MAE-3D) on volumetric microscopy data. Under matched architectures and training protocols, MAE-3D consistently outperforms 2D max-projection and slice-based variants on downstream single-cell tasks. We further align visual representations with a pretrained protein language model (ESM2) and show that cross-modal supervision yields larger gains for volumetric models. Channel cross-attention and frequency-domain regularization are critical for leveraging 3D spatial context. On a protein--protein interaction task, MAE-3D achieves a ROC--AUC of 0.865, outperforming prior methods by up to +0.025. For protein localization, our best 3D model attains state-of-the-art AUC$_{\text{micro}}$ (0.952) and F1$_{\text{micro}}$ (0.742), improving over previous approaches by +0.003 and +0.010 absolute, respectively. Overall, these results demonstrate the advantages of native 3D modeling and multimodal alignment for representation learning in single-cell microscopy.

QG-MIL: A Gated Transformer Aggregator for Domain-Agnostic Multiple Instance Learning in Medical Imaging

Attention-based Multiple Instance Learning aggregators in medical imaging are prone to attention concentration, producing overconfident and unstable predictions. We introduce QG-MIL, a gated transformer aggregator that addresses this through four synergistic architectural components: RMSNorm-based pre-normalization, per-head QK normalization, fine-grained attention output gating, and SwiGLU-style feed-forward modules. Together, these design choices stabilize training and distribute attention more uniformly across instances without auxiliary losses, masking, or multi-stage regularization. We evaluate QG-MIL across six benchmarks spanning whole-slide pathology and cell-level hematology, covering two fundamentally different MIL scales. The best-performing QG-MIL variants outperform leading baselines on all six benchmarks, with an average improvement of +6.1 mean macro F1 points. Attention overlays and attention mass analysis confirm more distributed instance weighting. Ablation studies show that while individual components can match the full model on specific datasets, the QG-MIL design provides the most consistent cross-domain performance and tightest variance when compared to selected baselines. We release a configurable implementation to support reproducibility at: https://github.com/unica-visual-intelligence-lab/QG-MIL

Genetically Aligned Patient Representations Improve Hematological Diagnosis

Multimodal alignment of histopathology encoders with transcriptomic and genomic data has been shown to significantly improve performance in downstream diagnostic tasks. Hematological cytology is unique in that visual single-cell evaluation is often paired with cytogenetics and molecular genetics for blood cancer diagnosis. In this study, we present a framework to align single white blood cell images with chromosomal aberrations (karyotype) and somatic mutations from targeted gene panels. Our training strategy follows a two-stage approach: (i) self-supervised, vision-only pretraining of a transformer aggregator using an iBOT head on a cohort of over 1500 patients, and (ii) genetic alignment via supervised contrastive loss on acute myeloid leukemia patients. Our genetically aligned patient encoder improves hematological diagnostic tasks, outperforming slide-level histopathology foundation models. Additionally, the model provides off-the-shelf retrieval capabilities for diseases and genetic alterations. Incorporating genetic data into patient encoders increases the quality of patient representations, providing a framework that aligns with clinical diagnostic workflows and paves the way for future multimodal hematology-specific AI. The code and model weights are available at https://github.com/marrlab/GenBloom.

Measuring Prediction Uncertainty in Neural Cellular Automata

Neural cellular automata (NCA) provide a lightweight alternative to encoder-decoder segmentation networks. However, it can be difficult to decide when a prediction should be trusted. Here, we study uncertainty estimation for NCA-based medical image segmentation without modifying the underlying architecture or retraining the model. Our approach is motivated by viewing the NCA as a dynamical system where convergent attractors correspond to confident predictions. Concretely, we propose resilience, a simple measure that leverages the intrinsic iterative structure of NCAs by probing the stability of the final prediction under small perturbations of the automaton state. Predictions that return to the same solution are deemed confident, while those that change substantially are flagged as uncertain. We evaluate uncertainty by its ability to predict segmentation quality using selective prediction metrics ($Δ$Dice@90 and AURC) and ranking metrics (AUROC and AUPRC). Across multiple medical segmentation benchmarks, resilience identifies failure cases more reliably than baselines, improving trust and safety in NCA-based models.

Are Object-Centric Representations Better At Compositional Generalization?

Compositional generalization, the ability to reason about novel combinations of familiar concepts, is fundamental to human cognition and a critical challenge for machine learning. Object-centric (OC) representations, which encode a scene as a set of objects, are often argued to support such generalization, but systematic evidence in visually rich settings is limited. We introduce a Visual Question Answering benchmark across three controlled visual worlds (CLEVRTex, Super-CLEVR, and MOVi-C) to measure how well vision encoders, with and without object-centric biases, generalize to unseen combinations of object properties. To ensure a fair and comprehensive comparison, we carefully account for training data diversity, sample size, representation size, downstream model capacity, and compute. We use DINOv2 and SigLIP2, two widely used vision encoders, as the foundation models and their OC counterparts. Our key findings reveal that (1) OC approaches are superior in harder compositional generalization settings; (2) original dense representations surpass OC only on easier settings and typically require substantially more downstream compute; and (3) OC models are more sample efficient, achieving stronger generalization with fewer images, whereas dense encoders catch up or surpass them only with sufficient data and diversity. Overall, object-centric representations offer stronger compositional generalization when any one of dataset size, training data diversity, or downstream compute is constrained.

A Multicenter Benchmark of Multiple Instance Learning Models for Lymphoma Subtyping from HE-stained Whole Slide Images

Timely and accurate lymphoma diagnosis is essential for guiding cancer treatment. Standard diagnostic practice combines hematoxylin and eosin (HE)-stained whole slide images with immunohistochemistry, flow cytometry, and molecular genetic tests to determine lymphoma subtypes, a process requiring costly equipment, skilled personnel, and causing treatment delays. Deep learning methods could assist pathologists by extracting diagnostic information from routinely available HE-stained slides, yet comprehensive benchmarks for lymphoma subtyping on multicenter data are lacking. In this work, we present the first multicenter lymphoma benchmarking dataset covering four common lymphoma subtypes and healthy control tissue. We systematically evaluate five publicly available pathology foundation models (H-optimus-1, H0-mini, Virchow2, UNI2, Titan) combined with attention-based (AB-MIL) and transformer-based (TransMIL) multiple instance learning aggregators across three magnifications (10x, 20x, 40x). On in-distribution test sets, models achieve multiclass balanced accuracies exceeding 80% across all magnifications, with all foundation models performing similarly and both aggregation methods showing comparable results. The magnification study reveals that 40x resolution is sufficient, with no performance gains from higher resolutions or cross-magnification aggregation. However, on out-of-distribution test sets, performance drops substantially to around 60%, highlighting significant generalization challenges. To advance the field, larger multicenter studies covering additional rare lymphoma subtypes are needed. We provide an automated benchmarking pipeline to facilitate such future research.

Neural Cellular Automata for Weakly Supervised Segmentation of White Blood Cells

The detection and segmentation of white blood cells in blood smear images is a key step in medical diagnostics, supporting various downstream tasks such as automated blood cell counting, morphological analysis, cell classification, and disease diagnosis and monitoring. Training robust and accurate models requires large amounts of labeled data, which is both time-consuming and expensive to acquire. In this work, we propose a novel approach for weakly supervised segmentation using neural cellular automata (NCA-WSS). By leveraging the feature maps generated by NCA during classification, we can extract segmentation masks without the need for retraining with segmentation labels. We evaluate our method on three white blood cell microscopy datasets and demonstrate that NCA-WSS significantly outperforms existing weakly supervised approaches. Our work illustrates the potential of NCA for both classification and segmentation in a weakly supervised framework, providing a scalable and efficient solution for medical image analysis.

Attention Pooling Enhances NCA-based Classification of Microscopy Images

Neural Cellular Automata (NCA) offer a robust and interpretable approach to image classification, making them a promising choice for microscopy image analysis. However, a performance gap remains between NCA and larger, more complex architectures. We address this challenge by integrating attention pooling with NCA to enhance feature extraction and improve classification accuracy. The attention pooling mechanism refines the focus on the most informative regions, leading to more accurate predictions. We evaluate our method on eight diverse microscopy image datasets and demonstrate that our approach significantly outperforms existing NCA methods while remaining parameter-efficient and explainable. Furthermore, we compare our method with traditional lightweight convolutional neural network and vision transformer architectures, showing improved performance while maintaining a significantly lower parameter count. Our results highlight the potential of NCA-based models an alternative for explainable image classification.

RedDino: A foundation model for red blood cell analysis

Red blood cells (RBCs) are essential to human health, and their precise morphological analysis is important for diagnosing hematological disorders. Despite the promise of foundation models in medical diagnostics, comprehensive AI solutions for RBC analysis remain scarce. We present RedDino, a self-supervised foundation model designed for RBC image analysis. RedDino uses an RBC-specific adaptation of the DINOv2 self-supervised learning framework and is trained on a curated dataset of 1.25 million RBC images from diverse acquisition modalities and sources. Extensive evaluations show that RedDino outperforms existing state-of-the-art models on RBC shape classification. Through assessments including linear probing and nearest neighbor classification, we confirm its strong feature representations and generalization ability. Our main contributions are: (1) a foundation model tailored for RBC analysis, (2) ablation studies exploring DINOv2 configurations for RBC modeling, and (3) a detailed evaluation of generalization performance. RedDino addresses key challenges in computational hematology by capturing nuanced morphological features, advancing the development of reliable diagnostic tools. The source code and pretrained models for RedDino are available at https://github.com/Snarci/RedDino, and the pretrained models can be downloaded from our Hugging Face collection at https://huggingface.co/collections/Snarcy/reddino-689a13e29241d2e5690202fc