# Sequential Attention-based Sampling for Histopathological Analysis

arXiv: https://arxiv.org/abs/2507.05077 · HTML: https://mlsanity.com/paper/2507.05077/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 24 of its 45 references that are in the map.
- First posted on arXiv 7 Jul 2025.

## Builds on (most cited first, 24 of 24)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [High-Dimensional Continuous Control Using Generalized Advantage Estimation](https://mlsanity.com/paper/1506.02438/) (2015)
- [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)
- [Deep neural network models for computational histopathology: A survey](https://mlsanity.com/paper/1912.12378/) (2019)
- [Patch-based Convolutional Neural Network for Whole Slide Tissue Image Classification](https://mlsanity.com/paper/1504.07947/) (2015)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [BRACS: A Dataset for BReAst Carcinoma Subtyping in H&E Histology Images](https://mlsanity.com/paper/2111.04740/) (2021)
- [Attention-Challenging Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2311.07125/) (2023)
- [Multiple Instance Learning for Digital Pathology: A Review on the State-of-the-Art, Limitations & Future Potential](https://mlsanity.com/paper/2206.04425/) (2022)
- [Towards a Visual-Language Foundation Model for Computational Pathology](https://mlsanity.com/paper/2307.12914/) (2023)
- [Differentiable Zooming for Multiple Instance Learning on Whole-Slide Images](https://mlsanity.com/paper/2204.12454/) (2022)
- [Iteratively-Refined Interactive 3D Medical Image Segmentation with Multi-Agent Reinforcement Learning](https://mlsanity.com/paper/1911.10334/) (2019)
- [A Multi-resolution Model for Histopathology Image Classification and Localization with Multiple Instance Learning](https://mlsanity.com/paper/2011.02679/) (2020)
- [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)
- [Dynamic Policy-Driven Adaptive Multi-Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2403.07939/) (2024)
- [RLogist: Fast Observation Strategy on Whole-slide Images with Deep Reinforcement Learning](https://mlsanity.com/paper/2212.01737/) (2022)
- [Reinforcement learning using Deep Q Networks and Q learning accurately localizes brain tumors on MRI with very small training sets](https://mlsanity.com/paper/2010.10763/) (2020)

## Built on by (most cited first, 2 of 2)

- [Clinically-Informed Modeling for Pediatric Brain Tumor Classification from Whole-Slide Histopathology Images](https://mlsanity.com/paper/2604.21060/) (2026)
- [Interactive Whole Slide Images for RL-based Tumour Segmentation](https://mlsanity.com/paper/2608.16607/) (2026)

## Abstract (arXiv)

Deep neural networks are increasingly applied in automated histopathology. Yet, whole-slide images (WSIs) are often acquired at gigapixel sizes, rendering them computationally infeasible to analyze entirely at high resolution. Diagnostic labels are largely available only at the slide-level, because expert annotation of images at a finer (patch) level is both laborious and expensive. Moreover, regions with diagnostic information typically occupy only a small fraction of the WSI, making it inefficient to examine the entire slide at full resolution. Here, we propose SASHA -- Sequential Attention-based Sampling for Histopathological Analysis -- a deep reinforcement learning approach for efficient analysis of histopathological images. First, SASHA learns informative features with a lightweight hierarchical, attention-based multiple instance learning (MIL) model. Second, SASHA samples intelligently and zooms selectively into a small fraction (10-20%) of high-resolution patches to achieve reliable diagnoses. We show that SASHA matches state-of-the-art methods that analyze the WSI fully at high resolution, albeit at a fraction of their computational and memory costs. In addition, it significantly outperforms competing, sparse sampling methods. We propose SASHA as an intelligent sampling model for medical imaging challenges that involve automated diagnosis with exceptionally large images containing sparsely informative features. Model implementation is available at: https://github.com/coglabiisc/SASHA.