arXiv:2501.18055cs.LGcs.AI2025-01被引 63

现有病理模型易受医院差异干扰,影响临床可靠性。

Current Pathology Foundation Models are unrobust to Medical Center Differences

  • 提出鲁棒性指数,量化生物特征与医院差异的主导关系。
  • 十款模型中仅一款鲁棒性略高于1,说明生物特征占优有限。
  • 模型嵌入空间按医院而非病种组织,适合关注泛化能力的研究者。

病理基础模型(FMs)在医疗领域前景广阔,但其临床应用前需确保对不同医疗机构间差异具有鲁棒性。本文评估当前十款公开可用的病理基础模型,是否聚焦于组织、癌症类型等生物学特征,还是受染色流程等医院特异性因素干扰。引入鲁棒性指数,衡量生物学特征相对于混杂因素的主导程度。结果表明,所有模型均显著反映医院特征;仅一款模型的鲁棒性指数超过1,且仅略微占优。研究还提出定量方法分析医院差异对模型性能的影响,发现癌症分类错误并非随机,而是特定由同源医院图像导致。可视化嵌入空间显示,模型表征更依附于医院而非生物学属性,导致医院来源预测精度高于组织或癌症类型。该鲁棒性指数旨在推动可靠病理模型的临床落地。

原文摘要 · Abstract (English)

Pathology Foundation Models (FMs) hold great promise for healthcare. Before they can be used in clinical practice, it is essential to ensure they are robust to variations between medical centers. We measure whether pathology FMs focus on biological features like tissue and cancer type, or on the well known confounding medical center signatures introduced by staining procedure and other differences. We introduce the Robustness Index. This novel robustness metric reflects to what degree biological features dominate confounding features. Ten current publicly available pathology FMs are evaluated. We find that all current pathology foundation models evaluated represent the medical center to a strong degree. Significant differences in the robustness index are observed. Only one model so far has a robustness index greater than one, meaning biological features dominate confounding features, but only slightly. A quantitative approach to measure the influence of medical center differences on FM-based prediction performance is described. We analyze the impact of unrobustness on classification performance of downstream models, and find that cancer-type classification errors are not random, but specifically attributable to same-center confounders: images of other classes from the same medical center. We visualize FM embedding spaces, and find these are more strongly organized by medical centers than by biological factors. As a consequence, the medical center of origin is predicted more accurately than the tissue source and cancer type. The robustness index introduced here is provided with the aim of advancing progress towards clinical adoption of robust and reliable pathology FMs.

病理模型鲁棒性医疗中心差异基础模型

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