# VLM-CPL: Consensus Pseudo Labels from Vision-Language Models for Annotation-Free Pathological Image Classification

arXiv: https://arxiv.org/abs/2403.15836 · HTML: https://mlsanity.com/paper/2403.15836/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 33 of its 52 references that are in the map.
- First posted on arXiv 23 Mar 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 33)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Class-Balanced Loss Based on Effective Number of Samples](https://mlsanity.com/paper/1901.05555/) (2019)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Co-teaching: Robust Training of Deep Neural Networks with Extremely Noisy Labels](https://mlsanity.com/paper/1804.06872/) (2018)
- [Generalized Cross Entropy Loss for Training Deep Neural Networks with Noisy Labels](https://mlsanity.com/paper/1805.07836/) (2018)
- [A Review of Uncertainty Quantification in Deep Learning: Techniques, Applications and Challenges](https://mlsanity.com/paper/2011.06225/) (2020)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [DivideMix: Learning with Noisy Labels as Semi-supervised Learning](https://mlsanity.com/paper/2002.07394/) (2020)
- [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)
- [Semi-Supervised Semantic Segmentation with Cross Pseudo Supervision](https://mlsanity.com/paper/2106.01226/) (2021)
- [Early-Learning Regularization Prevents Memorization of Noisy Labels](https://mlsanity.com/paper/2007.00151/) (2020)
- [How does Disagreement Help Generalization against Label Corruption?](https://mlsanity.com/paper/1901.04215/) (2019)
- [Aleatoric uncertainty estimation with test-time augmentation for medical image segmentation with convolutional neural networks](https://mlsanity.com/paper/1807.07356/) (2018)
- [Quilt-1M: One Million Image-Text Pairs for Histopathology](https://mlsanity.com/paper/2306.11207/) (2023)
- [BioCLIP: A Vision Foundation Model for the Tree of Life](https://mlsanity.com/paper/2311.18803/) (2023)
- [Visual Language Pretrained Multiple Instance Zero-Shot Transfer for Histopathology Images](https://mlsanity.com/paper/2306.07831/) (2023)
- [Mutual Consistency Learning for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2109.09960/) (2021)
- [Lung and Colon Cancer Histopathological Image Dataset (LC25000)](https://mlsanity.com/paper/1912.12142/) (2019)
- [MambaMIL: Enhancing Long Sequence Modeling with Sequence Reordering in Computational Pathology](https://mlsanity.com/paper/2403.06800/) (2024)
- [Does CLIP Benefit Visual Question Answering in the Medical Domain as Much as it Does in the General Domain?](https://mlsanity.com/paper/2112.13906/) (2021)
- [Selective Synthetic Augmentation with HistoGAN for Improved Histopathology Image Classification](https://mlsanity.com/paper/2111.06399/) (2021)
- [Enhancing CLIP with CLIP: Exploring Pseudolabeling for Limited-Label Prompt Tuning](https://mlsanity.com/paper/2306.01669/) (2023)
- [Online Easy Example Mining for Weakly-supervised Gland Segmentation from Histology Images](https://mlsanity.com/paper/2206.06665/) (2022)
- [SenseCare: A Research Platform for Medical Image Informatics and Interactive 3D Visualization](https://mlsanity.com/paper/2004.07031/) (2020)

## Built on by (most cited first, 5 of 5)

- [Multimodal Remote Sensing Scene Classification Using VLMs and Dual-Cross Attention Networks](https://mlsanity.com/paper/2412.02531/) (2024)
- [Efficient Learning for Product Attributes with Compact Multimodal Models](https://mlsanity.com/paper/2507.19679/) (2025)
- [CheXPO-v2: Preference Optimization for Chest X-ray VLMs with Knowledge Graph Consistency](https://mlsanity.com/paper/2512.17213/) (2025)
- [From Theory to Decision Rule: Calibrating the Noisy-Label Crossover for Vision-Language Model Weak Supervision Across Three Medical-Imaging Benchmarks](https://mlsanity.com/paper/2605.24771/) (2026)
- [Retrieve, Match, Escalate: Accurate and Scalable Product Linking with VLM-Distilled Cross-Encoders and Agentic VLMs](https://mlsanity.com/paper/2608.25037/) (2026)

## Abstract (arXiv)

Classification of pathological images is the basis for automatic cancer diagnosis. Despite that deep learning methods have achieved remarkable performance, they heavily rely on labeled data, demanding extensive human annotation efforts. In this study, we present a novel human annotation-free method by leveraging pre-trained Vision-Language Models (VLMs). Without human annotation, pseudo-labels of the training set are obtained by utilizing the zero-shot inference capabilities of VLM, which may contain a lot of noise due to the domain gap between the pre-training and target datasets. To address this issue, we introduce VLM-CPL, a novel approach that contains two noisy label filtering techniques with a semi-supervised learning strategy. Specifically, we first obtain prompt-based pseudo-labels with uncertainty estimation by zero-shot inference with the VLM using multiple augmented views of an input. Then, by leveraging the feature representation ability of VLM, we obtain feature-based pseudo-labels via sample clustering in the feature space. Prompt-feature consensus is introduced to select reliable samples based on the consensus between the two types of pseudo-labels. We further propose High-confidence Cross Supervision by to learn from samples with reliable pseudo-labels and the remaining unlabeled samples. Additionally, we present an innovative open-set prompting strategy that filters irrelevant patches from whole slides to enhance the quality of selected patches. Experimental results on five public pathological image datasets for patch-level and slide-level classification showed that our method substantially outperformed zero-shot classification by VLMs, and was superior to existing noisy label learning methods. The code is publicly available at https://github.com/HiLab-git/VLM-CPL.