Whole Slide Images based Cancer Survival Prediction using Attention Guided Deep Multiple Instance Learning Networks
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Abstract (arXiv)
Traditional image-based survival prediction models rely on discriminative patch labeling which make those methods not scalable to extend to large datasets. Recent studies have shown Multiple Instance Learning (MIL) framework is useful for histopathological images when no annotations are available in classification task. Different to the current image-based survival models that limit to key patches or clusters derived from Whole Slide Images (WSIs), we propose Deep Attention Multiple Instance Survival Learning (DeepAttnMISL) by introducing both siamese MI-FCN and attention-based MIL pooling to efficiently learn imaging features from the WSI and then aggregate WSI-level information to patient-level. Attention-based aggregation is more flexible and adaptive than aggregation techniques in recent survival models. We evaluated our methods on two large cancer whole slide images datasets and our results suggest that the proposed approach is more effective and suitable for large datasets and has better interpretability in locating important patterns and features that contribute to accurate cancer survival predictions. The proposed framework can also be used to assess individual patient's risk and thus assisting in delivering personalized medicine. Codes are available at https://github.com/uta-smile/DeepAttnMISL_MEDIA.
Key facts. Cited by 178 papers in the map (data through 7 Oct 2026). First posted on arXiv 23 Sep 2020.
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Citing papers per year: 2021: 14; 2022: 24; 2023: 37; 2024: 39; 2025: 48; 2026: 16.
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- 2022Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learningcited by 357
- 2021Whole Slide Images are 2D Point Clouds: Context-Aware Survival Prediction using Patch-based Graph Convolutional Networkscited by 124
- 2023Modeling Dense Multimodal Interactions Between Biological Pathways and Histology for Survival Predictioncited by 92
- 2023Interventional Bag Multi-Instance Learning On Whole-Slide Pathological Imagescited by 91
- 2023Multimodal Optimal Transport-based Co-Attention Transformer with Global Structure Consistency for Survival Predictioncited by 86
- 2023Cross-Modal Translation and Alignment for Survival Analysiscited by 70
- 2024Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathologycited by 70
- 2024Feature Re-Embedding: Towards Foundation Model-Level Performance in Computational Pathologycited by 66
- 2021Cluster-to-Conquer: A Framework for End-to-End Multi-Instance Learning for Whole Slide Image Classificationcited by 65
- 2023Attention-Challenging Multiple Instance Learning for Whole Slide Image Classificationcited by 61
- 2021Hierarchical Graph Representations in Digital Pathologycited by 58
- 2022Additive MIL: Intrinsically Interpretable Multiple Instance Learning for Pathologycited by 58
38 more
- 2022Multiple Instance Learning for Digital Pathology: A Review on the State-of-the-Art, Limitations & Future Potentialcited by 54
- 2024Transcriptomics-guided Slide Representation Learning in Computational Pathologycited by 50
- 2024Multimodal Prototyping for cancer survival predictioncited by 47
- 2022Differentiable Zooming for Multiple Instance Learning on Whole-Slide Imagescited by 43
- 2022Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classificationcited by 42
- 2023A General-Purpose Self-Supervised Model for Computational Pathologycited by 42
- 2023The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classificationcited by 41
- 2024Prototypical Information Bottlenecking and Disentangling for Multimodal Cancer Survival Predictioncited by 41
- 2022Deep Multi-modal Fusion of Image and Non-image Data in Disease Diagnosis and Prognosis: A Reviewcited by 37
- 2022ReMix: A General and Efficient Framework for Multiple Instance Learning based Whole Slide Image Classificationcited by 30
- 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
- 2022Transformer based multiple instance learning for weakly supervised histopathology image segmentationcited by 26
- 2022AdvMIL: Adversarial Multiple Instance Learning for the Survival Analysis on Whole-Slide Imagescited by 24
- 2023Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Good Instance Classifier is All You Needcited by 21
- 2023HIGT: Hierarchical Interaction Graph-Transformer for Whole Slide Image Analysiscited by 17
- 2021MHAttnSurv: Multi-Head Attention for Survival Prediction Using Whole-Slide Pathology Imagescited by 15
- 2023Rotation-Agnostic Image Representation Learning for Digital Pathologycited by 15
- 2023Label-Efficient Deep Learning in Medical Image Analysis: Challenges and Future Directionscited by 14
- 2023HVTSurv: Hierarchical Vision Transformer for Patient-Level Survival Prediction from Whole Slide Imagecited by 14
- 2024Interpretable Vision-Language Survival Analysis with Ordinal Inductive Bias for Computational Pathologycited by 14
- 2022Interventional Multi-Instance Learning with Deconfounded Instance-Level Predictioncited by 13
- 2023CAMIL: Context-Aware Multiple Instance Learning for Cancer Detection and Subtyping in Whole Slide Imagescited by 13
- 2024PathM3: A Multimodal Multi-Task Multiple Instance Learning Framework for Whole Slide Image Classification and Captioningcited by 13
- 2024Cohort-Individual Cooperative Learning for Multimodal Cancer Survival Analysiscited by 13
- 2024Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classificationcited by 13
- 2023Masked Pre-Training of Transformers for Histology Image Analysiscited by 12
- 2024Rethinking Transformer for Long Contextual Histopathology Whole Slide Image Analysiscited by 12
- 2023Cross-scale Multi-instance Learning for Pathological Image Diagnosiscited by 11
- 2025Multimodal Cancer Survival Analysis via Hypergraph Learning with Cross-Modality Rebalancecited by 11
- 2022DSCA: A Dual-Stream Network with Cross-Attention on Whole-Slide Image Pyramids for Cancer Prognosiscited by 10
- 2024AEM: Attention Entropy Maximization for Multiple Instance Learning based Whole Slide Image Classificationcited by 10
- 2024Benchmarking Embedding Aggregation Methods in Computational Pathology: A Clinical Data Perspectivecited by 10
- 2024Aligning Knowledge Concepts to Whole Slide Images for Precise Histopathology Image Analysiscited by 10
- 2023MulGT: Multi-task Graph-Transformer with Task-aware Knowledge Injection and Domain Knowledge-driven Pooling for Whole Slide Image Analysiscited by 9
- 2023Multi-Scale Prototypical Transformer for Whole Slide Image Classificationcited by 9
- 2022Improving Feature Extraction from Histopathological Images Through A Fine-tuning ImageNet Modelcited by 8
- 2022Hierarchical Transformer for Survival Prediction Using Multimodality Whole Slide Images and Genomicscited by 8
- 2023MGCT: Mutual-Guided Cross-Modality Transformer for Survival Outcome Prediction using Integrative Histopathology-Genomic Featurescited by 8
50 most cited of 178 All 178 (JSON)
- 2026Morphology signal in whole slide image foundation models can automatically triage slides2 Sep 2026
- 2026From Patches to Evidence Balls: Class-Conditioned Evidence Retrieval for Few-Shot Whole Slide Image Classification2 Aug 2026
- 2026MergeSurv: Merging-Based Continual Learning for Survival Analysis on Whole-Slide Images6 Jul 2026
- 2026AGE-MIL: Anchor-Guided Evidence Learning for Patient-Level Prediction10 Jun 2026
- 2026GCE-MIL: Faithful and Recoverable Evidence for Multiple Instance Learning in Whole-Slide Imaging17 May 2026
- 2026Diffusion Attention Expert Model for Predicting and Semi-automatic Localizing STAS in Lung Cancer Histopathological Images15 May 2026
- 2026Linking spatial biology and clinical histology via Haiku30 Apr 2026
- 2026Dictionary-based Pathology Mining with Hard-instance-assisted Classifier Debiasing for Genetic Biomarker Prediction from WSIs26 Mar 2026
- 2026HGP-Mamba: Integrating Histology and Generated Protein Features for Mamba-based Multimodal Survival Risk Prediction17 Mar 2026
- 2026PPGuide: Steering Diffusion Policies with Performance Predictive Guidance11 Mar 2026
- 2026Sparse Task Vector Mixup with Hypernetworks for Efficient Knowledge Transfer in Whole-Slide Image Prognosis11 Mar 2026
- 2026ASMIL: Attention-Stabilized Multiple Instance Learning for Whole Slide Imaging1 Mar 2026
38 more
- 2026CARE: A Molecular-Guided Foundation Model with Adaptive Region Modeling for Whole Slide Image Analysis25 Feb 2026
- 2026MUSE: Harnessing Precise and Diverse Semantics for Few-Shot Whole Slide Image Classification24 Feb 2026
- 2026Prototype-driven fusion of pathology and spatial transcriptomics for interpretable survival prediction12 Feb 2026
- 2026PA-MIL: Phenotype-Aware Multiple Instance Learning Guided by Language Prompting and Genotype-to-Phenotype Relationships30 Jan 2026
- 2025milearn: A Python Package for Multi-Instance Machine Learning1 Dec 2025
- 2025Structural Prognostic Event Modeling for Multimodal Cancer Survival Analysis30 Nov 2025
- 2025Together, Then Apart: Balancing Alignment and Distinctiveness for Multimodal Survival Analysis22 Nov 2025
- 2025SurvAgent: Hierarchical CoT-Enhanced Case Banking and Dichotomy-Based Multi-Agent System for Multimodal Survival Prediction20 Nov 2025
- 2025MeCaMIL: Causality-Aware Multiple Instance Learning for Fair and Interpretable Whole Slide Image Diagnosis14 Nov 2025
- 2025Fusion of Multi-scale Heterogeneous Pathology Foundation Models for Whole Slide Image Analysis31 Oct 2025
- 2025ITC-RWKV: Interactive Tissue-Cell Modeling with Recurrent Key-Value Aggregation for Histopathological Subtyping24 Oct 2025
- 2025A Flow Model with Low-Rank Transformers for Incomplete Multimodal Survival Analysis22 Oct 2025
- 2025DCMIL: A Progressive Representation Learning of Whole Slide Images for Cancer Prognosis Analysis16 Oct 2025
- 2025MMAP: A Multi-Magnification and Prototype-Aware Architecture for Predicting Spatial Gene Expression13 Oct 2025
- 2025Multimodal Feature Prototype Learning for Interpretable and Discriminative Cancer Survival Prediction7 Oct 2025
- 2025MAPLE: Multi-scale Attribute-enhanced Prompt Learning for Few-shot Whole Slide Image Classification30 Sep 2025
- 2025DPsurv: Dual-Prototype Evidential Fusion for Uncertainty-Aware and Interpretable Whole-Slide Image Survival Prediction28 Sep 2025
- 2025Revisiting Data Challenges of Computational Pathology: A Pack-based Multiple Instance Learning Training Framework25 Sep 2025
- 2025C2MIL: Synchronizing Semantic and Topological Causalities in Multiple Instance Learning for Robust and Interpretable Survival Analysis24 Sep 2025
- 2025PS3: A Multimodal Transformer Integrating Pathology Reports with Histology Images and Biological Pathways for Cancer Survival Prediction24 Sep 2025
- 2025ME-Mamba: Multi-Expert Mamba with Efficient Knowledge Capture and Fusion for Multimodal Survival Analysis21 Sep 2025
- 2025Enhancing WSI-Based Survival Analysis with Report-Auxiliary Self-Distillation19 Sep 2025
- 2025Multiple Instance Learning Framework with Masked Hard Instance Mining for Gigapixel Histopathology Image Analysis15 Sep 2025
- 2025Cluster-Level Sparse Multi-Instance Learning for Whole-Slide Images14 Sep 2025
- 2025ModalSurv: Investigating opportunities and limitations of multimodal deep survival learning in prostate and bladder cancer5 Sep 2025
- 2025The Next Layer: Augmenting Foundation Models with Structure-Preserving and Attention-Guided Learning for Local Patches to Global Context Awareness in Computational Pathology27 Aug 2025
- 2025Deformable Attention Graph Representation Learning for Histopathology Whole Slide Image Analysis7 Aug 2025
- 2025PTCMIL: Multiple Instance Learning via Prompt Token Clustering for Whole Slide Image Analysis24 Jul 2025
- 2025Survival Modeling from Whole Slide Images via Patch-Level Graph Clustering and Mixture Density Experts22 Jul 2025
- 2025OTSurv: A Novel Multiple Instance Learning Framework for Survival Prediction with Heterogeneity-aware Optimal Transport25 Jun 2025
- 2025Memory-Augmented Incomplete Multimodal Survival Prediction via Cross-Slide and Gene-Attentive Hypergraph Learning24 Jun 2025
- 2025MiCo: Multiple Instance Learning with Context-Aware Clustering for Whole Slide Image Analysis22 Jun 2025
- 2025FMaMIL: Frequency-Driven Mamba Multi-Instance Learning for Weakly Supervised Lesion Segmentation in Medical Images9 Jun 2025
- 2025DLiPath: A Benchmark for the Comprehensive Assessment of Donor Liver Based on Histopathological Image Dataset30 May 2025
- 2025Spectral Survival Analysis28 May 2025
- 2025Hypergraph Mamba for Efficient Whole Slide Image Understanding23 May 2025
- 2025Multimodal Cancer Survival Analysis via Hypergraph Learning with Cross-Modality Rebalance17 May 2025
- 2025SimMIL: A Universal Weakly Supervised Pre-Training Framework for Multi-Instance Learning in Whole Slide Pathology Images10 May 2025
50 newest of 178 All 178 (JSON)
- 2024Combining Graph Neural Network and Mamba to Capture Local and Global Tissue Spatial Relationships in Whole Slide Imagescited by 7
- 2025ME-Mamba: Multi-Expert Mamba with Efficient Knowledge Capture and Fusion for Multimodal Survival Analysiscited by 2
- 2025Hypergraph Mamba for Efficient Whole Slide Image Understandingcited by 1
- 2025FMaMIL: Frequency-Driven Mamba Multi-Instance Learning for Weakly Supervised Lesion Segmentation in Medical Imagescited by 1
- 2026HGP-Mamba: Integrating Histology and Generated Protein Features for Mamba-based Multimodal Survival Risk Predictioncited by 0
- 2026HGP-Mamba: Integrating Histology and Generated Protein Features for Mamba-based Multimodal Survival Risk Prediction17 Mar 2026
- 2025ME-Mamba: Multi-Expert Mamba with Efficient Knowledge Capture and Fusion for Multimodal Survival Analysis21 Sep 2025
- 2025FMaMIL: Frequency-Driven Mamba Multi-Instance Learning for Weakly Supervised Lesion Segmentation in Medical Images9 Jun 2025
- 2025Hypergraph Mamba for Efficient Whole Slide Image Understanding23 May 2025
- 2024Combining Graph Neural Network and Mamba to Capture Local and Global Tissue Spatial Relationships in Whole Slide Images5 Jun 2024
- 2022Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learningcited by 357
- 2021Whole Slide Images are 2D Point Clouds: Context-Aware Survival Prediction using Patch-based Graph Convolutional Networkscited by 124
- 2023Modeling Dense Multimodal Interactions Between Biological Pathways and Histology for Survival Predictioncited by 92
- 2023Interventional Bag Multi-Instance Learning On Whole-Slide Pathological Imagescited by 91
- 2023Multimodal Optimal Transport-based Co-Attention Transformer with Global Structure Consistency for Survival Predictioncited by 86
- 2023Cross-Modal Translation and Alignment for Survival Analysiscited by 70
- 2024Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathologycited by 70
- 2024Feature Re-Embedding: Towards Foundation Model-Level Performance in Computational Pathologycited by 66
- 2021Cluster-to-Conquer: A Framework for End-to-End Multi-Instance Learning for Whole Slide Image Classificationcited by 65
- 2023Attention-Challenging Multiple Instance Learning for Whole Slide Image Classificationcited by 61
- 2021Hierarchical Graph Representations in Digital Pathologycited by 58
- 2022Additive MIL: Intrinsically Interpretable Multiple Instance Learning for Pathologycited by 58
12 most cited of 169 All 169 (JSON)
- 2026Morphology signal in whole slide image foundation models can automatically triage slides2 Sep 2026
- 2026From Patches to Evidence Balls: Class-Conditioned Evidence Retrieval for Few-Shot Whole Slide Image Classification2 Aug 2026
- 2026MergeSurv: Merging-Based Continual Learning for Survival Analysis on Whole-Slide Images6 Jul 2026
- 2026AGE-MIL: Anchor-Guided Evidence Learning for Patient-Level Prediction10 Jun 2026
- 2026GCE-MIL: Faithful and Recoverable Evidence for Multiple Instance Learning in Whole-Slide Imaging17 May 2026
- 2026Diffusion Attention Expert Model for Predicting and Semi-automatic Localizing STAS in Lung Cancer Histopathological Images15 May 2026
- 2026Linking spatial biology and clinical histology via Haiku30 Apr 2026
- 2026Dictionary-based Pathology Mining with Hard-instance-assisted Classifier Debiasing for Genetic Biomarker Prediction from WSIs26 Mar 2026
- 2026Sparse Task Vector Mixup with Hypernetworks for Efficient Knowledge Transfer in Whole-Slide Image Prognosis11 Mar 2026
- 2026ASMIL: Attention-Stabilized Multiple Instance Learning for Whole Slide Imaging1 Mar 2026
- 2026CARE: A Molecular-Guided Foundation Model with Adaptive Region Modeling for Whole Slide Image Analysis25 Feb 2026
- 2026MUSE: Harnessing Precise and Diverse Semantics for Few-Shot Whole Slide Image Classification24 Feb 2026
12 newest of 169 All 169 (JSON)