A deep learning framework for efficient pathology image analysis

Artificial intelligence (AI) has transformed digital pathology by enabling biomarker prediction from high-resolution whole slide images (WSIs). However, current methods are computationally inefficient, processing thousands of redundant tiles per WSI and requiring complex aggregator models. We introduce EAGLE (Efficient Approach for Guided Local Examination), a deep learning framework that emulates pathologists by selectively analyzing informative regions. EAGLE incorporates two foundation models: CHIEF for efficient tile selection and Virchow2 for extracting high-quality features. Benchmarking was conducted against leading slide- and tile-level foundation models across 31 tasks from four cancer types, spanning morphology, biomarker prediction and prognosis. EAGLE outperformed state-of-the-art foundation models by up to 23% and achieved the highest AUROC overall. It processed a slide in 2.27 seconds, reducing computational time by more than 99% compared to existing models. This efficiency enables real-time workflows, allows pathologists to validate all tiles which are used by the model during analysis, and eliminates dependence on high-performance computing, making AI-powered pathology more accessible. By reliably identifying meaningful regions and minimizing artifacts, EAGLE provides robust and interpretable outputs, supporting rapid slide searches, integration into multi-omics pipelines and emerging clinical foundation models.

PD-L1 Classification of Weakly-Labeled Whole Slide Images of Breast Cancer

Specific and effective breast cancer therapy relies on the accurate quantification of PD-L1 positivity in tumors, which appears in the form of brown stainings in high resolution whole slide images (WSIs). However, the retrieval and extensive labeling of PD-L1 stained WSIs is a time-consuming and challenging task for pathologists, resulting in low reproducibility, especially for borderline images. This study aims to develop and compare models able to classify PD-L1 positivity of breast cancer samples based on WSI analysis, relying only on WSI-level labels. The task consists of two phases: identifying regions of interest (ROI) and classifying tumors as PD-L1 positive or negative. For the latter, two model categories were developed, with different feature extraction methodologies. The first encodes images based on the colour distance from a base color. The second uses a convolutional autoencoder to obtain embeddings of WSI tiles, and aggregates them into a WSI-level embedding. For both model types, features are fed into downstream ML classifiers. Two datasets from different clinical centers were used in two different training configurations: (1) training on one dataset and testing on the other; (2) combining the datasets. We also tested the performance with or without human preprocessing to remove brown artefacts Colour distance based models achieve the best performances on testing configuration (1) with artefact removal, while autoencoder-based models are superior in the remaining cases, which are prone to greater data variability.