FMaMIL: Frequency-Driven Mamba Multi-Instance Learning for Weakly Supervised Lesion Segmentation in Medical Images

Accurate lesion segmentation in histopathology images is essential for diagnostic interpretation and quantitative analysis, yet it remains challenging due to the limited availability of costly pixel-level annotations. To address this, we propose FMaMIL, a novel two-stage framework for weakly supervised lesion segmentation based solely on image-level labels. In the first stage, a lightweight Mamba-based encoder is introduced to capture long-range dependencies across image patches under the MIL paradigm. To enhance spatial sensitivity and structural awareness, we design a learnable frequency-domain encoding module that supplements spatial-domain features with spectrum-based information. CAMs generated in this stage are used to guide segmentation training. In the second stage, we refine the initial pseudo labels via a CAM-guided soft-label supervision and a self-correction mechanism, enabling robust training even under label noise. Extensive experiments on both public and private histopathology datasets demonstrate that FMaMIL outperforms state-of-the-art weakly supervised methods without relying on pixel-level annotations, validating its effectiveness and potential for digital pathology applications.

DSAGL: Dual-Stream Attention-Guided Learning for Weakly Supervised Whole Slide Image Classification

Whole-slide images (WSIs) are critical for cancer diagnosis due to their ultra-high resolution and rich semantic content. However, their massive size and the limited availability of fine-grained annotations pose substantial challenges for conventional supervised learning. We propose DSAGL (Dual-Stream Attention-Guided Learning), a novel weakly supervised classification framework that combines a teacher-student architecture with a dual-stream design. DSAGL explicitly addresses instance-level ambiguity and bag-level semantic consistency by generating multi-scale attention-based pseudo labels and guiding instance-level learning. A shared lightweight encoder (VSSMamba) enables efficient long-range dependency modeling, while a fusion-attentive module (FASA) enhances focus on sparse but diagnostically relevant regions. We further introduce a hybrid loss to enforce mutual consistency between the two streams. Experiments on CIFAR-10, NCT-CRC, and TCGA-Lung datasets demonstrate that DSAGL consistently outperforms state-of-the-art MIL baselines, achieving superior discriminative performance and robustness under weak supervision.