# FALFormer: Feature-aware Landmarks self-attention for Whole-slide Image Classification

arXiv: https://arxiv.org/abs/2407.07340 · HTML: https://mlsanity.com/paper/2407.07340/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 15 references that are in the map.
- First posted on arXiv 10 Jul 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)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Nystr"omformer: A Nystr"om-Based Algorithm for Approximating Self-Attention](https://mlsanity.com/paper/2102.03902/) (2021)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Patch-based Convolutional Neural Network for Whole Slide Tissue Image Classification](https://mlsanity.com/paper/1504.07947/) (2015)
- [Revisiting Multiple Instance Neural Networks](https://mlsanity.com/paper/1610.02501/) (2016)
- [A Comprehensive Review of Computer-aided Whole-slide Image Analysis: from Datasets to Feature Extraction, Segmentation, Classification, and Detection Approaches](https://mlsanity.com/paper/2102.10553/) (2021)
- [HIGT: Hierarchical Interaction Graph-Transformer for Whole Slide Image Analysis](https://mlsanity.com/paper/2309.07400/) (2023)
- [Multi-Scale Prototypical Transformer for Whole Slide Image Classification](https://mlsanity.com/paper/2307.02308/) (2023)

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

- [PathoHR: Breast Cancer Survival Prediction on High-Resolution Pathological Images](https://mlsanity.com/paper/2503.17970/) (2025)
- [Welcome New Doctor: Continual Learning with Expert Consultation and Autoregressive Inference for Whole Slide Image Analysis](https://mlsanity.com/paper/2508.02220/) (2025)
- [Test-Time Instance Selection for Improved Whole Slide Image Analysis](https://mlsanity.com/paper/2608.14759/) (2026)

## Abstract (arXiv)

Slide-level classification for whole-slide images (WSIs) has been widely recognized as a crucial problem in digital and computational pathology. Current approaches commonly consider WSIs as a bag of cropped patches and process them via multiple instance learning due to the large number of patches, which cannot fully explore the relationship among patches; in other words, the global information cannot be fully incorporated into decision making. Herein, we propose an efficient and effective slide-level classification model, named as FALFormer, that can process a WSI as a whole so as to fully exploit the relationship among the entire patches and to improve the classification performance. FALFormer is built based upon Transformers and self-attention mechanism. To lessen the computational burden of the original self-attention mechanism and to process the entire patches together in a WSI, FALFormer employs Nystr"om self-attention which approximates the computation by using a smaller number of tokens or landmarks. For effective learning, FALFormer introduces feature-aware landmarks to enhance the representation power of the landmarks and the quality of the approximation. We systematically evaluate the performance of FALFormer using two public datasets, including CAMELYON16 and TCGA-BRCA. The experimental results demonstrate that FALFormer achieves superior performance on both datasets, outperforming the state-of-the-art methods for the slide-level classification. This suggests that FALFormer can facilitate an accurate and precise analysis of WSIs, potentially leading to improved diagnosis and prognosis on WSIs.