用锚点引导证据学习,提升病理患者级预测准确性
AGE-MIL: Anchor-Guided Evidence Learning for Patient-Level Prediction

- 以患者级锚点整合多张切片信息,引导关键病灶检索
- 在六个任务中均优于8种先进MIL方法,提升预测稳定性
- 适合需要多切片融合的临床病理诊断研究者
现有计算病理方法主要基于全切片图像(WSI)层面的多重实例学习(MIL),而患者级建模仍缺乏探索。实际病理诊断中,医生需综合多个WSI的信息做出判断,而非依赖单一切片。这一差异导致直接将患者级监督施加于传统MIL框架时,常引发优化不稳定和预测可靠性下降。为此,我们提出锚点引导证据学习(AGE-MIL),一种用于患者级预测的弱监督框架。该方法从切片表示构建患者级锚点,捕捉全局病理上下文,并引导诊断相关局部区域的检索与融合,实现稳健的患者级建模。患者风险进一步建模为证据累积过程,增强弱监督下的优化稳定性。AGE-MIL在两个独立队列的六个临床相关患者级预测任务上进行评估,结果表明其持续优于八种先进MIL方法。代码已开源:https://github.com/wodeniua/AGE-MIL。
原文摘要 · Abstract (English)
Existing computational pathology methods predominantly operate within whole-slide image (WSI)-level multiple instance learning (MIL) paradigms, while patient-level modeling remains underexplored. In routine pathological practice, however, pathologists derive diagnostic and prognostic conclusions by integrating evidence across multiple WSIs rather than relying on any single slide. This discrepancy creates a fundamental misalignment when patient-level supervision is directly imposed on conventional MIL frameworks, often leading to unstable optimization and degraded predictive reliability. To address this issue, we propose Anchor-Guided Evidence MIL (AGE-MIL), a weakly supervised framework for patient-level prediction. AGE-MIL constructs a patient-level anchor from slide representations to capture global pathological context and guide the retrieval and integration of diagnostically relevant local patches, enabling robust patient-level modeling. Patient-level risk is further modeled as an evidence accumulation process, promoting stable optimization under weak supervision. AGE-MIL is evaluated on six clinically relevant patient-level prediction tasks from two independent cohorts. Experimental results show that the proposed framework consistently outperforms eight state-of-the-art MIL methods. Code is available at https://github.com/wodeniua/AGE-MIL.
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