Xiang Li, Yuqi Wang, Casey C. Heirman +2cs.CV cs.LG
Cell mimicry arises when different cell types appear morphologically similar. Human pathologists resolve this ambiguity using surrounding tissue context, whereas current vision models either lack contextual reasoning (cell foundation models) or cannot operate at the cell level (pathology MLLMs). We present Loki-OT, which propagates region-level tissue reasoning to individual cell predictions via Unbalanced Optimal Transport, using MLLM-derived density priors as soft guidance for ambiguous cell reassignment. Loki-OT is motivated by the observation that pretrained cell foundation model features already encode discriminative information, including tissue context, but standard cell-level supervision fails to use tissue context effectively. The resulting transport plan is distilled into a lightweight student MLP classifier that learns context-aware decision boundaries within the pretrained feature space. On the independent TCGA-BRCA cohort, Loki-OT achieved lower patient-level MAE than the fully supervised in-domain PanopTILs classifier and improved F1 in epithelium-rich mimicry tissues, using 278 weak region-level MLLM estimates built on a general-domain cell foundation model. Code: https://github.com/xiangli980/Lymphocyte_Mimicry_Correction_via_Loki_OT
Identifying cell types directly from routine haematoxylin and eosin (H&E) histology would enable single-cell analysis at scale, but training such models has relied on manual pathologist annotations, which are slow, expensive and unreliable for many cell types. We instead supervise morphology with molecules. Imaging-based spatial transcriptomics profiles individual cells in situ on a section that can afterwards be stained with H&E, so that molecular identity and morphology are observed for the same physical cell. We assembled 81 such paired Xenium sections spanning 16 organs, derived per-cell labels by clustering, marker-gene annotation, organ-wise human review and quality control, and mapped them onto the cell types commonly reported in each organ. This yielded 15.4 million cells, each with a paired H&E image patch and one of 23 cell types, on which we trained CytoFormer, a cell foundation model with a multi-task, per-organ classification head. On spatially held-out tissue CytoFormer reached an accuracy of 0.85 and a macro-F1 of 0.78 across all 16 organs, and its predictions reproduced the tissue architecture of an entire held-out section. The representation also transfers: with the encoder frozen, a linear head on CytoFormer features performed better than six pathology foundation models on four expert-annotated benchmarks, including on organs and cell types that were not part of pretraining. Finally, in an interactive active-learning setting, CytoFormer's embeddings are markedly more label-efficient than existing pathology foundation models, detecting normal epithelium amid look-alike tumour with an F1 of 0.82 from only a few annotations and leading the strongest baseline by 0.13 in F1. CytoFormer turns paired H&E and spatial transcriptomics into a reusable, label-efficient representation for cell-level analysis of routine histology.
Many single-cell annotation tools refine an initial cell label using nearby cells or cluster-level voting. We study whether this refinement can be manipulated without changing the target cell. We introduce CohortHijack, a robustness audit that removes selected non-target cells from the query cohort while preserving the target expression profile, base prediction, and trained model. We evaluate random and structured removal methods, together with greedy, multi-start, and beam search, on PBMC3K and Paul15 using logistic regression and calibrated linear SVM classifiers. Structured removal was consistently stronger than random removal on Paul15. Multi-start search changed 24.33% of linear-SVM targets and 19.67% of logistic-regression targets while removing a small fraction of the cohort and keeping mean collateral changes below 0.4%. Ablations confirmed that the effect disappeared when neighborhood refinement was disabled. We also evaluated CellTypist majority voting, where independent predictions remained unchanged across all evaluations, but refined labels changed after small companion-cell removals. These findings identify query cohort composition as a target-preserving attack surface in single-cell annotation.
Accurate cell segmentation and classification are foundational to digital pathology, enabling quantitative tissue analysis for diagnosis and treatment planning. Encoder-decoder architectures that fuse multi-scale features through skip connections have become the dominant paradigm for this task, yet standard direct skip connections treat every spatial location equally, which leads to redundant and potentially conflicting information reaching the decoder. To overcome this problem, various gating mechanisms have been introduced, but most of them operate solely on filtering encoder information, neglecting the benefit of global contextual information from the decoder. This study proposes replacing conventional skip connections in a CellViT-based model with a novel Spatial Attention Fusion (SAF) Gating module. Each SAF gate concatenates the encoder skip and upsampled decoder features, compresses them through two pointwise convolutions with an intermediate ReLU, and applies a channel-wise softmax to produce a per-pixel "heatmap of trust" that sums to unity at every spatial location, allowing the network to learn where each source is most trustworthy. The resulting fused features improve the model's ability to detect the minority "Dead" class, which in turn enhances the multi-class panoptic quality (mPQ) on the PanNuke dataset. SAF Gating is compared against six gating alternatives including no gating, attention gates, squeeze-and-excitation, CBAM, cross-attention, and attentional feature fusion on PanNuke and MoNuSeg datasets. SAF Gating achieves the highest mPQ (0.471), a gain driven primarily by a 14.5-point improvement in Dead-class F1 score compared to ungated CellViT baseline.
Recent advances in pathology foundation models have substantially improved patch and slide level representation learning from whole-slide images (WSIs).However, cell-level representations learning remain underexplored, limiting cell resolved interpretability, biological discovery, and clinical translation. We propose CellDETR, a detection-guided framework built on Deformable DETR for scalable cell representation learning from WSIs. By introducing location feature decoupling and box-constrained attention mechanism, CellDETR enables automated extraction of cell-level embeddings, and outperform existing state-of-the-art methods in supervised cell classification on PanNuke data. In addition, by incorporating contrastive learning design, we build a CellDETR-based pretraining model for scalable cell representation learning from unlabeled WSIs, which improves downstream cell classification performance. Furthermore, we show that after pretraining with Xenium spatial transcriptomics-derived cell annotations, CellDETR achieves accurate cross-dataset cell classification, demonstrating the transferability and biological relevance of the learned cell embeddings. Together, CellDETR provides a scalable route toward general cell-level representation learning framework for interpretable computational patholog
Kai Standvoss, Miriam Hägele, Rosemarie Krupar +25cs.CV cs.AI cs.LG
Hematoxylin and eosin (H&E) staining is the cornerstone of histopathology, yet scalable, quantitative analysis of H&E whole-slide images (WSIs) remains a central challenge in computational pathology. We present Atlas H&E-TME, an AI-based system built on the Atlas family of pathology foundation models that predicts tissue quality, tissue region, and cell type labels across multiple cancer types, yielding over 4,500 quantitative readouts per slide at cell-level resolution. A key challenge to validating such systems is overcoming morphological ambiguity inherent to H&E-only ground truth and the limited scalability of more informed references drawing on modalities such as immunohistochemistry (IHC). We address this with a dual validation framework combining biologically grounded depth with technical and morphological breadth. For depth, we propose an IHC-informed multi-pathologist consensus protocol that substantially improves inter-rater agreement over conventional H&E-only annotation. This yields a molecularly grounded reference against which we compare Atlas H&E-TME and pathologists working from H&E alone. For breadth, we benchmark Atlas H&E-TME on over 200,000 high-confidence H&E-only pathologist annotations across 1,500+ cases spanning eight cancer types and their most common metastatic sites, with subtypes covering >90% of clinical cases per cancer type, drawn from 25+ sources and 8+ scanner models. Benchmarked against the IHC-informed consensus, Atlas H&E-TME matches or exceeds pathologist H&E-only performance and generalizes consistently and robustly across this broad morphological and technical scope. In doing so, Atlas H&E-TME turns the H&E slide -- the most ubiquitous data in pathology -- into a scalable, quantitative window into the tumor and its microenvironment, laying a foundation for the next generation of tissue-based biomarkers in translational and clinical research.