# CARMIL: Context-Aware Regularization on Multiple Instance Learning models for Whole Slide Images

arXiv: https://arxiv.org/abs/2408.00427 · HTML: https://mlsanity.com/paper/2408.00427/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 23 references that are in the map.
- First posted on arXiv 1 Aug 2024.

## Builds on (most cited first, 10 of 10)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Semi-Supervised Classification with Graph Convolutional Networks](https://mlsanity.com/paper/1609.02907/) (2016)
- [Variational Graph Auto-Encoders](https://mlsanity.com/paper/1611.07308/) (2016)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Additive MIL: Intrinsically Interpretable Multiple Instance Learning for Pathology](https://mlsanity.com/paper/2206.01794/) (2022)
- [Classification and Disease Localization in Histopathology Using Only Global Labels: A Weakly-Supervised Approach](https://mlsanity.com/paper/1802.02212/) (2018)
- [DELTACON: A Principled Massive-Graph Similarity Function](https://mlsanity.com/paper/1304.4657/) (2013)
- [Local Attention Graph-based Transformer for Multi-target Genetic Alteration Prediction](https://mlsanity.com/paper/2205.06672/) (2022)
- [Multi-Scale Attention-based Multiple Instance Learning for Classification of Multi-Gigapixel Histology Images](https://mlsanity.com/paper/2209.03041/) (2022)

## Abstract (arXiv)

Multiple Instance Learning (MIL) models have proven effective for cancer prognosis from Whole Slide Images. However, the original MIL formulation incorrectly assumes the patches of the same image to be independent, leading to a loss of spatial context as information flows through the network. Incorporating contextual knowledge into predictions is particularly important given the inclination for cancerous cells to form clusters and the presence of spatial indicators for tumors. State-of-the-art methods often use attention mechanisms eventually combined with graphs to capture spatial knowledge. In this paper, we take a novel and transversal approach, addressing this issue through the lens of regularization. We propose Context-Aware Regularization for Multiple Instance Learning (CARMIL), a versatile regularization scheme designed to seamlessly integrate spatial knowledge into any MIL model. Additionally, we present a new and generic metric to quantify the Context-Awareness of any MIL model when applied to Whole Slide Images, resolving a previously unexplored gap in the field. The efficacy of our framework is evaluated for two survival analysis tasks on glioblastoma (TCGA GBM) and colon cancer data (TCGA COAD).