# Visual Language Pretrained Multiple Instance Zero-Shot Transfer for Histopathology Images

arXiv: https://arxiv.org/abs/2306.07831 · HTML: https://mlsanity.com/paper/2306.07831/

## Key facts

- Cited by 134 papers in the map (data through 14 Oct 2026).
- Builds on 55 of its 96 references that are in the map.
- First posted on arXiv 13 Jun 2023.

## Builds on (most cited first, 30 of 55)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [ViLBERT: Pretraining Task-Agnostic Visiolinguistic Representations for Vision-and-Language Tasks](https://mlsanity.com/paper/1908.02265/) (2019)
- [An Empirical Study of Training Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.02057/) (2021)
- [Multitask Prompted Training Enables Zero-Shot Task Generalization](https://mlsanity.com/paper/2110.08207/) (2021)
- [Contrastive Multiview Coding](https://mlsanity.com/paper/1906.05849/) (2019)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [SimVLM: Simple Visual Language Model Pretraining with Weak Supervision](https://mlsanity.com/paper/2108.10904/) (2021)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [LiT: Zero-Shot Transfer with Locked-image text Tuning](https://mlsanity.com/paper/2111.07991/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Image as a Foreign Language: BEiT Pretraining for All Vision and Vision-Language Tasks](https://mlsanity.com/paper/2208.10442/) (2022)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [SLIP: Self-supervision meets Language-Image Pre-training](https://mlsanity.com/paper/2112.12750/) (2021)
- [Supervision Exists Everywhere: A Data Efficient Contrastive Language-Image Pre-training Paradigm](https://mlsanity.com/paper/2110.05208/) (2021)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [VirTex: Learning Visual Representations from Textual Annotations](https://mlsanity.com/paper/2006.06666/) (2020)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Vision-Language Pre-Training with Triple Contrastive Learning](https://mlsanity.com/paper/2202.10401/) (2022)
- [Unified Contrastive Learning in Image-Text-Label Space](https://mlsanity.com/paper/2204.03610/) (2022)

## Built on by (most cited first, 30 of 134)

- [HEST-1k: A Dataset for Spatial Transcriptomics and Histology Image Analysis](https://mlsanity.com/paper/2406.16192/) (2024)
- [A Comprehensive Survey of Scientific Large Language Models and Their Applications in Scientific Discovery](https://mlsanity.com/paper/2406.10833/) (2024)
- [PRISM: A Multi-Modal Generative Foundation Model for Slide-Level Histopathology](https://mlsanity.com/paper/2405.10254/) (2024)
- [A Foundation Language-Image Model of the Retina (FLAIR): Encoding Expert Knowledge in Text Supervision](https://mlsanity.com/paper/2308.07898/) (2023)
- [Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions](https://mlsanity.com/paper/2404.03264/) (2024)
- [Foundational Models in Medical Imaging: A Comprehensive Survey and Future Vision](https://mlsanity.com/paper/2310.18689/) (2023)
- [Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11643/) (2024)
- [A Multimodal Knowledge-enhanced Whole-slide Pathology Foundation Model](https://mlsanity.com/paper/2407.15362/) (2024)
- [Towards a Visual-Language Foundation Model for Computational Pathology](https://mlsanity.com/paper/2307.12914/) (2023)
- [PathLDM: Text conditioned Latent Diffusion Model for Histopathology](https://mlsanity.com/paper/2309.00748/) (2023)
- [Transcriptomics-guided Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11618/) (2024)
- [HistGen: Histopathology Report Generation via Local-Global Feature Encoding and Cross-modal Context Interaction](https://mlsanity.com/paper/2403.05396/) (2024)
- [A General-Purpose Self-Supervised Model for Computational Pathology](https://mlsanity.com/paper/2308.15474/) (2023)
- [SleepFM: Multi-modal Representation Learning for Sleep Across Brain Activity, ECG and Respiratory Signals](https://mlsanity.com/paper/2405.17766/) (2024)
- [BrainSegFounder: Towards 3D Foundation Models for Neuroimage Segmentation](https://mlsanity.com/paper/2406.10395/) (2024)
- [WSI-VQA: Interpreting Whole Slide Images by Generative Visual Question Answering](https://mlsanity.com/paper/2407.05603/) (2024)
- [WsiCaption: Multiple Instance Generation of Pathology Reports for Gigapixel Whole-Slide Images](https://mlsanity.com/paper/2311.16480/) (2023)
- [CT-GLIP: 3D Grounded Language-Image Pretraining with CT Scans and Radiology Reports for Full-Body Scenarios](https://mlsanity.com/paper/2404.15272/) (2024)
- [PathAlign: A vision-language model for whole slide images in histopathology](https://mlsanity.com/paper/2406.19578/) (2024)
- [ViLa-MIL: Dual-scale Vision-Language Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2502.08391/) (2025)
- [Data-Centric Foundation Models in Computational Healthcare: A Survey](https://mlsanity.com/paper/2401.02458/) (2024)
- [Evidence-based diagnostic reasoning with multi-agent copilot for human pathology](https://mlsanity.com/paper/2506.20964/) (2025)
- [SI-MIL: Taming Deep MIL for Self-Interpretability in Gigapixel Histopathology](https://mlsanity.com/paper/2312.15010/) (2023)
- [Medical Vision Language Pretraining: A survey](https://mlsanity.com/paper/2312.06224/) (2023)
- [A Foundational Multimodal Vision Language AI Assistant for Human Pathology](https://mlsanity.com/paper/2312.07814/) (2023)
- [Knowledge-enhanced Pretraining for Vision-language Pathology Foundation Model on Cancer Diagnosis](https://mlsanity.com/paper/2412.13126/) (2024)
- [CPLIP: Zero-Shot Learning for Histopathology with Comprehensive Vision-Language Alignment](https://mlsanity.com/paper/2406.05205/) (2024)
- [Graph Domain Adaptation with Dual-branch Encoder and Two-level Alignment for Whole Slide Image-based Survival Prediction](https://mlsanity.com/paper/2411.14001/) (2024)
- [FOCUS: Knowledge-enhanced Adaptive Visual Compression for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2411.14743/) (2024)
- [MERGE: Multi-faceted Hierarchical Graph-based GNN for Gene Expression Prediction from Whole Slide Histopathology Images](https://mlsanity.com/paper/2412.02601/) (2024)

## Abstract (arXiv)

Contrastive visual language pretraining has emerged as a powerful method for either training new language-aware image encoders or augmenting existing pretrained models with zero-shot visual recognition capabilities. However, existing works typically train on large datasets of image-text pairs and have been designed to perform downstream tasks involving only small to medium sized-images, neither of which are applicable to the emerging field of computational pathology where there are limited publicly available paired image-text datasets and each image can span up to 100,000 x 100,000 pixels. In this paper we present MI-Zero, a simple and intuitive framework for unleashing the zero-shot transfer capabilities of contrastively aligned image and text models on gigapixel histopathology whole slide images, enabling multiple downstream diagnostic tasks to be carried out by pretrained encoders without requiring any additional labels. MI-Zero reformulates zero-shot transfer under the framework of multiple instance learning to overcome the computational challenge of inference on extremely large images. We used over 550k pathology reports and other available in-domain text corpora to pre-train our text encoder. By effectively leveraging strong pre-trained encoders, our best model pretrained on over 33k histopathology image-caption pairs achieves an average median zero-shot accuracy of 70.2% across three different real-world cancer subtyping tasks. Our code is available at: https://github.com/mahmoodlab/MI-Zero.