# FOCUS: Knowledge-enhanced Adaptive Visual Compression for Few-shot Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2411.14743 · HTML: https://mlsanity.com/paper/2411.14743/

## Key facts

- Cited by 20 papers in the map (data through 14 Oct 2026).
- Builds on 34 of its 61 references that are in the map.
- First posted on arXiv 22 Nov 2024.

## Builds on (most cited first, 30 of 34)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [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)
- [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)
- [Pathomic Fusion: An Integrated Framework for Fusing Histopathology and Genomic Features for Cancer Diagnosis and Prognosis](https://mlsanity.com/paper/1912.08937/) (2019)
- [A Comprehensive Survey of Few-shot Learning: Evolution, Applications, Challenges, and Opportunities](https://mlsanity.com/paper/2205.06743/) (2022)
- [Visual Language Pretrained Multiple Instance Zero-Shot Transfer for Histopathology Images](https://mlsanity.com/paper/2306.07831/) (2023)
- [Modeling Dense Multimodal Interactions Between Biological Pathways and Histology for Survival Prediction](https://mlsanity.com/paper/2304.06819/) (2023)
- [Interventional Bag Multi-Instance Learning On Whole-Slide Pathological Images](https://mlsanity.com/paper/2303.06873/) (2023)
- [MambaMIL: Enhancing Long Sequence Modeling with Sequence Reordering in Computational Pathology](https://mlsanity.com/paper/2403.06800/) (2024)
- [Multimodal Optimal Transport-based Co-Attention Transformer with Global Structure Consistency for Survival Prediction](https://mlsanity.com/paper/2306.08330/) (2023)
- [A graph-transformer for whole slide image classification](https://mlsanity.com/paper/2205.09671/) (2022)
- [Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11643/) (2024)
- [Cross-Modal Translation and Alignment for Survival Analysis](https://mlsanity.com/paper/2309.12855/) (2023)
- [Dynamic Graph Representation with Knowledge-aware Attention for Histopathology Whole Slide Image Analysis](https://mlsanity.com/paper/2403.07719/) (2024)
- [A Multimodal Knowledge-enhanced Whole-slide Pathology Foundation Model](https://mlsanity.com/paper/2407.15362/) (2024)
- [Multimodal Prototyping for cancer survival prediction](https://mlsanity.com/paper/2407.00224/) (2024)
- [HistGen: Histopathology Report Generation via Local-Global Feature Encoding and Cross-modal Context Interaction](https://mlsanity.com/paper/2403.05396/) (2024)
- [The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classification](https://mlsanity.com/paper/2305.17891/) (2023)
- [Prototypical Information Bottlenecking and Disentangling for Multimodal Cancer Survival Prediction](https://mlsanity.com/paper/2401.01646/) (2024)
- [Towards A Generalizable Pathology Foundation Model via Unified Knowledge Distillation](https://mlsanity.com/paper/2407.18449/) (2024)
- [Diagnose Like a Pathologist: Transformer-Enabled Hierarchical Attention-Guided Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2301.08125/) (2023)
- [MoME: Mixture of Multimodal Experts for Cancer Survival Prediction](https://mlsanity.com/paper/2406.09696/) (2024)
- [Towards better understanding and better generalization of few-shot classification in histology images with contrastive learning](https://mlsanity.com/paper/2202.09059/) (2022)
- [Label-Efficient Deep Learning in Medical Image Analysis: Challenges and Future Directions](https://mlsanity.com/paper/2303.12484/) (2023)
- [MSCPT: Few-shot Whole Slide Image Classification with Multi-scale and Context-focused Prompt Tuning](https://mlsanity.com/paper/2408.11505/) (2024)

## Built on by (most cited first, 20 of 20)

- [Efficient Whole Slide Pathology VQA via Token Compression](https://mlsanity.com/paper/2507.14497/) (2025)
- [Multimodal Model for Computational Pathology:Representation Learning and Image Compression](https://mlsanity.com/paper/2603.18660/) (2026)
- [Act Like a Pathologist: Tissue-Aware Whole Slide Image Reasoning](https://mlsanity.com/paper/2603.00667/) (2026)
- [Few-Shot Learning from Gigapixel Images via Hierarchical Vision-Language Alignment and Modeling](https://mlsanity.com/paper/2505.17982/) (2025)
- [PathSelect: Sequential Token Selection for Whole Slide Pathology](https://mlsanity.com/paper/2607.23631/) (2026)
- [Exploiting Low-Dimensional Manifold of Features for Few-Shot Whole Slide Image Classification](https://mlsanity.com/paper/2505.15504/) (2025)
- [A Unified Low-level Foundation Model for Enhancing Pathology Image Quality](https://mlsanity.com/paper/2509.01071/) (2025)
- [MAPLE: Multi-scale Attribute-enhanced Prompt Learning for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2509.25863/) (2025)
- [MUSE: Harnessing Precise and Diverse Semantics for Few-Shot Whole Slide Image Classification](https://mlsanity.com/paper/2602.20873/) (2026)
- [ChimeraLoRA: Multi-Head LoRA-Guided Synthetic Datasets](https://mlsanity.com/paper/2602.19708/) (2026)
- [AINet: Anchor Instances Learning for Regional Heterogeneity in Whole Slide Image](https://mlsanity.com/paper/2602.20187/) (2026)
- [Parameter-efficient Prompt Tuning and Hierarchical Textual Guidance for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2603.21504/) (2026)
- [VidPrism: Heterogeneous Mixture of Experts for Image-to-Video Transfer](https://mlsanity.com/paper/2605.28229/) (2026)
- [LRMIL: Efficient Low-Resolution Multiple Instance Learning via High-Resolution Knowledge Distillation for Whole Slide Image Classification](https://mlsanity.com/paper/2606.06864/) (2026)
- [From Patches to Evidence Balls: Class-Conditioned Evidence Retrieval for Few-Shot Whole Slide Image Classification](https://mlsanity.com/paper/2608.01104/) (2026)
- [Understanding Synergistic Interactions among Pathology Foundation Models via Adaptive Fusion](https://mlsanity.com/paper/2608.01370/) (2026)
- [From Multi-Resolution Cells to Gigapixel Whole Slide Images Foundation Model for Computational Pathology](https://mlsanity.com/paper/2608.03508/) (2026)
- [Gated Spatial Redundancy Projection for Pathology Transformer Attentions](https://mlsanity.com/paper/2608.08374/) (2026)
- [FFM-CP: Cross-Backbone Fusion of Vision-Language Foundation Models for Few-Shot Computational Pathology](https://mlsanity.com/paper/2609.27710/) (2026)
- [A Multimodal Dataset for Survival Prediction in Resected Pancreatic Ductal Adenocarcinoma](https://mlsanity.com/paper/2609.29726/) (2026)

## Abstract (arXiv)

Few-shot learning presents a critical solution for cancer diagnosis in computational pathology (CPath), addressing fundamental limitations in data availability, particularly the scarcity of expert annotations and patient privacy constraints. A key challenge in this paradigm stems from the inherent disparity between the limited training set of whole slide images (WSIs) and the enormous number of contained patches, where a significant portion of these patches lacks diagnostically relevant information, potentially diluting the model's ability to learn and focus on critical diagnostic features. While recent works attempt to address this by incorporating additional knowledge, several crucial gaps hinder further progress: (1) despite the emergence of powerful pathology foundation models (FMs), their potential remains largely untapped, with most approaches limiting their use to basic feature extraction; (2) current language guidance mechanisms attempt to align text prompts with vast numbers of WSI patches all at once, struggling to leverage rich pathological semantic information. To this end, we introduce the knowledge-enhanced adaptive visual compression framework, dubbed FOCUS, which uniquely combines pathology FMs with language prior knowledge to enable a focused analysis of diagnostically relevant regions by prioritizing discriminative WSI patches. Our approach implements a progressive three-stage compression strategy: we first leverage FMs for global visual redundancy elimination, and integrate compressed features with language prompts for semantic relevance assessment, then perform neighbor-aware visual token filtering while preserving spatial coherence. Extensive experiments on pathological datasets spanning breast, lung, and ovarian cancers demonstrate its superior performance in few-shot pathology diagnosis. Codes are available at https://github.com/dddavid4real/FOCUS.