让模型像病理医生一样,只关注关键组织区域,提升病理图像问答效率与准确率。
Act Like a Pathologist: Tissue-Aware Whole Slide Image Reasoning
- 根据问题引导,分步筛选关键组织区域和高信息量切片。
- 视觉标记使用减少70%,在3个病理问答任务中准确率提升。
- 适合需要可解释性与高效推理的医学AI研究者与临床辅助系统开发。
近年来,计算病理学快速发展,得益于领域专用图像编码器及视觉语言模型在疾病自然语言问答中的应用。然而,病理问答的核心问题仍未解决:一张吉字节级幻灯片包含的信息远超回答特定问题所需。病理医生会先整体扫描,再根据临床问题选择性放大关键区域。现有模型则依赖均匀采样或全局注意力,对无关区域同样关注,遗漏关键视觉证据。本文提出一种问题引导、组织感知、由粗到精的检索框架HistoSelect,包含两部分:群体采样器识别问题相关组织区域,随后的切片选择器从中提取最信息丰富的切片。该方法仅选取高信息量切片,平均减少70%的视觉标记使用量,同时在3个病理问答任务中提升准确率。在356,000个问答对上评估,表现优于现有方法,且答案基于可解释、与病理医生一致的区域。结果表明,将人类搜索与注意力模式融入全幻灯片图像推理,是构建实用可靠病理视觉语言模型的可行方向。代码已开源。
原文摘要 · Abstract (English)
Computational pathology has advanced rapidly in recent years, driven by domain-specific image encoders and growing interest in using vision-language models to answer natural-language questions about diseases. Yet, the core problem behind pathology question-answering remains unsolved, considering that a gigapixel slide contains far more information than necessary for a given question. Pathologists naturally navigate tissue and morphology complexity by scanning broadly, and zooming in selectively according to the clinical questions. Current models, in contrast, rely on uniform patch sampling or broad attention maps, often attending equally to irrelevant regions while overlooking key visual evidence. In this work, we try to bring models closer to how humans actually examine slides. We propose a question-guided, tissue-aware, and coarse-to-fine retrieval framework, HistoSelect, that consists of two key components: a group sampler that identifies question-relevant tissue regions, followed by a patch selector that retrieves the most informative patches within those regions. By selecting only the most informative patches, our method becomes significantly more efficient: reducing visual token usage by 70% on average, while improving accuracy across three pathology QA tasks. Evaluated on 356,000 question-answer pairs, our approach outperforms existing methods and produces answers grounded in interpretable, pathologist-consistent regions. Our results suggest that bringing human-like search and attention patterns into WSI reasoning is a promising direction for building practical and reliable pathology VLMs. Code is available at https://github.com/winston52/HistoSelect.
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