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Multimodal Whole Slide Foundation Model for Pathology

arXiv 2411.19666 ↗First posted 29 Nov 2024eess.IV cs.AI cs.CVcited by 162

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Abstract (arXiv)

The field of computational pathology has been transformed with recent advances in foundation models that encode histopathology region-of-interests (ROIs) into versatile and transferable feature representations via self-supervised learning (SSL). However, translating these advancements to address complex clinical challenges at the patient and slide level remains constrained by limited clinical data in disease-specific cohorts, especially for rare clinical conditions. We propose TITAN, a multimodal whole slide foundation model pretrained using 335,645 WSIs via visual self-supervised learning and vision-language alignment with corresponding pathology reports and 423,122 synthetic captions generated from a multimodal generative AI copilot for pathology. Without any finetuning or requiring clinical labels, TITAN can extract general-purpose slide representations and generate pathology reports that generalize to resource-limited clinical scenarios such as rare disease retrieval and cancer prognosis. We evaluate TITAN on diverse clinical tasks and find that TITAN outperforms both ROI and slide foundation models across machine learning settings such as linear probing, few-shot and zero-shot classification, rare cancer retrieval and cross-modal retrieval, and pathology report generation.

Key facts. Cited by 162 papers in the map (data through 14 Oct 2026). Builds on 18 of its 134 references that are in the map. First posted on arXiv 29 Nov 2024.

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18 of 134 references.

References · 18

  1. 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 30,186
  2. 2023DINOv2: Learning Robust Visual Features without Supervisioncited by 7,974
  3. 2020Scaling Laws for Neural Language Modelscited by 6,586
  4. 2021On the Opportunities and Risks of Foundation Modelscited by 4,033
  5. 2024Qwen2 Technical Reportcited by 2,120
  6. 2021iBOT: Image BERT Pre-Training with Online Tokenizercited by 903
  7. 2024PaliGemma: A versatile 3B VLM for transfercited by 696
  8. 2024Rotary Position Embedding for Vision Transformercited by 236
  9. 2019SimpleShot: Revisiting Nearest-Neighbor Classification for Few-Shot Learningcited by 195
  10. 2024Virchow2: Scaling Self-Supervised Mixed Magnification Models in Pathologycited by 161
  11. 2024PRISM: A Multi-Modal Generative Foundation Model for Slide-Level Histopathologycited by 85
  12. 2024A Clinical Benchmark of Public Self-Supervised Pathology Foundation Modelscited by 66
6 more
  1. 2024A Multimodal Knowledge-enhanced Whole-slide Pathology Foundation Modelcited by 59
  2. 2024Benchmarking foundation models as feature extractors for weakly-supervised computational pathologycited by 49
  3. 2024RudolfV: A Foundation Model by Pathologists for Pathologistscited by 41
  4. 2024PLUTO: Pathology-Universal Transformercited by 17
  5. 2024Frozen Feature Augmentation for Few-Shot Image Classificationcited by 13
  6. 2023AugDiff: Diffusion based Feature Augmentation for Multiple Instance Learning in Whole Slide Imagecited by 3

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2024: 1; 2025: 69; 2026: 92.

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  1. 2025Patho-R1: A Multimodal Reinforcement Learning-Based Pathology Expert Reasonercited by 40
  2. 2025SurgVLM: A Large Vision-Language Model and Systematic Evaluation Benchmark for Surgical Intelligencecited by 31
  3. 2025CPathAgent: An Agent-based Foundation Model for Interpretable High-Resolution Pathology Image Analysis Mimicking Pathologists' Diagnostic Logiccited by 29
  4. 2025Do Multiple Instance Learning Models Transfer?cited by 29
  5. 2025Evidence-based diagnostic reasoning with multi-agent copilot for human pathologycited by 27
  6. 2025A Survey on Computational Pathology Foundation Models: Datasets, Adaptation Strategies, and Evaluation Taskscited by 16
  7. 2025A Survey of Pathology Foundation Model: Progress and Future Directionscited by 16
  8. 2025Atlas: A Novel Pathology Foundation Model by Mayo Clinic, Charit'e, and Aignosticscited by 11
  9. 2025PixCell: A generative foundation model for digital histopathology imagescited by 11
  10. 2025Multi-Modal Foundation Models for Computational Pathology: A Surveycited by 9
  11. 2026Scanner-Induced Domain Shifts Undermine the Robustness of Pathology Foundation Modelscited by 9
  12. 2025SurGen: 1020 H&E-stained Whole Slide Images With Survival and Genetic Markerscited by 8
38 more
  1. 2025GECKO: Gigapixel Vision-Concept Contrastive Pretraining in Histopathologycited by 8
  2. 2025Foundation Models in Medical Imaging: A Review and Outlookcited by 8
  3. 2025PRISM2: Unlocking Multi-Modal General Pathology AI with Clinical Dialoguecited by 8
  4. 2025A Large-Scale Benchmark of Cross-Modal Learning for Histology and Gene Expression in Spatial Transcriptomicscited by 8
  5. 2025MiCo: Multiple Instance Learning with Context-Aware Clustering for Whole Slide Image Analysiscited by 7
  6. 2025WSI-Agents: A Collaborative Multi-Agent System for Multi-Modal Whole Slide Image Analysiscited by 7
  7. 2025Navigating Gigapixel Pathology Images with Large Multimodal Modelscited by 7
  8. 2026Atlas 2 -- Foundation models for clinical deploymentcited by 7
  9. 2026PathNavigate: A Training-Free Pathology Agent with Surprise-Guided Scan and Shared Slide Memory for Whole-Slide Image VQAcited by 7
  10. 2025Pathology Report Generation and Multimodal Representation Learning for Cutaneous Melanocytic Lesionscited by 6
  11. 2025From Classical Machine Learning to Emerging Foundation Models: Review on Multimodal Data Integration for Cancer Researchcited by 6
  12. 2025Beyond the Failures: Rethinking Foundation Models in Pathologycited by 6
  13. 2025LoC-Path: Learning to Compress for Pathology Multimodal Large Language Modelscited by 6
  14. 2025TICON: A Slide-Level Tile Contextualizer for Histopathology Representation Learningcited by 6
  15. 2026CARE: A Molecular-Guided Foundation Model with Adaptive Region Modeling for Whole Slide Image Analysiscited by 6
  16. 2025PolyPath: Adapting a Large Multimodal Model for Multi-slide Pathology Report Generationcited by 4
  17. 2025Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imagingcited by 4
  18. 2025Enhancing Zero-Shot Brain Tumor Subtype Classification via Fine-Grained Patch-Text Alignmentcited by 4
  19. 2025PathFLIP: Fine-grained Language-Image Pretraining for Versatile Computational Pathologycited by 4
  20. 2026QCAgent: An agentic framework for quality-controllable pathology report generation from whole slide imagecited by 4
  21. 2025Can We Simplify Slide-level Fine-tuning of Pathology Foundation Models?cited by 3
  22. 2025PathVQ: Reforming Computational Pathology Foundation Model for Whole Slide Image Analysis via Vector Quantizationcited by 3
  23. 2025Exploiting Layer Normalization Fine-tuning in Visual Transformer Foundation Models for Classificationcited by 3
  24. 2026MOOZY: A Patient-First Foundation Model for Computational Pathologycited by 3
  25. 2025ModalTune: Fine-Tuning Slide-Level Foundation Models with Multi-Modal Information for Multi-task Learning in Digital Pathologycited by 2
  26. 2025Lifelong Whole Slide Image Analysis: Online Vision-Language Adaptation and Past-to-Present Gradient Distillationcited by 2
  27. 2025Controllable Latent Space Augmentation for Digital Pathologycited by 2
  28. 2025MergeSlide: Continual Model Merging and Task-to-Class Prompt-Aligned Inference for Lifelong Learning on Whole Slide Imagescited by 2
  29. 2025EXAONE Path 2.5: Pathology Foundation Model with Multi-Omics Alignmentcited by 2
  30. 2026VISTA-PATH: An interactive foundation model for pathology image segmentation and quantitative analysis in computational pathologycited by 2
  31. 2026SurgSigma: A Spectrum of Large-Scale Multimodal Data and Foundation Models for Surgical Intelligencecited by 2
  32. 2026NeuroSeg Meets DINOv3: Transferring 2D Self-Supervised Visual Priors to 3D Neuron Segmentation via DINOv3 Initializationcited by 2
  33. 2026Bridging the Modality Bottleneck in Pathology MIL through Virtual Molecular Stainingcited by 2
  34. 2026Thinking in Scales: Accelerating Gigapixel Pathology Image Analysis via Adaptive Continuous Reasoningcited by 2
  35. 2026Astar: Learning to Propose Evolution Directions for Self-Evolving Industrial AI Systemscited by 2
  36. 2024Unlocking adaptive digital pathology through dynamic feature learningcited by 1
  37. 2025A Lightweight and Extensible Cell Segmentation and Classification Model for Whole Slide Imagescited by 1
  38. 2025On the Importance of Text Preprocessing for Multimodal Representation Learning and Pathology Report Generationcited by 1

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