arXiv:2605.23559cs.CVcs.AI2026-05被引 3

无需训练的病理图像问答系统,通过意外度扫描发现异常区域

PathNavigate: A Training-Free Pathology Agent with Surprise-Guided Scan and Shared Slide Memory for Whole-Slide Image VQA

论文配图:PathNavigate: A Training-Free Pathology Agent with Surprise-Guided Scan and Shared Slide Memory for Whole-Slide Image VQA
图 1 · 摘自论文原文
  • 先低倍扫描生成异常区域热力图,再聚焦提问相关区域
  • 在多个数据集上准确率提升,且推理效率更高
  • 适合临床辅助诊断场景,无需重新训练

全切片图像视觉问答(WSI-VQA)将病理分析视为极端上下文搜索问题:回答自由形式的临床问题,需在严格检查预算下从千兆像素切片中定位稀疏的高分辨率证据。现有方法主要分为两类:一是监督式病理多模态大语言模型与智能体,虽可融合定位与推理,但依赖任务特定标注和重训练,实用性受限;二是无训练路径智能体,保持核心模型冻结,但常采用问题优先设计,仅依据提问相关性构建候选集,可能遗漏未被提及的关键形态特征,导致推理负担加重。为此,本文提出 PathNavigate,一种基于‘扫描-搜索-读出’流程的无训练病理智能体。它先在低倍下扫描切片,利用共享在线记忆模块对冻结的病理特征进行处理,生成滑片特异的‘意外度场’,标记异常区域池;随后仅在该池内应用提问条件下的PLIP相关性筛选高倍率搜索目标;最后通过冻结的感知器-仲裁器堆栈提取局部高倍证据并作答,使用同一在线记忆作为滑片级上下文。在WSI-VQA与SlideBench-BCNB上的实验表明,该设计显著提升答案准确率,证据选择轨迹更具可解释性,且效率更高。代码已公开。

原文摘要 · Abstract (English)

Whole-slide image visual question answering (WSI-VQA) frames pathology as an extreme-context search problem: to answer a free-form clinical query, a system must first navigate a gigapixel slide under a strict inspection budget to locate sparse, high-resolution evidence. Existing approaches largely fall into two paradigms: i) supervised pathology multimodal large language models (MLLMs) and agents can absorb localization and reasoning into learned modules, but they often couple navigation to task-specific supervision and retraining, limiting their practicality; ii) training-free pathology agents avoid this cost by keeping core models frozen, but often follow a question-first design, constructing the initial candidate set mainly from query-conditioned relevance. This can miss decisive morphology that is not named in the question, and force heavier inference-time scaffolding. To address this challenge, we introduce PathNavigate, a training-free pathology agent built around a scan-search-readout routine. Before question matching, PathNavigate scans the current slide at low magnification with a shared online memory module over frozen pathology features, producing a slide-specific surprise field that marks an abnormal-region pool. It then applies question-conditioned PLIP relevance only within this pool to select high-magnification search targets. Finally, it extracts local high-magnification evidence and answers with a frozen perceptor-adjudicator stack, using the same online memory as slide-level context. Experiments on WSI-VQA and SlideBench-BCNB show that the proposed scan-search-readout design improves answer accuracy and yields more interpretable evidence-selection trajectories with higher efficiency.The code is available online.

病理图像无训练视觉问答智能体

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