# Multiple Instance Learning with Mixed Supervision in Gleason Grading

arXiv: https://arxiv.org/abs/2206.12798 · HTML: https://mlsanity.com/paper/2206.12798/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 17 references that are in the map.
- First posted on arXiv 26 Jun 2022.

## Builds on (most cited first, 13 of 13)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [All Tokens Matter: Token Labeling for Training Better Vision Transformers](https://mlsanity.com/paper/2104.10858/) (2021)
- [Mask-guided Spectral-wise Transformer for Efficient Hyperspectral Image Reconstruction](https://mlsanity.com/paper/2111.07910/) (2021)
- [MST++: Multi-stage Spectral-wise Transformer for Efficient Spectral Reconstruction](https://mlsanity.com/paper/2204.07908/) (2022)
- [Going Deeper through the Gleason Scoring Scale: An Automatic end-to-end System for Histology Prostate Grading and Cribriform Pattern Detection](https://mlsanity.com/paper/2105.10490/) (2021)
- [Accounting for Dependencies in Deep Learning Based Multiple Instance Learning for Whole Slide Imaging](https://mlsanity.com/paper/2111.01556/) (2021)
- [Learning Whole-Slide Segmentation from Inexact and Incomplete Labels using Tissue Graphs](https://mlsanity.com/paper/2103.03129/) (2021)

## Built on by (most cited first, 8 of 8)

- [HVTSurv: Hierarchical Vision Transformer for Patient-Level Survival Prediction from Whole Slide Image](https://mlsanity.com/paper/2306.17373/) (2023)
- [MGCT: Mutual-Guided Cross-Modality Transformer for Survival Outcome Prediction using Integrative Histopathology-Genomic Features](https://mlsanity.com/paper/2311.11659/) (2023)
- [PathoTune: Adapting Visual Foundation Model to Pathological Specialists](https://mlsanity.com/paper/2403.16497/) (2024)
- [AugDiff: Diffusion based Feature Augmentation for Multiple Instance Learning in Whole Slide Image](https://mlsanity.com/paper/2303.06371/) (2023)
- [DISC: Latent Diffusion Models with Self-Distillation from Separated Conditions for Prostate Cancer Grading](https://mlsanity.com/paper/2404.13097/) (2024)
- [Dynamic Residual Encoding with Slide-Level Contrastive Learning for End-to-End Whole Slide Image Representation](https://mlsanity.com/paper/2511.05034/) (2025)
- [Graph Laplacian Transformer with Progressive Sampling for Prostate Cancer Grading](https://mlsanity.com/paper/2512.10808/) (2025)
- [Weakly Supervised Instance-Level Gleason Pattern Estimation Using Primary and Secondary Labels](https://mlsanity.com/paper/2607.23594/) (2026)

## Abstract (arXiv)

With the development of computational pathology, deep learning methods for Gleason grading through whole slide images (WSIs) have excellent prospects. Since the size of WSIs is extremely large, the image label usually contains only slide-level label or limited pixel-level labels. The current mainstream approach adopts multi-instance learning to predict Gleason grades. However, some methods only considering the slide-level label ignore the limited pixel-level labels containing rich local information. Furthermore, the method of additionally considering the pixel-level labels ignores the inaccuracy of pixel-level labels. To address these problems, we propose a mixed supervision Transformer based on the multiple instance learning framework. The model utilizes both slide-level label and instance-level labels to achieve more accurate Gleason grading at the slide level. The impact of inaccurate instance-level labels is further reduced by introducing an efficient random masking strategy in the mixed supervision training process. We achieve the state-of-the-art performance on the SICAPv2 dataset, and the visual analysis shows the accurate prediction results of instance level. The source code is available at https://github.com/bianhao123/Mixed_supervision.