arXiv:2609.02390eess.IVcs.CV2026-09

即使只看非病变组织,模型仍能识别疾病,突破传统诊断盲区。

Seeing Beyond the Lesion: Disease Recognition from Reactive CNS Tissue

论文配图:Seeing Beyond the Lesion: Disease Recognition from Reactive CNS Tissue
图 1 · 摘自论文原文
  • 用多实例学习框架,将病理切片分成小块并提取特征
  • 在245张切片上,模型准确识别出疾病类别,显著高于随机水平
  • 结果表明:非病变组织中仍有可被识别的微弱疾病信号

大量颅内活检因取样误差仅获取反应性、非病灶脑实质,导致疾病无法确诊。我们基于245张全切片图像(来自186名患者,有明确后续诊断)评估了四种病理基础模型(UNI2-h, Virchow2, Prov-GigaPath, H-optimus-0)作为冻结的补丁编码器,在共享注意力机制的多实例学习框架中的表现。结果表明,粗粒度疾病分类可由切片大小基本解释;但在限制于常见组织类别内的三个更细分类后,该混淆因素不再成立,而疾病标签在置换检验中仍显著优于随机水平(p ≤ 10⁻⁴)。令人惊讶的是,所有基础模型编码器性能无统计差异,说明当前补丁表示能力并未限制对微弱形态学信号的恢复。通过带符号实例贡献图与专家评审,验证预测证据是否定位在反应性实质而非采样引入的血液等偏倚。研究强调,在计算病理基准中,应以仅依赖来源信息的基线进行采集捷径审计,并证明:一旦排除该混杂因素,弱监督模型仍能从传统视为非诊断性的组织中恢复疾病信号。

原文摘要 · Abstract (English)

Sampling error yields exclusively reactive, non-lesional brain parenchyma in a significant proportion of intracranial biopsies, leaving the underlying disease undiagnosed. We benchmark four pathology foundation models (UNI2-h, Virchow2, Prov-GigaPath, H-optimus-0) as frozen patch encoders within a shared attention-based multiple-instance learning framework using 245 whole-slide images from 186 patients with confirmed downstream diagnoses. We first show that coarse disease-category prediction can be reproduced largely from slide size alone. After restricting classification to three finer diagnostic distinctions within common tissue categories, this confound no longer explains performance, yet disease labels remain predictable above chance under permutation testing (p $\le 10^{-4}$ throughout). Surprisingly, performance is statistically indistinguishable across all foundation-model encoders, suggesting that recovering these weak morphological signatures is not limited by current patch representations. Signed instance-contribution maps and expert review further test whether predictive evidence localizes to reactive parenchyma rather than sampling-induced bias like blood introduced during tissue sampling. These results position acquisition-shortcut auditing via a provenance-only baseline as a necessary control in computational-pathology benchmarks, and show, once that confound is removed, that weakly supervised models still recover disease signal from tissue conventionally regarded as non-diagnostic.

病理分析弱监督模型鲁棒性

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