# MOC: Meta-Optimized Classifier for Few-Shot Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2508.09967 · HTML: https://mlsanity.com/paper/2508.09967/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 20 references that are in the map.
- First posted on arXiv 13 Aug 2025.

## Builds on (most cited first, 16 of 16)

- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [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)
- [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)
- [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)
- [Interventional Bag Multi-Instance Learning On Whole-Slide Pathological Images](https://mlsanity.com/paper/2303.06873/) (2023)
- [A graph-transformer for whole slide image classification](https://mlsanity.com/paper/2205.09671/) (2022)
- [Multiple Instance Learning Framework with Masked Hard Instance Mining for Whole Slide Image Classification](https://mlsanity.com/paper/2307.15254/) (2023)
- [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)
- [ViLa-MIL: Dual-scale Vision-Language Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2502.08391/) (2025)
- [Generalizable Whole Slide Image Classification with Fine-Grained Visual-Semantic Interaction](https://mlsanity.com/paper/2402.19326/) (2024)
- [MSCPT: Few-shot Whole Slide Image Classification with Multi-scale and Context-focused Prompt Tuning](https://mlsanity.com/paper/2408.11505/) (2024)
- [Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2407.10814/) (2024)
- [FAST: A Dual-tier Few-Shot Learning Paradigm for Whole Slide Image Classification](https://mlsanity.com/paper/2409.19720/) (2024)

## Abstract (arXiv)

Recent advances in histopathology vision-language foundation models (VLFMs) have shown promise in addressing data scarcity for whole slide image (WSI) classification via zero-shot adaptation. However, these methods remain outperformed by conventional multiple instance learning (MIL) approaches trained on large datasets, motivating recent efforts to enhance VLFM-based WSI classification through fewshot learning paradigms. While existing few-shot methods improve diagnostic accuracy with limited annotations, their reliance on conventional classifier designs introduces critical vulnerabilities to data scarcity. To address this problem, we propose a Meta-Optimized Classifier (MOC) comprising two core components: (1) a meta-learner that automatically optimizes a classifier configuration from a mixture of candidate classifiers and (2) a classifier bank housing diverse candidate classifiers to enable a holistic pathological interpretation. Extensive experiments demonstrate that MOC outperforms prior arts in multiple few-shot benchmarks. Notably, on the TCGA-NSCLC benchmark, MOC improves AUC by 10.4% over the state-of-the-art few-shot VLFM-based methods, with gains up to 26.25% under 1-shot conditions, offering a critical advancement for clinical deployments where diagnostic training data is severely limited. Code is available at https://github.com/xmed-lab/MOC.
