# Iteratively Coupled Multiple Instance Learning from Instance to Bag Classifier for Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2303.15749 · HTML: https://mlsanity.com/paper/2303.15749/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 25 references that are in the map.
- First posted on arXiv 28 Mar 2023.

## Builds on (most cited first, 15 of 15)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [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)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Patch-based Convolutional Neural Network for Whole Slide Tissue Image Classification](https://mlsanity.com/paper/1504.07947/) (2015)
- [Deep Learning-based Computational Pathology Predicts Origins for Cancers of Unknown Primary](https://mlsanity.com/paper/2006.13932/) (2020)
- [Weakly-Supervised Action Localization with Expectation-Maximization Multi-Instance Learning](https://mlsanity.com/paper/2004.00163/) (2020)
- [Self-supervised driven consistency training for annotation efficient histopathology image analysis](https://mlsanity.com/paper/2102.03897/) (2021)
- [Multiple Instance Learning via Iterative Self-Paced Supervised Contrastive Learning](https://mlsanity.com/paper/2210.09452/) (2022)

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

- [Attention-Challenging Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2311.07125/) (2023)
- [Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directions](https://mlsanity.com/paper/2304.06662/) (2023)
- [Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Bag-Level Classifier is a Good Instance-Level Teacher](https://mlsanity.com/paper/2312.01099/) (2023)
- [Image Distillation for Safe Data Sharing in Histopathology](https://mlsanity.com/paper/2406.13536/) (2024)
- [PTCMIL: Multiple Instance Learning via Prompt Token Clustering for Whole Slide Image Analysis](https://mlsanity.com/paper/2507.18848/) (2025)
- [MixUp-MIL: A Study on Linear & Multilinear Interpolation-Based Data Augmentation for Whole Slide Image Classification](https://mlsanity.com/paper/2311.03052/) (2023)
- [LadderMIL: Multiple Instance Learning with Coarse-to-Fine Self-Distillation](https://mlsanity.com/paper/2502.02707/) (2025)
- [SimMIL: A Universal Weakly Supervised Pre-Training Framework for Multi-Instance Learning in Whole Slide Pathology Images](https://mlsanity.com/paper/2505.06710/) (2025)

## Abstract (arXiv)

Whole Slide Image (WSI) classification remains a challenge due to their extremely high resolution and the absence of fine-grained labels. Presently, WSI classification is usually regarded as a Multiple Instance Learning (MIL) problem when only slide-level labels are available. MIL methods involve a patch embedding module and a bag-level classification module, but they are prohibitively expensive to be trained in an end-to-end manner. Therefore, existing methods usually train them separately, or directly skip the training of the embedder. Such schemes hinder the patch embedder's access to slide-level semantic labels, resulting in inconsistency within the entire MIL pipeline. To overcome this issue, we propose a novel framework called Iteratively Coupled MIL (ICMIL), which bridges the loss back-propagation process from the bag-level classifier to the patch embedder. In ICMIL, we use category information in the bag-level classifier to guide the patch-level fine-tuning of the patch feature extractor. The refined embedder then generates better instance representations for achieving a more accurate bag-level classifier. By coupling the patch embedder and bag classifier at a low cost, our proposed framework enables information exchange between the two modules, benefiting the entire MIL classification model. We tested our framework on two datasets using three different backbones, and our experimental results demonstrate consistent performance improvements over state-of-the-art MIL methods. The code is available at: https://github.com/Dootmaan/ICMIL.