# Finding Regions of Interest in Whole Slide Images Using Multiple Instance Learning

arXiv: https://arxiv.org/abs/2404.01446 · HTML: https://mlsanity.com/paper/2404.01446/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 23 references that are in the map.
- First posted on arXiv 1 Apr 2024.

## Builds on (most cited first, 11 of 11)

- [Neural Machine Translation by Jointly Learning to Align and Translate](https://mlsanity.com/paper/1409.0473/) (2014)
- [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)
- [Whole Slide Images based Cancer Survival Prediction using Attention Guided Deep Multiple Instance Learning Networks](https://mlsanity.com/paper/2009.11169/) (2020)
- [Additive MIL: Intrinsically Interpretable Multiple Instance Learning for Pathology](https://mlsanity.com/paper/2206.01794/) (2022)
- [Fine-Tuning and Training of DenseNet for Histopathology Image Representation Using TCGA Diagnostic Slides](https://mlsanity.com/paper/2101.07903/) (2021)
- [Deep Learning for Whole Slide Image Analysis: An Overview](https://mlsanity.com/paper/1910.11097/) (2019)
- [A Generalized Deep Learning Framework for Whole-Slide Image Segmentation and Analysis](https://mlsanity.com/paper/2001.00258/) (2020)
- [Local Attention Graph-based Transformer for Multi-target Genetic Alteration Prediction](https://mlsanity.com/paper/2205.06672/) (2022)
- [A robust and lightweight deep attention multiple instance learning algorithm for predicting genetic alterations](https://mlsanity.com/paper/2206.00455/) (2022)

## Abstract (arXiv)

Whole Slide Images (WSI), obtained by high-resolution digital scanning of microscope slides at multiple scales, are the cornerstone of modern Digital Pathology. However, they represent a particular challenge to AI-based/AI-mediated analysis because pathology labeling is typically done at slide-level, instead of tile-level. It is not just that medical diagnostics is recorded at the specimen level, the detection of oncogene mutation is also experimentally obtained, and recorded by initiatives like The Cancer Genome Atlas (TCGA), at the slide level. This configures a dual challenge: a) accurately predicting the overall cancer phenotype and b) finding out what cellular morphologies are associated with it at the tile level. To address these challenges, a weakly supervised Multiple Instance Learning (MIL) approach was explored for two prevalent cancer types, Invasive Breast Carcinoma (TCGA-BRCA) and Lung Squamous Cell Carcinoma (TCGA-LUSC). This approach was explored for tumor detection at low magnification levels and TP53 mutations at various levels. Our results show that a novel additive implementation of MIL matched the performance of reference implementation (AUC 0.96), and was only slightly outperformed by Attention MIL (AUC 0.97). More interestingly from the perspective of the molecular pathologist, these different AI architectures identify distinct sensitivities to morphological features (through the detection of Regions of Interest, RoI) at different amplification levels. Tellingly, TP53 mutation was most sensitive to features at the higher applications where cellular morphology is resolved.