# Establishing Causal Relationship Between Whole Slide Image Predictions and Diagnostic Evidence Subregions in Deep Learning

arXiv: https://arxiv.org/abs/2407.17157 · HTML: https://mlsanity.com/paper/2407.17157/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 43 references that are in the map.
- First posted on arXiv 24 Jul 2024.

## Builds on (most cited first, 17 of 17)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Shortcut Learning in Deep Neural Networks](https://mlsanity.com/paper/2004.07780/) (2020)
- [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)
- [A Survey on Visual Transformer](https://mlsanity.com/paper/2012.12556/) (2020)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Causal Intervention for Weakly-Supervised Semantic Segmentation](https://mlsanity.com/paper/2009.12547/) (2020)
- [Deep Stable Learning for Out-Of-Distribution Generalization](https://mlsanity.com/paper/2104.07876/) (2021)
- [Causal Attention for Vision-Language Tasks](https://mlsanity.com/paper/2103.03493/) (2021)
- [Interventional Bag Multi-Instance Learning On Whole-Slide Pathological Images](https://mlsanity.com/paper/2303.06873/) (2023)
- [Stable Learning via Sample Reweighting](https://mlsanity.com/paper/1911.12580/) (2019)
- [Stable Prediction with Model Misspecification and Agnostic Distribution Shift](https://mlsanity.com/paper/2001.11713/) (2020)
- [Stable Prediction across Unknown Environments](https://mlsanity.com/paper/1806.06270/) (2018)
- [Computational Pathology: Challenges and Promises for Tissue Analysis](https://mlsanity.com/paper/1601.00027/) (2015)
- [Global Contrast Masked Autoencoders Are Powerful Pathological Representation Learners](https://mlsanity.com/paper/2205.09048/) (2022)

## Built on by (most cited first, 1 of 1)

- [Positive Semi-definite Latent Factor Grouping-Boosted Cluster-reasoning Instance Disentangled Learning for WSI Representation](https://mlsanity.com/paper/2511.01304/) (2025)

## Abstract (arXiv)

Due to the lack of fine-grained annotation guidance, current Multiple Instance Learning (MIL) struggles to establish a robust causal relationship between Whole Slide Image (WSI) diagnosis and evidence sub-images, just like fully supervised learning. So many noisy images can undermine the network's prediction. The proposed Causal Inference Multiple Instance Learning (CI-MIL), uses out-of-distribution generalization to reduce the recognition confusion of sub-images by MIL network, without requiring pixelwise annotations. Specifically, feature distillation is introduced to roughly identify the feature representation of lesion patches. Then, in the random Fourier feature space, these features are re-weighted to minimize the cross-correlation, effectively correcting the feature distribution deviation. These processes reduce the uncertainty when tracing the prediction results back to patches. Predicted diagnoses are more direct and reliable because the causal relationship between them and diagnostic evidence images is more clearly recognized by the network. Experimental results demonstrate that CI-MIL outperforms state-of-the-art methods, achieving 92.25% accuracy and 95.28% AUC on the Camelyon16 dataset (breast cancer), while 94.29% accuracy and 98.07% AUC on the TCGA-NSCLC dataset (non-small cell lung cancer). Additionally, CI-MIL exhibits superior interpretability, as its selected regions demonstrate high consistency with ground truth annotations, promising more reliable diagnostic assistance for pathologists.