以患者为单位构建病理图像模型,提升跨任务泛化能力。
MOOZY: A Patient-First Foundation Model for Computational Pathology
- 用患者整体而非单张切片作为核心表示,通过病例变换器建模多切片关系。
- 在16个任务上比PRISM提升4.19%~6.95%,参数量仅为GigaPath的1/14。
- 适合需要患者级分析的临床研究,尤其关注可扩展性与低成本训练。
计算病理学需要能在多种临床任务间迁移的全切片图像(WSI)基础模型,但现有方法多聚焦于切片级别,依赖私有数据和昂贵的配对报告监督,且未显式建模同一患者多张切片间的关系。我们提出MOOZY,一种以患者为中心的病理基础模型,将患者病例作为表征的核心单元。在预训练中,通过病例变换器显式建模同一患者所有切片间的依赖关系,结合多阶段自监督与低成本任务监督。第一阶段在77,134张公开切片特征图上,使用掩码自蒸馏训练仅视觉的切片编码器;第二阶段利用病例变换器,通过来自56个公开数据集的333项任务(含205个分类和128个生存预测任务,覆盖四个终点)进行多任务监督对齐。在16个保留任务上,相比PRISM,MOOZY在宏加权F1、平衡准确率和宏加权ROC-AUC上分别提升+4.19%、+7.93%和+6.95%。此外,MOOZY仅含8577万参数,是GigaPath的14倍小。结果表明,患者级预训练能生成可迁移的嵌入,为可扩展的患者优先组织病理基础模型提供路径。
原文摘要 · Abstract (English)
Computational pathology needs whole-slide image (WSI) foundation models that transfer across diverse clinical tasks, yet current approaches remain largely slide-centric, often depend on private data and expensive paired-report supervision, and do not explicitly model relationships among multiple slides from the same patient. We present MOOZY, a patient-first pathology foundation model in which the patient case, not the individual slide, is the core unit of representation. MOOZY explicitly models dependencies across all slides from the same patient via a case transformer during pretraining, combining multi-stage self-supervision with scaled low-cost task supervision. In Stage 1, we pretrain a vision-only slide encoder on 77,134 public slide feature grids using masked self-distillation. In Stage 2, we align these representations with clinical semantics using a case transformer and multi-task supervision over 333 tasks from 56 public datasets, including 205 classification and 128 survival tasks across four endpoints. Across sixteen held-out tasks, MOOZY improves macro weighted F1, balanced accuracy, and macro weighted ROC-AUC relative to PRISM by +4.19\%, +7.93\%, and +6.95\%, respectively. MOOZY is also parameter efficient with 85.77M parameters, 14$\times$ smaller than GigaPath. These results suggest that patient-level pretraining yields transferable embeddings, providing a path toward scalable patient-first histopathology foundation models.
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