# A Foundational Multimodal Vision Language AI Assistant for Human Pathology

arXiv: https://arxiv.org/abs/2312.07814 · HTML: https://mlsanity.com/paper/2312.07814/

## Key facts

- Cited by 21 papers in the map (data through 14 Oct 2026).
- Builds on 70 of its 125 references that are in the map.
- First posted on arXiv 13 Dec 2023.

## Builds on (most cited first, 30 of 70)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [LAION-5B: An open large-scale dataset for training next generation image-text models](https://mlsanity.com/paper/2210.08402/) (2022)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [Emergent Abilities of Large Language Models](https://mlsanity.com/paper/2206.07682/) (2022)
- [ViLBERT: Pretraining Task-Agnostic Visiolinguistic Representations for Vision-and-Language Tasks](https://mlsanity.com/paper/1908.02265/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Align before Fuse: Vision and Language Representation Learning with Momentum Distillation](https://mlsanity.com/paper/2107.07651/) (2021)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [Oscar: Object-Semantics Aligned Pre-training for Vision-Language Tasks](https://mlsanity.com/paper/2004.06165/) (2020)
- [PaLM 2 Technical Report](https://mlsanity.com/paper/2305.10403/) (2023)

## Built on by (most cited first, 21 of 21)

- [Capabilities of Gemini Models in Medicine](https://mlsanity.com/paper/2404.18416/) (2024)
- [CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models](https://mlsanity.com/paper/2406.06007/) (2024)
- [WSI-LLaVA: A Multimodal Large Language Model for Whole Slide Image](https://mlsanity.com/paper/2412.02141/) (2024)
- [MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning](https://mlsanity.com/paper/2506.00555/) (2025)
- [Data-Centric Foundation Models in Computational Healthcare: A Survey](https://mlsanity.com/paper/2401.02458/) (2024)
- [Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2410.18387/) (2024)
- [Has Multimodal Learning Delivered Universal Intelligence in Healthcare? A Comprehensive Survey](https://mlsanity.com/paper/2408.12880/) (2024)
- [GP-VLS: A general-purpose vision language model for surgery](https://mlsanity.com/paper/2407.19305/) (2024)
- [Dr-LLaVA: Visual Instruction Tuning with Symbolic Clinical Grounding](https://mlsanity.com/paper/2405.19567/) (2024)
- [OctoMed: Data Recipes for State-of-the-Art Multimodal Medical Reasoning](https://mlsanity.com/paper/2511.23269/) (2025)
- [LoC-Path: Learning to Compress for Pathology Multimodal Large Language Models](https://mlsanity.com/paper/2512.05391/) (2025)
- [MOOZY: A Patient-First Foundation Model for Computational Pathology](https://mlsanity.com/paper/2603.27048/) (2026)
- [Leveraging Expert Input for Robust and Explainable AI-Assisted Lung Cancer Detection in Chest X-rays](https://mlsanity.com/paper/2403.19444/) (2024)
- [From Histopathology Images to Cell Clouds: Learning Slide Representations with Hierarchical Cell Transformer](https://mlsanity.com/paper/2412.16715/) (2024)
- [Enhancing Multi-task Learning Capability of Medical Generalist Foundation Model via Image-centric Multi-annotation Data](https://mlsanity.com/paper/2504.09967/) (2025)
- [The Eye as a Window to Systemic Health: A Survey of Retinal Imaging from Classical Techniques to Oculomics](https://mlsanity.com/paper/2505.04006/) (2025)
- [CTIS-QA: Clinical Template-Informed Slide-level Question Answering for Pathology](https://mlsanity.com/paper/2601.01769/) (2026)
- [A Survey on Cell Nuclei Instance Segmentation and Classification: Leveraging Context and Attention](https://mlsanity.com/paper/2407.18673/) (2024)
- [The Butterfly Effect in Pathology: Exploring Security in Pathology Foundation Models](https://mlsanity.com/paper/2505.24141/) (2025)
- [Unified Multi-Foundation-Model Slide Representation for Pan-Cancer Recognition and Text-Guided Tumor Localization](https://mlsanity.com/paper/2604.22846/) (2026)
- [CapCLIP: A Vision-Language Representation Alignment Approach for Wireless Capsule Endoscopy Analysis](https://mlsanity.com/paper/2605.08493/) (2026)

## Abstract (arXiv)

The field of computational pathology has witnessed remarkable progress in the development of both task-specific predictive models and task-agnostic self-supervised vision encoders. However, despite the explosive growth of generative artificial intelligence (AI), there has been limited study on building general purpose, multimodal AI assistants tailored to pathology. Here we present PathChat, a vision-language generalist AI assistant for human pathology using an in-house developed foundational vision encoder pretrained on 100 million histology images from over 100,000 patient cases and 1.18 million pathology image-caption pairs. The vision encoder is then combined with a pretrained large language model and the whole system is finetuned on over 250,000 diverse disease agnostic visual language instructions. We compare PathChat against several multimodal vision language AI assistants as well as GPT4V, which powers the commercially available multimodal general purpose AI assistant ChatGPT-4. When relevant clinical context is provided with the histology image, PathChat achieved a diagnostic accuracy of 87% on multiple-choice questions based on publicly available cases of diverse tissue origins and disease models. Additionally, using open-ended questions and human expert evaluation, we found that overall PathChat produced more accurate and pathologist-preferable responses to diverse queries related to pathology. As an interactive and general vision language AI assistant that can flexibly handle both visual and natural language inputs, PathChat can potentially find impactful applications in pathology education, research, and human-in-the-loop clinical decision making.