解决病理切片多专家标注不一致问题,提升诊断准确性。
RaLMPH: Reliability-aware Learning for Multi-Pathologist Harmonization in Whole-Slide Image Classification

- 引入可靠性场,融合局部特征与专家不确定性判断可信区域。
- 在六位专家标注数据上表现优于现有方法,显著提升分类性能。
- 适合临床病理图像分析中需处理专家分歧的场景。
全切片图像(WSI)分析中,多重实例学习(MIL)是主流范式,但多数方法假设每张切片只有一个“金标准”标签,与临床中多位病理专家意见不一致的实际情况不符。现有多标注者学习和标签优化方法通常估计全局标注者可靠性或依赖单实例假设,难以适应MIL及局部诊断场景。本文提出RaLMPH(可靠性感知的多病理专家协同框架),一种基于MIL的多专家标注协调方法。RaLMPH引入可靠性场,联合建模WSI特征空间中的局部邻域结构与专家不确定性(熵),实现对每个样本可信参考邻域的精准识别。基于该可靠性场,模型执行样本级局部标注者排序,为每张切片选取可靠意见,并通过自适应门控机制融合标签,条件依赖于局部可靠性。在包含六位病理专家标注的临床WSI数据集及受控模拟基准上的实验表明,RaLMPH持续优于现有方法。进一步分析揭示了其可靠性感知机制如何改善标签协调并提升下游MIL性能。
原文摘要 · Abstract (English)
Multiple Instance Learning (MIL) is a standard paradigm for Whole-Slide Image (WSI) analysis and has achieved strong results in computational pathology. However, most MIL pipelines assume a single "gold" label per slide, which conflicts with clinical practice where substantial inter-pathologist variability is common. Existing multi-annotator learning and label-refinement methods typically estimate global annotator reliability or rely on single-instance assumptions, making them poorly suited to MIL and to localized diagnostic contexts where experts disagree. We propose RaLMPH (Reliability-aware Learning for Multi-Pathologist Harmonization), a MIL-based label reconciliation framework for WSIs annotated by multiple pathologists. RaLMPH introduces a reliability field that jointly models (i) local neighborhood structure in WSI feature space and (ii) expert uncertainty (entropy), enabling per-sample identification of trustworthy reference neighborhoods. Leveraging this field, RaLMPH performs sample-wise local annotator ranking to select reliable opinions per slide and applies an adaptive gating mechanism to fuse labels conditioned on local reliability. Experiments on a clinical WSI dataset with labels from six pathologists, as well as controlled simulated benchmarks, show that RaLMPH consistently outperforms existing approaches. Further analyses clarify how our reliability-aware mechanism improves label reconciliation and downstream MIL performance.
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