# Slide-Level Prompt Learning with Vision Language Models for Few-Shot Multiple Instance Learning in Histopathology

arXiv: https://arxiv.org/abs/2503.17238 · HTML: https://mlsanity.com/paper/2503.17238/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 15 of its 19 references that are in the map.
- First posted on arXiv 21 Mar 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 15 of 15)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [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)
- [Self-Path: Self-supervision for Classification of Pathology Images with Limited Annotations](https://mlsanity.com/paper/2008.05571/) (2020)
- [Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11643/) (2024)
- [Text-guided Foundation Model Adaptation for Pathological Image Classification](https://mlsanity.com/paper/2307.14901/) (2023)
- [A Comprehensive Review of Computer-aided Whole-slide Image Analysis: from Datasets to Feature Extraction, Segmentation, Classification, and Detection Approaches](https://mlsanity.com/paper/2102.10553/) (2021)
- [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)
- [Inference of captions from histopathological patches](https://mlsanity.com/paper/2202.03432/) (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)
- [A Simple Framework for Open-Vocabulary Zero-Shot Segmentation](https://mlsanity.com/paper/2406.16085/) (2024)
- [Self-supervised learning-based cervical cytology for the triage of HPV-positive women in resource-limited settings and low-data regime](https://mlsanity.com/paper/2302.05195/) (2023)

## Built on by (most cited first, 1 of 1)

- [Spatial Blindness in Whole-Slide Multiple Instance Learning](https://mlsanity.com/paper/2605.17449/) (2026)

## Abstract (arXiv)

In this paper, we address the challenge of few-shot classification in histopathology whole slide images (WSIs) by utilizing foundational vision-language models (VLMs) and slide-level prompt learning. Given the gigapixel scale of WSIs, conventional multiple instance learning (MIL) methods rely on aggregation functions to derive slide-level (bag-level) predictions from patch representations, which require extensive bag-level labels for training. In contrast, VLM-based approaches excel at aligning visual embeddings of patches with candidate class text prompts but lack essential pathological prior knowledge. Our method distinguishes itself by utilizing pathological prior knowledge from language models to identify crucial local tissue types (patches) for WSI classification, integrating this within a VLM-based MIL framework. Our approach effectively aligns patch images with tissue types, and we fine-tune our model via prompt learning using only a few labeled WSIs per category. Experimentation on real-world pathological WSI datasets and ablation studies highlight our method's superior performance over existing MIL- and VLM-based methods in few-shot WSI classification tasks. Our code is publicly available at https://github.com/LTS5/SLIP.