# Beyond Multiple Instance Learning: Full Resolution All-In-Memory End-To-End Pathology Slide Modeling

arXiv: https://arxiv.org/abs/2403.04865 · HTML: https://mlsanity.com/paper/2403.04865/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 27 references that are in the map.
- First posted on arXiv 7 Mar 2024.

## Builds on (most cited first, 14 of 14)

- [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)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [LongNet: Scaling Transformers to 1,000,000,000 Tokens](https://mlsanity.com/paper/2307.02486/) (2023)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [Virchow: A Million-Slide Digital Pathology Foundation Model](https://mlsanity.com/paper/2309.07778/) (2023)
- [Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classification](https://mlsanity.com/paper/2210.03664/) (2022)
- [A General-Purpose Self-Supervised Model for Computational Pathology](https://mlsanity.com/paper/2308.15474/) (2023)
- [Streaming convolutional neural networks for end-to-end learning with multi-megapixel images](https://mlsanity.com/paper/1911.04432/) (2019)
- [Computational Pathology at Health System Scale -- Self-Supervised Foundation Models from Three Billion Images](https://mlsanity.com/paper/2310.07033/) (2023)
- [Detection of prostate cancer in whole-slide images through end-to-end training with image-level labels](https://mlsanity.com/paper/2006.03394/) (2020)
- [When an Image is Worth 1,024 x 1,024 Words: A Case Study in Computational Pathology](https://mlsanity.com/paper/2312.03558/) (2023)
- [H&E-based Computational Biomarker Enables Universal EGFR Screening for Lung Adenocarcinoma](https://mlsanity.com/paper/2206.10573/) (2022)

## Built on by (most cited first, 2 of 2)

- [Mixed Magnification Aggregation for Generalizable Region-Level Representations in Computational Pathology](https://mlsanity.com/paper/2602.22176/) (2026)
- [Single GPU Task Adaptation of Pathology Foundation Models for Whole Slide Image Analysis](https://mlsanity.com/paper/2506.05184/) (2025)

## Abstract (arXiv)

Artificial Intelligence (AI) has great potential to improve health outcomes by training systems on vast digitized clinical datasets. Computational Pathology, with its massive amounts of microscopy image data and impact on diagnostics and biomarkers, is at the forefront of this development. Gigapixel pathology slides pose a unique challenge due to their enormous size and are usually divided into tens of thousands of smaller tiles for analysis. This results in a discontinuity in the machine learning process by separating the training of tile-level encoders from slide-level aggregators and the need to adopt weakly supervised learning strategies. Training models from entire pathology slides end-to-end has been largely unexplored due to its computational challenges. To overcome this problem, we propose a novel approach to jointly train both a tile encoder and a slide-aggregator fully in memory and end-to-end at high-resolution, bridging the gap between input and slide-level supervision. While more computationally expensive, detailed quantitative validation shows promise for large-scale pre-training and fine-tuning of pathology foundation models.