# Triage of 3D pathology data via 2.5D multiple-instance learning to guide pathologist assessments

arXiv: https://arxiv.org/abs/2406.07061 · HTML: https://mlsanity.com/paper/2406.07061/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 63 references that are in the map.
- First posted on arXiv 11 Jun 2024.

## Builds on (most cited first, 12 of 12)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [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)
- [Whole Slide Images are 2D Point Clouds: Context-Aware Survival Prediction using Patch-based Graph Convolutional Networks](https://mlsanity.com/paper/2107.13048/) (2021)
- [Artificial Intelligence for Digital and Computational Pathology](https://mlsanity.com/paper/2401.06148/) (2023)
- [Bridging 2D and 3D Segmentation Networks for Computation Efficient Volumetric Medical Image Segmentation: An Empirical Study of 2.5D Solutions](https://mlsanity.com/paper/2010.06163/) (2020)
- [Inter-slice Context Residual Learning for 3D Medical Image Segmentation](https://mlsanity.com/paper/2011.14155/) (2020)
- [Incorporating intratumoral heterogeneity into weakly-supervised deep learning models via variance pooling](https://mlsanity.com/paper/2206.08885/) (2022)
- [Embedding Space Augmentation for Weakly Supervised Learning in Whole-Slide Images](https://mlsanity.com/paper/2210.17013/) (2022)
- [Video Pretraining Advances 3D Deep Learning on Chest CT Tasks](https://mlsanity.com/paper/2304.00546/) (2023)

## Abstract (arXiv)

Accurate patient diagnoses based on human tissue biopsies are hindered by current clinical practice, where pathologists assess only a limited number of thin 2D tissue slices sectioned from 3D volumetric tissue. Recent advances in non-destructive 3D pathology, such as open-top light-sheet microscopy, enable comprehensive imaging of spatially heterogeneous tissue morphologies, offering the feasibility to improve diagnostic determinations. A potential early route towards clinical adoption for 3D pathology is to rely on pathologists for final diagnosis based on viewing familiar 2D H&E-like image sections from the 3D datasets. However, manual examination of the massive 3D pathology datasets is infeasible. To address this, we present CARP3D, a deep learning triage approach that automatically identifies the highest-risk 2D slices within 3D volumetric biopsy, enabling time-efficient review by pathologists. For a given slice in the biopsy, we estimate its risk by performing attention-based aggregation of 2D patches within each slice, followed by pooling of the neighboring slices to compute a context-aware 2.5D risk score. For prostate cancer risk stratification, CARP3D achieves an area under the curve (AUC) of 90.4% for triaging slices, outperforming methods relying on independent analysis of 2D sections (AUC=81.3%). These results suggest that integrating additional depth context enhances the model's discriminative capabilities. In conclusion, CARP3D has the potential to improve pathologist diagnosis via accurate triage of high-risk slices within large-volume 3D pathology datasets.