# Adaptive Prototype-based Interpretable Grading of Prostate Cancer

arXiv: https://arxiv.org/abs/2603.04947 · HTML: https://mlsanity.com/paper/2603.04947/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 28 references that are in the map.
- First posted on arXiv 5 Mar 2026.

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

- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Sanity Checks for Saliency Maps](https://mlsanity.com/paper/1810.03292/) (2018)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [This Looks Like That: Deep Learning for Interpretable Image Recognition](https://mlsanity.com/paper/1806.10574/) (2018)
- [The (Un)reliability of saliency methods](https://mlsanity.com/paper/1711.00867/) (2017)
- [Interpretable Image Classification with Differentiable Prototypes Assignment](https://mlsanity.com/paper/2112.02902/) (2021)
- [IAIA-BL: A Case-based Interpretable Deep Learning Model for Classification of Mass Lesions in Digital Mammography](https://mlsanity.com/paper/2103.12308/) (2021)
- [Going Deeper through the Gleason Scoring Scale: An Automatic end-to-end System for Histology Prostate Grading and Cribriform Pattern Detection](https://mlsanity.com/paper/2105.10490/) (2021)
- [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 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)
- [Self-learning for weakly supervised Gleason grading of local patterns](https://mlsanity.com/paper/2105.10420/) (2021)
- [Beyond accuracy: quantifying the reliability of Multiple Instance Learning for Whole Slide Image classification](https://mlsanity.com/paper/2409.11110/) (2024)
- [Beyond Occlusion: In Search for Near Real-Time Explainability of CNN-Based Prostate Cancer Classification](https://mlsanity.com/paper/2512.17416/) (2025)

## Abstract (arXiv)

Prostate cancer being one of the frequently diagnosed malignancy in men, the rising demand for biopsies places a severe workload on pathologists. The grading procedure is tedious and subjective, motivating the development of automated systems. Although deep learning has made inroads in terms of performance, its limited interpretability poses challenges for widespread adoption in high-stake applications like medicine. Existing interpretability techniques for prostate cancer classifiers provide a coarse explanation but do not reveal why the highlighted regions matter. In this scenario, we propose a novel prototype-based weakly-supervised framework for an interpretable grading of prostate cancer from histopathology images. These networks can prove to be more trustworthy since their explicit reasoning procedure mirrors the workflow of a pathologist in comparing suspicious regions with clinically validated examples. The network is initially pre-trained at patch-level to learn robust prototypical features associated with each grade. In order to adapt it to a weakly-supervised setup for prostate cancer grading, the network is fine-tuned with a new prototype-aware loss function. Finally, a new attention-based dynamic pruning mechanism is introduced to handle inter-sample heterogeneity, while selectively emphasizing relevant prototypes for optimal performance. Extensive validation on the benchmark PANDA and SICAP datasets confirms that the framework can serve as a reliable assistive tool for pathologists in their routine diagnostic workflows.