# GMAT: Grounded Multi-Agent Clinical Description Generation for Text Encoder in Vision-Language MIL for Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2508.01293 · HTML: https://mlsanity.com/paper/2508.01293/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 18 references that are in the map.
- First posted on arXiv 2 Aug 2025.

## Builds on (most cited first, 14 of 14)

- [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)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Visual Language Pretrained Multiple Instance Zero-Shot Transfer for Histopathology Images](https://mlsanity.com/paper/2306.07831/) (2023)
- [DGMIL: Distribution Guided Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2206.08861/) (2022)
- [ViLa-MIL: Dual-scale Vision-Language Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2502.08391/) (2025)
- [MSCPT: Few-shot Whole Slide Image Classification with Multi-scale and Context-focused Prompt Tuning](https://mlsanity.com/paper/2408.11505/) (2024)
- [CAMIL: Context-Aware Multiple Instance Learning for Cancer Detection and Subtyping in Whole Slide Images](https://mlsanity.com/paper/2305.05314/) (2023)
- [Snuffy: Efficient Whole Slide Image Classifier](https://mlsanity.com/paper/2408.08258/) (2024)
- [MGPATH: Vision-Language Model with Multi-Granular Prompt Learning for Few-Shot WSI Classification](https://mlsanity.com/paper/2502.07409/) (2025)

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

- [SurvAgent: Hierarchical CoT-Enhanced Case Banking and Dichotomy-Based Multi-Agent System for Multimodal Survival Prediction](https://mlsanity.com/paper/2511.16635/) (2025)

## Abstract (arXiv)

Multiple Instance Learning (MIL) is the leading approach for whole slide image (WSI) classification, enabling efficient analysis of gigapixel pathology slides. Recent work has introduced vision-language models (VLMs) into MIL pipelines to incorporate medical knowledge through text-based class descriptions rather than simple class names. However, when these methods rely on large language models (LLMs) to generate clinical descriptions or use fixed-length prompts to represent complex pathology concepts, the limited token capacity of VLMs often constrains the expressiveness and richness of the encoded class information. Additionally, descriptions generated solely by LLMs may lack domain grounding and fine-grained medical specificity, leading to suboptimal alignment with visual features. To address these challenges, we propose a vision-language MIL framework with two key contributions: (1) A grounded multi-agent description generation system that leverages curated pathology textbooks and agent specialization (e.g., morphology, spatial context) to produce accurate and diverse clinical descriptions; (2) A text encoding strategy using a list of descriptions rather than a single prompt, capturing fine-grained and complementary clinical signals for better alignment with visual features. Integrated into a VLM-MIL pipeline, our approach shows improved performance over single-prompt class baselines and achieves results comparable to state-of-the-art models, as demonstrated on renal and lung cancer datasets.