Deep Weakly-Supervised Learning Methods for Classification and Localization in Histology Images: A Survey
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Abstract (arXiv)
Using deep learning models to diagnose cancer from histology data presents several challenges. Cancer grading and localization of regions of interest (ROIs) in these images normally relies on both image- and pixel-level labels, the latter requiring a costly annotation process. Deep weakly-supervised object localization (WSOL) methods provide different strategies for low-cost training of deep learning models. Using only image-class annotations, these methods can be trained to classify an image, and yield class activation maps (CAMs) for ROI localization. This paper provides a review of state-of-art DL methods for WSOL. We propose a taxonomy where these methods are divided into bottom-up and top-down methods according to the information flow in models. Although the latter have seen limited progress, recent bottom-up methods are currently driving much progress with deep WSOL methods. Early works focused on designing different spatial pooling functions. However, these methods reached limited localization accuracy, and unveiled a major limitation -- the under-activation of CAMs which leads to high false negative localization. Subsequent works aimed to alleviate this issue and recover complete object. Representative methods from our taxonomy are evaluated and compared in terms of classification and localization accuracy on two challenging histology datasets. Overall, the results indicate poor localization performance, particularly for generic methods that were initially designed to process natural images. Methods designed to address the challenges of histology data yielded good results. However, all methods suffer from high false positive/negative localization. Four key challenges are identified for the application of deep WSOL methods in histology -- under/over activation of CAMs, sensitivity to thresholding, and model selection.
Key facts. Cited by 28 papers in the map (data through 7 Oct 2026). First posted on arXiv 8 Sep 2019.
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Citing papers per year: 2021: 3; 2022: 6; 2023: 7; 2024: 8; 2025: 3; 2026: 1.
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- 2021Cluster-to-Conquer: A Framework for End-to-End Multi-Instance Learning for Whole Slide Image Classificationcited by 65
- 2023A Review of Uncertainty Estimation and its Application in Medical Imagingcited by 59
- 2022Multiple Instance Learning for Digital Pathology: A Review on the State-of-the-Art, Limitations & Future Potentialcited by 54
- 2022Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classificationcited by 42
- 2023The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classificationcited by 41
- 2022DGMIL: Distribution Guided Multiple Instance Learning for Whole Slide Image Classificationcited by 40
- 2022Towards Label-efficient Automatic Diagnosis and Analysis: A Comprehensive Survey of Advanced Deep Learning-based Weakly-supervised, Semi-supervised and Self-supervised Techniques in Histopathological Image Analysiscited by 29
- 2021F-CAM: Full Resolution Class Activation Maps via Guided Parametric Upscalingcited by 26
- 2023Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Good Instance Classifier is All You Needcited by 21
- 2024Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classificationcited by 13
- 2022TCAM: Temporal Class Activation Maps for Object Localization in Weakly-Labeled Unconstrained Videoscited by 12
- 2024Guided Interpretable Facial Expression Recognition via Spatial Action Unit Cuescited by 11
16 more
- 2024Source-Free Domain Adaptation of Weakly-Supervised Object Localization Models for Histologycited by 9
- 2022Negative Evidence Matters in Interpretable Histology Image Classificationcited by 8
- 2023DiPS: Discriminative Pseudo-Label Sampling with Self-Supervised Transformers for Weakly Supervised Object Localizationcited by 8
- 2023CoLo-CAM: Class Activation Mapping for Object Co-Localization in Weakly-Labeled Unconstrained Videoscited by 7
- 2024Snuffy: Efficient Whole Slide Image Classifiercited by 6
- 2023TPMIL: Trainable Prototype Enhanced Multiple Instance Learning for Whole Slide Image Classificationcited by 5
- 2024A Realistic Protocol for Evaluation of Weakly Supervised Object Localizationcited by 5
- 2024Leveraging Transformers for Weakly Supervised Object Localization in Unconstrained Videoscited by 2
- 2024Spatial Action Unit Cues for Interpretable Deep Facial Expression Recognitioncited by 2
- 2025TeD-Loc: Text Distillation for Weakly Supervised Object Localizationcited by 2
- 2025PixelCAM: Pixel Class Activation Mapping for Histology Image Classification and ROI Localizationcited by 2
- 2024Advancing Histopathology with Deep Learning Under Data Scarcity: A Decade in Reviewcited by 1
- 2021SKID: Self-Supervised Learning for Knee Injury Diagnosis from MRI Datacited by 0
- 2023An Evaluation of Non-Contrastive Self-Supervised Learning for Federated Medical Image Analysiscited by 0
- 2025Weakly Semi-supervised Whole Slide Image Classification by Two-level Cross Consistency Supervisioncited by 0
- 2026Adaptation of Weakly Supervised Localization in Histopathology by Debiasing Predictionscited by 0
- 2026Adaptation of Weakly Supervised Localization in Histopathology by Debiasing Predictions12 Mar 2026
- 2025Weakly Semi-supervised Whole Slide Image Classification by Two-level Cross Consistency Supervision16 Apr 2025
- 2025PixelCAM: Pixel Class Activation Mapping for Histology Image Classification and ROI Localization31 Mar 2025
- 2025TeD-Loc: Text Distillation for Weakly Supervised Object Localization22 Jan 2025
- 2024Advancing Histopathology with Deep Learning Under Data Scarcity: A Decade in Review18 Oct 2024
- 2024Spatial Action Unit Cues for Interpretable Deep Facial Expression Recognition1 Oct 2024
- 2024Snuffy: Efficient Whole Slide Image Classifier15 Aug 2024
- 2024Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classification15 Jul 2024
- 2024Leveraging Transformers for Weakly Supervised Object Localization in Unconstrained Videos8 Jul 2024
- 2024Source-Free Domain Adaptation of Weakly-Supervised Object Localization Models for Histology29 Apr 2024
- 2024A Realistic Protocol for Evaluation of Weakly Supervised Object Localization15 Apr 2024
- 2024Guided Interpretable Facial Expression Recognition via Spatial Action Unit Cues1 Feb 2024
16 more
- 2023DiPS: Discriminative Pseudo-Label Sampling with Self-Supervised Transformers for Weakly Supervised Object Localization9 Oct 2023
- 2023Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Good Instance Classifier is All You Need5 Jul 2023
- 2023The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classification29 May 2023
- 2023TPMIL: Trainable Prototype Enhanced Multiple Instance Learning for Whole Slide Image Classification1 May 2023
- 2023CoLo-CAM: Class Activation Mapping for Object Co-Localization in Weakly-Labeled Unconstrained Videos16 Mar 2023
- 2023An Evaluation of Non-Contrastive Self-Supervised Learning for Federated Medical Image Analysis9 Mar 2023
- 2023A Review of Uncertainty Estimation and its Application in Medical Imaging16 Feb 2023
- 2022Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classification7 Oct 2022
- 2022TCAM: Temporal Class Activation Maps for Object Localization in Weakly-Labeled Unconstrained Videos30 Aug 2022
- 2022Towards Label-efficient Automatic Diagnosis and Analysis: A Comprehensive Survey of Advanced Deep Learning-based Weakly-supervised, Semi-supervised and Self-supervised Techniques in Histopathological Image Analysis18 Aug 2022
- 2022DGMIL: Distribution Guided Multiple Instance Learning for Whole Slide Image Classification17 Jun 2022
- 2022Multiple Instance Learning for Digital Pathology: A Review on the State-of-the-Art, Limitations & Future Potential9 Jun 2022
- 2022Negative Evidence Matters in Interpretable Histology Image Classification7 Jan 2022
- 2021F-CAM: Full Resolution Class Activation Maps via Guided Parametric Upscaling15 Sep 2021
- 2021SKID: Self-Supervised Learning for Knee Injury Diagnosis from MRI Data21 Apr 2021
- 2021Cluster-to-Conquer: A Framework for End-to-End Multi-Instance Learning for Whole Slide Image Classification19 Mar 2021
- 2021Cluster-to-Conquer: A Framework for End-to-End Multi-Instance Learning for Whole Slide Image Classificationcited by 65
- 2023A Review of Uncertainty Estimation and its Application in Medical Imagingcited by 59
- 2022Multiple Instance Learning for Digital Pathology: A Review on the State-of-the-Art, Limitations & Future Potentialcited by 54
- 2022Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classificationcited by 42
- 2023The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classificationcited by 41
- 2022DGMIL: Distribution Guided Multiple Instance Learning for Whole Slide Image Classificationcited by 40
- 2022Towards Label-efficient Automatic Diagnosis and Analysis: A Comprehensive Survey of Advanced Deep Learning-based Weakly-supervised, Semi-supervised and Self-supervised Techniques in Histopathological Image Analysiscited by 29
- 2021F-CAM: Full Resolution Class Activation Maps via Guided Parametric Upscalingcited by 26
- 2023Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Good Instance Classifier is All You Needcited by 21
- 2024Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classificationcited by 13
- 2022TCAM: Temporal Class Activation Maps for Object Localization in Weakly-Labeled Unconstrained Videoscited by 12
- 2024Guided Interpretable Facial Expression Recognition via Spatial Action Unit Cuescited by 11
12 most cited of 28 All 28 (JSON)
- 2026Adaptation of Weakly Supervised Localization in Histopathology by Debiasing Predictions12 Mar 2026
- 2025Weakly Semi-supervised Whole Slide Image Classification by Two-level Cross Consistency Supervision16 Apr 2025
- 2025PixelCAM: Pixel Class Activation Mapping for Histology Image Classification and ROI Localization31 Mar 2025
- 2025TeD-Loc: Text Distillation for Weakly Supervised Object Localization22 Jan 2025
- 2024Advancing Histopathology with Deep Learning Under Data Scarcity: A Decade in Review18 Oct 2024
- 2024Spatial Action Unit Cues for Interpretable Deep Facial Expression Recognition1 Oct 2024
- 2024Snuffy: Efficient Whole Slide Image Classifier15 Aug 2024
- 2024Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classification15 Jul 2024
- 2024Leveraging Transformers for Weakly Supervised Object Localization in Unconstrained Videos8 Jul 2024
- 2024Source-Free Domain Adaptation of Weakly-Supervised Object Localization Models for Histology29 Apr 2024
- 2024A Realistic Protocol for Evaluation of Weakly Supervised Object Localization15 Apr 2024
- 2024Guided Interpretable Facial Expression Recognition via Spatial Action Unit Cues1 Feb 2024
12 newest of 28 All 28 (JSON)