Abstract:Whole slide image (WSI) analysis is central to computational pathology, with multiple instance learning (MIL) emerging as the standard pipeline for slide-level diagnosis. However, conventional approaches formulate WSI diagnosis as a flat classification task over discrete labels, contradicting the inherently hierarchical, coarse-to-fine nature of clinical reasoning. Although recent hierarchical classifiers and vision-language models (VLMs) have sought to address this structural gap, they either fail to capture semantic continuity between related diagnoses or suffer from unconstrained text generation that produces taxonomic hallucinations and parent-child label violations. To address these limitations, we propose TaxoMIL, a taxonomy-constrained framework that reformulates WSI diagnosis as a multi-granularity text generation task. TaxoMIL utilizes a dual-head Transformer decoder to generate coarse- and fine-level diagnostic text, and introduces taxonomy-guided objectives that explicitly structure the label embedding space and strictly ground slide-level visual representations within the clinical taxonomy. Extensive experiments across three diverse WSI datasets demonstrate that TaxoMIL consistently outperforms state-of-the-art MIL classifiers and VLM-based generative methods, yielding accurate and hierarchy-aware diagnostic predictions. The code is released at https://github.com/QuIIL/TaxoMIL
Abstract:Whole-slide image analysis is essential for diagnostic tasks in pathology, yet existing deep learning methods primarily rely on flat classification, ignoring hierarchical relationships among class labels. In this study, we propose HiClass, a hierarchical classification framework for improved histopathology image analysis, that enhances both coarse-grained and fine-grained WSI classification. Built based upon a multiple instance learning approach, HiClass extends it by introducing bidirectional feature integration that facilitates information exchange between coarse-grained and fine-grained feature representations, effectively learning hierarchical features. Moreover, we introduce tailored loss functions, including hierarchical consistency loss, intra- and inter-class distance loss, and group-wise cross-entropy loss, to further optimize hierarchical learning. We assess the performance of HiClass on a gastric biopsy dataset with 4 coarse-grained and 14 fine-grained classes, achieving superior classification performance for both coarse-grained classification and fine-grained classification. These results demonstrate the effectiveness of HiClass in improving WSI classification by capturing coarse-grained and fine-grained histopathological characteristics.
Abstract:Anomaly detection is an emerging approach in digital pathology for its ability to efficiently and effectively utilize data for disease diagnosis. While supervised learning approaches deliver high accuracy, they rely on extensively annotated datasets, suffering from data scarcity in digital pathology. Unsupervised anomaly detection, however, offers a viable alternative by identifying deviations from normal tissue distributions without requiring exhaustive annotations. Recently, denoising diffusion probabilistic models have gained popularity in unsupervised anomaly detection, achieving promising performance in both natural and medical imaging datasets. Building on this, we incorporate a vision-language model with a diffusion model for unsupervised anomaly detection in digital pathology, utilizing histopathology prompts during reconstruction. Our approach employs a set of pathology-related keywords associated with normal tissues to guide the reconstruction process, facilitating the differentiation between normal and abnormal tissues. To evaluate the effectiveness of the proposed method, we conduct experiments on a gastric lymph node dataset from a local hospital and assess its generalization ability under domain shift using a public breast lymph node dataset. The experimental results highlight the potential of the proposed method for unsupervised anomaly detection across various organs in digital pathology. Code: https://github.com/QuIIL/AnoPILaD.