Foundation Models for Slide-level Cancer Subtyping in Digital Pathology

Since the emergence of the ImageNet dataset, the pretraining and fine-tuning approach has become widely adopted in computer vision due to the ability of ImageNet-pretrained models to learn a wide variety of visual features. However, a significant challenge arises when adapting these models to domain-specific fields, such as digital pathology, due to substantial gaps between domains. To address this limitation, foundation models (FM) have been trained on large-scale in-domain datasets to learn the intricate features of histopathology images. In cancer diagnosis, whole-slide image (WSI) prediction is essential for patient prognosis, and multiple instance learning (MIL) has been implemented to handle the giga-pixel size of WSI. As MIL frameworks rely on patch-level feature aggregation, this work aims to compare the performance of various feature extractors developed under different pretraining strategies for cancer subtyping on WSI under a MIL framework. Results demonstrate the ability of foundation models to surpass ImageNet-pretrained models for the prediction of six skin cancer subtypes