# MsaMIL-Net: An End-to-End Multi-Scale Aware Multiple Instance Learning Network for Efficient Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2503.08581 · HTML: https://mlsanity.com/paper/2503.08581/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 20 of its 32 references that are in the map.
- First posted on arXiv 11 Mar 2025.

## Builds on (most cited first, 20 of 20)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [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)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Deep neural network models for computational histopathology: A survey](https://mlsanity.com/paper/1912.12378/) (2019)
- [Deep Learning-based Computational Pathology Predicts Origins for Cancers of Unknown Primary](https://mlsanity.com/paper/2006.13932/) (2020)
- [MambaMIL: Enhancing Long Sequence Modeling with Sequence Reordering in Computational Pathology](https://mlsanity.com/paper/2403.06800/) (2024)
- [Multi-scale Domain-adversarial Multiple-instance CNN for Cancer Subtype Classification with Unannotated Histopathological Images](https://mlsanity.com/paper/2001.01599/) (2020)
- [Phikon-v2, A large and public feature extractor for biomarker prediction](https://mlsanity.com/paper/2409.09173/) (2024)
- [CAMEL: A Weakly Supervised Learning Framework for Histopathology Image Segmentation](https://mlsanity.com/paper/1908.10555/) (2019)
- [Deep Adversarial Training for Multi-Organ Nuclei Segmentation in Histopathology Images](https://mlsanity.com/paper/1810.00236/) (2018)
- [Federated Learning for Computational Pathology on Gigapixel Whole Slide Images](https://mlsanity.com/paper/2009.10190/) (2020)
- [Bi-directional Weakly Supervised Knowledge Distillation for Whole Slide Image Classification](https://mlsanity.com/paper/2210.03664/) (2022)
- [DGMIL: Distribution Guided Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2206.08861/) (2022)
- [Towards Label-efficient Automatic Diagnosis and Analysis: A Comprehensive Survey of Advanced Deep Learning-based Weakly-supervised, Semi-supervised and Self-supervised Techniques in Histopathological Image Analysis](https://mlsanity.com/paper/2208.08789/) (2022)
- [Rethinking Multiple Instance Learning for Whole Slide Image Classification: A Good Instance Classifier is All You Need](https://mlsanity.com/paper/2307.02249/) (2023)
- [MamMIL: Multiple Instance Learning for Whole Slide Images with State Space Models](https://mlsanity.com/paper/2403.05160/) (2024)
- [Cross-scale Attention Guided Multi-instance Learning for Crohn's Disease Diagnosis with Pathological Images](https://mlsanity.com/paper/2208.07322/) (2022)

## Abstract (arXiv)

Bag-based Multiple Instance Learning (MIL) approaches have emerged as the mainstream methodology for Whole Slide Image (WSI) classification. However, most existing methods adopt a segmented training strategy, which first extracts features using a pre-trained feature extractor and then aggregates these features through MIL. This segmented training approach leads to insufficient collaborative optimization between the feature extraction network and the MIL network, preventing end-to-end joint optimization and thereby limiting the overall performance of the model. Additionally, conventional methods typically extract features from all patches of fixed size, ignoring the multi-scale observation characteristics of pathologists. This not only results in significant computational resource waste when tumor regions represent a minimal proportion (as in the Camelyon16 dataset) but may also lead the model to suboptimal solutions. To address these limitations, this paper proposes an end-to-end multi-scale WSI classification framework that integrates multi-scale feature extraction with multiple instance learning. Specifically, our approach includes: (1) a semantic feature filtering module to reduce interference from non-lesion areas; (2) a multi-scale feature extraction module to capture pathological information at different levels; and (3) a multi-scale fusion MIL module for global modeling and feature integration. Through an end-to-end training strategy, we simultaneously optimize both the feature extractor and MIL network, ensuring maximum compatibility between them. Experiments were conducted on three cross-center datasets (DigestPath2019, BCNB, and UBC-OCEAN). Results demonstrate that our proposed method outperforms existing state-of-the-art approaches in terms of both accuracy (ACC) and AUC metrics.
