NOVA: An Agentic Framework for Automated Histopathology Analysis and Discovery

Digitized histopathology analysis involves complex, time-intensive workflows and specialized expertise, limiting its accessibility. We introduce NOVA, an agentic framework that translates scientific queries into executable analysis pipelines by iteratively generating and running Python code. NOVA integrates 49 domain-specific tools (e.g., nuclei segmentation, whole-slide encoding) built on open-source software, and can also create new tools ad hoc. To evaluate such systems, we present SlideQuest, a 90-question benchmark -- verified by pathologists and biomedical scientists -- spanning data processing, quantitative analysis, and hypothesis testing. Unlike prior biomedical benchmarks focused on knowledge recall or diagnostic QA, SlideQuest demands multi-step reasoning, iterative coding, and computational problem solving. Quantitative evaluation shows NOVA outperforms coding-agent baselines, and a pathologist-verified case study links morphology to prognostically relevant PAM50 subtypes, demonstrating its scalable discovery potential.

Giga-SSL: Self-Supervised Learning for Gigapixel Images

Whole slide images (WSI) are microscopy images of stained tissue slides routinely prepared for diagnosis and treatment selection in medical practice. WSI are very large (gigapixel size) and complex (made of up to millions of cells). The current state-of-the-art (SoTA) approach to classify WSI subdivides them into tiles, encodes them by pre-trained networks and applies Multiple Instance Learning (MIL) to train for specific downstream tasks. However, annotated datasets are often small, typically a few hundred to a few thousand WSI, which may cause overfitting and underperforming models. Conversely, the number of unannotated WSI is ever increasing, with datasets of tens of thousands (soon to be millions) of images available. While it has been previously proposed to use these unannotated data to identify suitable tile representations by self-supervised learning (SSL), downstream classification tasks still require full supervision because parts of the MIL architecture is not trained during tile level SSL pre-training. Here, we propose a strategy of slide level SSL to leverage the large number of WSI without annotations to infer powerful slide representations. Applying our method to The Cancer-Genome Atlas, one of the most widely used data resources in cancer research (16 TB image data), we are able to downsize the dataset to 23 MB without any loss in predictive power: we show that a linear classifier trained on top of these embeddings maintains or improves previous SoTA performances on various benchmark WSI classification tasks. Finally, we observe that training a classifier on these representations with tiny datasets (e.g. 50 slides) improved performances over SoTA by an average of +6.3 AUC points over all downstream tasks.