# PathAR: Structure-First Autoregressive Synthesis of Multimodal Pathology Images

arXiv: https://arxiv.org/abs/2606.01543 · HTML: https://mlsanity.com/paper/2606.01543/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 39 of its 60 references that are in the map.
- First posted on arXiv 1 Jun 2026.

## Builds on (most cited first, 30 of 39)

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- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Scalable Diffusion Models with Transformers](https://mlsanity.com/paper/2212.09748/) (2022)
- [Classifier-Free Diffusion Guidance](https://mlsanity.com/paper/2207.12598/) (2022)
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- [Neural Discrete Representation Learning](https://mlsanity.com/paper/1711.00937/) (2017)
- [RoFormer: Enhanced Transformer with Rotary Position Embedding](https://mlsanity.com/paper/2104.09864/) (2021)
- [Taming Transformers for High-Resolution Image Synthesis](https://mlsanity.com/paper/2012.09841/) (2020)
- [ImageNet-trained CNNs are biased towards texture; increasing shape bias improves accuracy and robustness](https://mlsanity.com/paper/1811.12231/) (2018)
- [T2I-Adapter: Learning Adapters to Dig out More Controllable Ability for Text-to-Image Diffusion Models](https://mlsanity.com/paper/2302.08453/) (2023)
- [Semantic Image Synthesis with Spatially-Adaptive Normalization](https://mlsanity.com/paper/1903.07291/) (2019)
- [Training Generative Adversarial Networks with Limited Data](https://mlsanity.com/paper/2006.06676/) (2020)
- [MaskGIT: Masked Generative Image Transformer](https://mlsanity.com/paper/2202.04200/) (2022)
- [Visual Autoregressive Modeling: Scalable Image Generation via Next-Scale Prediction](https://mlsanity.com/paper/2404.02905/) (2024)
- [Improved Precision and Recall Metric for Assessing Generative Models](https://mlsanity.com/paper/1904.06991/) (2019)
- [Emu3: Next-Token Prediction is All You Need](https://mlsanity.com/paper/2409.18869/) (2024)
- [Autoregressive Model Beats Diffusion: Llama for Scalable Image Generation](https://mlsanity.com/paper/2406.06525/) (2024)
- [Janus: Decoupling Visual Encoding for Unified Multimodal Understanding and Generation](https://mlsanity.com/paper/2410.13848/) (2024)
- [PanNuke Dataset Extension, Insights and Baselines](https://mlsanity.com/paper/2003.10778/) (2020)
- [Distribution Matching Losses Can Hallucinate Features in Medical Image Translation](https://mlsanity.com/paper/1805.08841/) (2018)
- [ImageFolder: Autoregressive Image Generation with Folded Tokens](https://mlsanity.com/paper/2410.01756/) (2024)
- [On hallucinations in tomographic image reconstruction](https://mlsanity.com/paper/2012.00646/) (2020)
- [Efficient Semantic Image Synthesis via Class-Adaptive Normalization](https://mlsanity.com/paper/2012.04644/) (2020)
- [Deep learning-based transformation of the H&E stain into special stains](https://mlsanity.com/paper/2008.08871/) (2020)

## Abstract (arXiv)

Data scarcity in multimodal pathology motivates unified generative models that synthesize modality-specific appearance while preserving anatomically coherent structure. Although modalities differ in appearance statistics, morphological structures such as cellular topology and tissue boundaries are largely preserved across acquisition protocols. However, existing methods often model these factors within a homogeneous token stream, implicitly coupling structure with appearance and weakening structural controllability under modality shifts. To address this, we propose pathology Autorgressive modeling (PathAR), a structure-first autoregressive synthesis framework that explicitly factorizes structure and appearance for modality-label-conditioned pathology generation.PathAR employs a dual vector quantization (Dual-VQ) tokenizer to decompose samples into mask-grounded structure and appearance tokens, and an interleaved autoregressive (IAR) transformer with asymmetric attention visibility to enforce structure-to-appearance dependence. PathAR stabilizes morphology under heterogeneous modality-specific appearances and enables spatially aligned image--mask pair generation. Extensive experiments show that PathAR improves structural consistency and modality fidelity over baselines, maintains sample diversity, supports downstream segmentation in data-scarce regimes, and demonstrates extensibility to finer-grained intra-modality organ-label variation.