# Hierarchical Vision Transformers for Context-Aware Prostate Cancer Grading in Whole Slide Images

arXiv: https://arxiv.org/abs/2312.12619 · HTML: https://mlsanity.com/paper/2312.12619/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 7 of its 10 references that are in the map.
- First posted on arXiv 19 Dec 2023.

## Builds on (most cited first, 7 of 7)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [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)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [Detection of prostate cancer in whole-slide images through end-to-end training with image-level labels](https://mlsanity.com/paper/2006.03394/) (2020)
- [SparseConvMIL: Sparse Convolutional Context-Aware Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2105.02726/) (2021)

## Built on by (most cited first, 3 of 3)

- [Masked Attention as a Mechanism for Improving Interpretability of Vision Transformers](https://mlsanity.com/paper/2404.18152/) (2024)
- [Feature Learning with Multi-Stage Vision Transformers on Inter-Modality HER2 Status Scoring and Tumor Classification on Whole Slides](https://mlsanity.com/paper/2512.22335/) (2025)
- [Explainable Artificial Intelligence (XAI) in Computational Pathology: Definitions, Taxonomy, and Recommendations](https://mlsanity.com/paper/2608.28820/) (2026)

## Abstract (arXiv)

Vision Transformers (ViTs) have ushered in a new era in computer vision, showcasing unparalleled performance in many challenging tasks. However, their practical deployment in computational pathology has largely been constrained by the sheer size of whole slide images (WSIs), which result in lengthy input sequences. Transformers faced a similar limitation when applied to long documents, and Hierarchical Transformers were introduced to circumvent it. Given the analogous challenge with WSIs and their inherent hierarchical structure, Hierarchical Vision Transformers (H-ViTs) emerge as a promising solution in computational pathology. This work delves into the capabilities of H-ViTs, evaluating their efficiency for prostate cancer grading in WSIs. Our results show that they achieve competitive performance against existing state-of-the-art solutions.