# Hepato-LLaVA: An Expert MLLM with Sparse Topo-Pack Attention for Hepatocellular Pathology Analysis on Whole Slide Images

arXiv: https://arxiv.org/abs/2602.19424 · HTML: https://mlsanity.com/paper/2602.19424/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 18 references that are in the map.
- First posted on arXiv 23 Feb 2026.

## Builds on (most cited first, 12 of 12)

- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [Quilt-LLaVA: Visual Instruction Tuning by Extracting Localized Narratives from Open-Source Histopathology Videos](https://mlsanity.com/paper/2312.04746/) (2023)
- [Morphological Prototyping for Unsupervised Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11643/) (2024)
- [SlideChat: A Large Vision-Language Assistant for Whole-Slide Pathology Image Understanding](https://mlsanity.com/paper/2410.11761/) (2024)
- [WSI-LLaVA: A Multimodal Large Language Model for Whole Slide Image](https://mlsanity.com/paper/2412.02141/) (2024)
- [Patho-R1: A Multimodal Reinforcement Learning-Based Pathology Expert Reasoner](https://mlsanity.com/paper/2505.11404/) (2025)
- [CAMIL: Context-Aware Multiple Instance Learning for Cancer Detection and Subtyping in Whole Slide Images](https://mlsanity.com/paper/2305.05314/) (2023)
- [MedReasoner: Reinforcement Learning Drives Reasoning Grounding from Clinical Thought to Pixel-Level Precision](https://mlsanity.com/paper/2508.08177/) (2025)
- [Libra-MIL: Multimodal Prototypes Stereoscopic Infused with Task-specific Language Priors for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2511.07941/) (2025)

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

- [PathoSage: Towards Multi-Source Evidence Adjudication in Pathology via Experience-Aware Agentic Workflow](https://mlsanity.com/paper/2606.07549/) (2026)

## Abstract (arXiv)

Hepatocellular Carcinoma diagnosis relies heavily on the interpretation of gigapixel Whole Slide Images. However, current computational approaches are constrained by fixed-resolution processing mechanisms and inefficient feature aggregation, which inevitably lead to either severe information loss or high feature redundancy. To address these challenges, we propose Hepato-LLaVA, a specialized Multi-modal Large Language Model designed for fine-grained hepatocellular pathology analysis. We introduce a novel Sparse Topo-Pack Attention mechanism that explicitly models 2D tissue topology. This mechanism effectively aggregates local diagnostic evidence into semantic summary tokens while preserving global context. Furthermore, to overcome the lack of multi-scale data, we present HepatoPathoVQA, a clinically grounded dataset comprising 33K hierarchically structured question-answer pairs validated by expert pathologists. Our experiments demonstrate that Hepato-LLaVA achieves state-of-the-art performance on HCC diagnosis and captioning tasks, significantly outperforming existing methods. Our code and implementation details are available at https://pris-cv.github.io/Hepto-LLaVA/.
