# Anatomy-Privileged Distillation with Token Routing for MRI-Based Prediction of Perineural Invasion

arXiv: https://arxiv.org/abs/2607.11987 · HTML: https://mlsanity.com/paper/2607.11987/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 11 of its 29 references that are in the map.
- First posted on arXiv 13 Jul 2026.

## Builds on (most cited first, 11 of 11)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [DynamicViT: Efficient Vision Transformers with Dynamic Token Sparsification](https://mlsanity.com/paper/2106.02034/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Not All Patches are What You Need: Expediting Vision Transformers via Token Reorganizations](https://mlsanity.com/paper/2202.07800/) (2022)
- [Unifying distillation and privileged information](https://mlsanity.com/paper/1511.03643/) (2015)
- [TriDeNT: Triple Deep Network Training for Privileged Knowledge Distillation in Histopathology](https://mlsanity.com/paper/2312.02111/) (2023)

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

- [Order-Aware 2.5D Multiple Instance Learning for Preoperative MRI-Based Perineural Invasion Risk Assessment in Intrahepatic Cholangiocarcinoma](https://mlsanity.com/paper/2609.11271/) (2026)

## Abstract (arXiv)

Perineural invasion (PNI) is associated with poor postoperative outcomes in intrahepatic cholangiocarcinoma, but it is confirmed by surgical pathology. Existing preoperative imaging models often rely on radiologist-defined variables, contrast-enhanced imaging, or manual annotations. We propose an anatomy-privileged teacher--student framework for patient-level PNI prediction from T2-weighted MRI. During training, the teacher uses MRI with tumor and liver masks to learn dense token routing, and the student distills this guidance to retain and aggregate informative tokens under a fixed budget. Anatomical supervision is restricted to training, and the deployed model does not require masks at inference. In 155 patients, the proposed method achieved the highest mean AUROC of 0.750 among matched MRI-only baselines evaluated under the same protocol, with 1.43 GFLOPs and 8.02 ms per case on a Jetson Orin Nano Super Developer Kit.