Cited by 704AI in cancer detectionArtificial Intelligence in Healthcare and EducationRadiomics and Machine Learning in Medical Imaging

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A foundation model for clinical-grade computational pathology and rare cancers detection

Open access

Abstract

The analysis of histopathology images with artificial intelligence aims to enable clinical decision support systems and precision medicine. The success of such applications depends on the ability to model the diverse patterns observed in pathology images. To this end, we present Virchow, the largest foundation model for computational pathology to date. In addition to the evaluation of biomarker prediction and cell identification, we demonstrate that a large foundation model enables pan-cancer detection, achieving 0.95 specimen-level area under the (receiver operating characteristic) curve across nine common and seven rare cancers. Furthermore, we show that with less training data, the pan-cancer detector built on Virchow can achieve similar performance to tissue-specific clinical-grade models in production and outperform them on some rare variants of cancer. Virchow’s performance gains highlight the value of a foundation model and open possibilities for many high-impact applications with limited amounts of labeled training data.

Overview

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TL;DR

Virchow is a 632-million-parameter vision transformer foundation model for computational pathology trained on ~1.5 million H&E whole-slide images from ~100,000 patients. It enables pan-cancer detection with 0.950 specimen-level AUC across common and rare cancers and approaches or exceeds clinical-grade specialist models on several tasks with less training data.

Key findings

  • Virchow embeddings achieved the best pan-cancer detection performance across all tested cancer types: overall AUC 0.950, versus 0.940 for UNI, 0.932 for Phikon and 0.907 for CTransPath; rare-cancer AUC was 0.937.
  • At 95% sensitivity, the Virchow-based pan-cancer model reached 72.5% specificity, compared with 68.9%, 62.9% and 52.3% for UNI, Phikon and CTransPath, respectively.
  • Against clinical products, the pan-cancer model reached AUC 0.980 on prostate, 0.985 on breast and 0.971 on breast lymph node; it was below Paige Prostate (0.995, P < 0.05) and Paige Breast (0.992, P < 0.01), but better than Paige BLN for macrometastases (0.999 versus 0.994, P < 0.05).
  • Virchow embeddings ranked top in 7 of 9 biomarker prediction tasks and matched or surpassed other embeddings in 7 of 8 tile-level benchmark tasks.

Methods

  • Design: Virchow is a ViT-H/14 model with 632 million parameters trained with DINO v.2 self-supervised learning on 2 billion tiles sampled from approximately 13 billion available tissue tiles.
  • Data: training used 1,488,550 H&E WSIs from 119,629 patients across 17 tissue groups; pan-cancer evaluation used 22,932 slides from 6,142 specimens across 16 cancer types, including internal MSKCC and external consultation cases.
  • Analysis: downstream pan-cancer and biomarker tasks used a weakly supervised Agata aggregator; tile-level tasks used linear probing. Performance was assessed mainly by AUC, specificity at 95% sensitivity, F1, DeLong’s test, Cochran’s Q/McNemar tests and Holm correction.

Limitations

  • Stated: training data came from one center with limited scanner types; embeddings are tile-level at ×20 magnification (0.5 mpp), requiring an aggregation model, and slide-level models may be needed for low-data tasks such as biomarker, treatment-response or outcome prediction.
  • Stated: rare-variant and biomarker comparisons lacked statistical power; thorough stratified clinical validation, hardware/deployment considerations and possible model distillation remain necessary, and data-balancing/distillation strategies were not fully explored.
  • Evident from the text: the evaluation is retrospective and uses deidentified secondary data, with no prospective clinical deployment study reported.

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Crossref · 10.1038/s41591-024-03141-0

Cites

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Figures

Fig. 1 Overview of the study. The training dataset, training algorithm and application of Virchow, a foundation model for computational pathology. a, The training data can be described in terms of patients, cases, specimens, blocks or slides, as shown. b–d, The slide distribution as a function of cancer status (b), surgery (c) and tissue type (d). e, The dataflow during training requires processing the slide into tiles, which are then cropped into global and local views. f, Schematic of applications of the foundation model using an aggregator model to predict attributes at the slide level. GI, gastrointestinal.
Fig. 1 Overview of the study. The training dataset, training algorithm and application of Virchow, a foundation model for computational pathology. a, The training data can be described in terms of patients, cases, specimens, blocks or slides, as shown. b–d, The slide distribution as a function of cancer status (b), surgery (c) and tissue type (d). e, The dataflow during training requires processing the slide into tiles, which are then cropped into global and local views. f, Schematic of applications of the foundation model using an aggregator model to predict attributes at the slide level. GI, gastrointestinal.CC BY · PubMed Central
Fig. 2 Virchow enables training a robust pan-cancer detector. Pan-cancer detection results. Detection is predicted at the specimen level using an aggregator network trained with Virchow, UNI, Phikon or CTransPath tile embeddings as input. a, Cancer detection performance (AUC) stratified by cancer type as determined by origin tissue. The incidence rate and proportion of metastasis of each cancer are shown. Virchow embeddings enable the best cancer detection performance across all cancer types, including rare cancers. For each cancer type, the AUC corresponding to the statistically significantly (P < 0.05) top-performing embeddings is highlighted in magenta. When more than one AUC is not gray, performance is ‘tied’ (no statistically significant difference). The foundation model used to produce tile embeddings for the aggregator is shown in the margin on the left, along with the number of cancer types for which the corresponding aggregator achieved (or tied for) the top AUC. All statistical significance (a–e) is computed using the pairwise DeLong’s test for AUC and Cochran’s Q test followed by McNemar’s test for specificity, both corrected for multiple comparisons with Holm’s method. b,c, Cancer detection performance summarized for all cancers (b) and for rare cancers (c). Error bars (b–e) show the two-sided 95% confidence interval computed with DeLong’s method for AUC and Wilson’s method for specificity; the • denotes the differences that are statistically significant from the rest (P < 0.0001). d, Sensitivity at 95% specificity for rare cancer detection (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001). e, Virchow-based cancer detection generalizes well to data from external institutions that were not represented in the training set; all aggregators and Virchow were trained only on data from MSKCC. Only half of the specimens in the pan-cancer testing set are from MSKCC. f, One-fifth of the specimens used for pan-cancer model evaluation contained tissues that were not observed in the training sets of Virchow or the pan-cancer aggregators. g, Cancer detection performance scales with the size of the underlying foundation model and the number of training samples (tiles) used to train it. H&N, head and neck.
Fig. 2 Virchow enables training a robust pan-cancer detector. Pan-cancer detection results. Detection is predicted at the specimen level using an aggregator network trained with Virchow, UNI, Phikon or CTransPath tile embeddings as input. a, Cancer detection performance (AUC) stratified by cancer type as determined by origin tissue. The incidence rate and proportion of metastasis of each cancer are shown. Virchow embeddings enable the best cancer detection performance across all cancer types, including rare cancers. For each cancer type, the AUC corresponding to the statistically significantly (P < 0.05) top-performing embeddings is highlighted in magenta. When more than one AUC is not gray, performance is ‘tied’ (no statistically significant difference). The foundation model used to produce tile embeddings for the aggregator is shown in the margin on the left, along with the number of cancer types for which the corresponding aggregator achieved (or tied for) the top AUC. All statistical significance (a–e) is computed using the pairwise DeLong’s test for AUC and Cochran’s Q test followed by McNemar’s test for specificity, both corrected for multiple comparisons with Holm’s method. b,c, Cancer detection performance summarized for all cancers (b) and for rare cancers (c). Error bars (b–e) show the two-sided 95% confidence interval computed with DeLong’s method for AUC and Wilson’s method for specificity; the • denotes the differences that are statistically significant from the rest (P < 0.0001). d, Sensitivity at 95% specificity for rare cancer detection (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001). e, Virchow-based cancer detection generalizes well to data from external institutions that were not represented in the training set; all aggregators and Virchow were trained only on data from MSKCC. Only half of the specimens in the pan-cancer testing set are from MSKCC. f, One-fifth of the specimens used for pan-cancer model evaluation contained tissues that were not observed in the training sets of Virchow or the pan-cancer aggregators. g, Cancer detection performance scales with the size of the underlying foundation model and the number of training samples (tiles) used to train it. H&N, head and neck.CC BY · PubMed Central
Fig. 3 Pan-cancer detection approaches and sometimes surpasses clinical product performance, using less data. a,b, Performance as measured by AUC of three clinical products compared to the pan-cancer model trained on Virchow embeddings, on the rare variant (a) and product testing datasets (b). The pan-cancer detector, trained on Virchow foundation model embeddings, achieves similar performance to clinical-grade products in general and outperforms them on rare variants of cancers. c, The pan-cancer detector was trained on fewer labeled specimens than the Prostate, Breast and BLN clinical models, including a small fraction of the prostate (teal), breast (blue) and BLN (yellow) tissue specimens that these clinical models were respectively trained on. d, A categorization of failure models of the pan-cancer model and four canonical examples of the primary types of failures. In all panels, * is used to indicate pairwise statistical significance (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001; pairwise DeLong’s test). Error bars denote the two-sided 95% confidence interval, estimated with DeLong’s method. C., carcinoma. Inv., invasive.
Fig. 3 Pan-cancer detection approaches and sometimes surpasses clinical product performance, using less data. a,b, Performance as measured by AUC of three clinical products compared to the pan-cancer model trained on Virchow embeddings, on the rare variant (a) and product testing datasets (b). The pan-cancer detector, trained on Virchow foundation model embeddings, achieves similar performance to clinical-grade products in general and outperforms them on rare variants of cancers. c, The pan-cancer detector was trained on fewer labeled specimens than the Prostate, Breast and BLN clinical models, including a small fraction of the prostate (teal), breast (blue) and BLN (yellow) tissue specimens that these clinical models were respectively trained on. d, A categorization of failure models of the pan-cancer model and four canonical examples of the primary types of failures. In all panels, * is used to indicate pairwise statistical significance (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001; pairwise DeLong’s test). Error bars denote the two-sided 95% confidence interval, estimated with DeLong’s method. C., carcinoma. Inv., invasive.CC BY · PubMed Central
Fig. 4 Biomarker prediction results. a, Virchow embeddings help predict biomarkers directly from H& E slides, reducing the need for targeted sequencing or IHC staining. b, The fraction of positive cases in each biomarker testing dataset. c, The number of biomarkers on which using Virchow, UNI, Phikon or CTransPath embeddings to train an aggregator produced an AUC in the top x. This ranking does not consider statistical significance across models for each biomarker due to low statistical power; instead, it relies on considering the ranking across many biomarkers. d, Biomarker detection performance as measured by AUC using aggregator networks trained on embeddings from Virchow, Phikon or CTransPath. For each prediction task, the top scoring embeddings are marked with a colored circle next to the biomarker label, below the plot (this corresponds to the top-1 ranking in c). The error bars denote the two-sided 95% confidence interval computed from 1,000 bootstrapping iterations. Endomet., endometrial.
Fig. 4 Biomarker prediction results. a, Virchow embeddings help predict biomarkers directly from H& E slides, reducing the need for targeted sequencing or IHC staining. b, The fraction of positive cases in each biomarker testing dataset. c, The number of biomarkers on which using Virchow, UNI, Phikon or CTransPath embeddings to train an aggregator produced an AUC in the top x. This ranking does not consider statistical significance across models for each biomarker due to low statistical power; instead, it relies on considering the ranking across many biomarkers. d, Biomarker detection performance as measured by AUC using aggregator networks trained on embeddings from Virchow, Phikon or CTransPath. For each prediction task, the top scoring embeddings are marked with a colored circle next to the biomarker label, below the plot (this corresponds to the top-1 ranking in c). The error bars denote the two-sided 95% confidence interval computed from 1,000 bootstrapping iterations. Endomet., endometrial.CC BY · PubMed Central
Fig. 5 A summary of tile-level linear probing. a, A description of each tile-level benchmark (top) along with the corresponding results for the embeddings of different foundation models (bottom). For each task, the top result is bolded and highlighted in magenta. Multiple results are highlighted when there is no statistically significant difference between them (P < 0.05; McNemar’s test). Error bars denote two-sided 95% confidence intervals computed using 1,000 bootstrapping iterations. b, The number of tasks in which each model scored in the top x. Models can tie for a rank depending on statistical significance (P < 0.05). c, Virchow embedding features learn meaningful structures. Cells in the CoNSeP dataset highlighted by embedding principal components: malignant epithelium (red), miscellaneous (yellow) and inflammatory (magenta).
Fig. 5 A summary of tile-level linear probing. a, A description of each tile-level benchmark (top) along with the corresponding results for the embeddings of different foundation models (bottom). For each task, the top result is bolded and highlighted in magenta. Multiple results are highlighted when there is no statistically significant difference between them (P < 0.05; McNemar’s test). Error bars denote two-sided 95% confidence intervals computed using 1,000 bootstrapping iterations. b, The number of tasks in which each model scored in the top x. Models can tie for a rank depending on statistical significance (P < 0.05). c, Virchow embedding features learn meaningful structures. Cells in the CoNSeP dataset highlighted by embedding principal components: malignant epithelium (red), miscellaneous (yellow) and inflammatory (magenta).CC BY · PubMed Central
Extended Data Fig. 1 Schematic of the Agata aggregator. The Agata aggregator learns to attend to tiles that contribute toward the label decision using cross-attention. The operation is defined using query Q, key K, and value matrix V: softmax((QK^T)/(√dk))V, where dk is the output dimension of the key matrix. In contrast to the typical self-attention mechanism where Q, K, V are projected from the inputs, Q is parameterized directly by the model to reduce GPU memory consumption. When aggregating across the tens or hundreds of thousands of tiles in a specimen, full attention requires too much GPU memory. This simplified attention can be interpreted as a learned weighted sum of all tile-level features. Indeed, full self-attention is quadratic in memory with respect to the number of tiles whereas the attention in Agata is linear. K and V are obtained with two consecutive Gaussian Error Linear Unit (GELU) projection layers as: K=GELU(W1^Tx+b1) and V=GELU(W2^TK+b2), where x is the tile embedding, and Wn, bn are the weight and bias parameters for the projection layers. In our experiments, W1 produces 256-dimensional keys, W2 produces 512-dimensional values, and we omit scaling by √({dk})=16. After the attention step, two linear layers with non-linear activation (ReLU) are used followed by a final linear layer with softmax activation.
Extended Data Fig. 1 Schematic of the Agata aggregator. The Agata aggregator learns to attend to tiles that contribute toward the label decision using cross-attention. The operation is defined using query Q, key K, and value matrix V: softmax((QK^T)/(√dk))V, where dk is the output dimension of the key matrix. In contrast to the typical self-attention mechanism where Q, K, V are projected from the inputs, Q is parameterized directly by the model to reduce GPU memory consumption. When aggregating across the tens or hundreds of thousands of tiles in a specimen, full attention requires too much GPU memory. This simplified attention can be interpreted as a learned weighted sum of all tile-level features. Indeed, full self-attention is quadratic in memory with respect to the number of tiles whereas the attention in Agata is linear. K and V are obtained with two consecutive Gaussian Error Linear Unit (GELU) projection layers as: K=GELU(W1^Tx+b1) and V=GELU(W2^TK+b2), where x is the tile embedding, and Wn, bn are the weight and bias parameters for the projection layers. In our experiments, W1 produces 256-dimensional keys, W2 produces 512-dimensional values, and we omit scaling by √({dk})=16. After the attention step, two linear layers with non-linear activation (ReLU) are used followed by a final linear layer with softmax activation.CC BY · PubMed Central
Extended Data Fig. 2 Schematic of the DINOv2 training routine. Virchow used a ViT-H architecture, trained with DINOv2. From a single tile, 2 global crops and 8 local crops all with random augmentations are created. The global crops are randomly masked and fed to the student model, and the unmasked versions are fed to the teacher model. The student tries to produce a global representation of the views (via the CLS token) that matches the teacher’s representation of the opposite view. The student also tries to produce representations of the masked image tokens that match the teacher’s representations of the same tokens but unmasked. The local crops are only fed to the student which tries to produce a representation that matches the teacher’s representations of the global crops. The teacher is an exponential moving average (EMA) copy of the student.
Extended Data Fig. 2 Schematic of the DINOv2 training routine. Virchow used a ViT-H architecture, trained with DINOv2. From a single tile, 2 global crops and 8 local crops all with random augmentations are created. The global crops are randomly masked and fed to the student model, and the unmasked versions are fed to the teacher model. The student tries to produce a global representation of the views (via the CLS token) that matches the teacher’s representation of the opposite view. The student also tries to produce representations of the masked image tokens that match the teacher’s representations of the same tokens but unmasked. The local crops are only fed to the student which tries to produce a representation that matches the teacher’s representations of the global crops. The teacher is an exponential moving average (EMA) copy of the student.CC BY · PubMed Central
Extended Data Fig. 3 Pan-cancer detection results for every cancer origin site. a. Area under (the receiver operator characteristic) curve (AUC); b. specificity at 95% sensitivity. H&N is head and neck. In both plots, a pairwise comparison of statistical significance is computed using the pairwise DeLong’s test for AUC and Cochran’s Q test followed by McNemar’s test for specificity, both corrected for multiple comparisons with Holm’s method (* p < 0.05, ** p < 0.01, *** p < 0.001, **** p < 0.0001). Error bars show the two-sided 95% confidence interval computed with DeLong’s method for AUC and Wilson’s method for specificity.
Extended Data Fig. 3 Pan-cancer detection results for every cancer origin site. a. Area under (the receiver operator characteristic) curve (AUC); b. specificity at 95% sensitivity. H&N is head and neck. In both plots, a pairwise comparison of statistical significance is computed using the pairwise DeLong’s test for AUC and Cochran’s Q test followed by McNemar’s test for specificity, both corrected for multiple comparisons with Holm’s method (* p < 0.05, ** p < 0.01, *** p < 0.001, **** p < 0.0001). Error bars show the two-sided 95% confidence interval computed with DeLong’s method for AUC and Wilson’s method for specificity.CC BY · PubMed Central
Extended Data Fig. 4 Pan-cancer dataset distribution. a. Specimen counts per cancer origin site in the pan-cancer testing dataset (H&N is head and neck). b. Specimen counts per tissue type in the pan-cancer aggregator training dataset.
Extended Data Fig. 4 Pan-cancer dataset distribution. a. Specimen counts per cancer origin site in the pan-cancer testing dataset (H&N is head and neck). b. Specimen counts per tissue type in the pan-cancer aggregator training dataset.CC BY · PubMed Central

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  • The paper relies on this without support.

    The prediction of biomarkers from standard H&E stained images can reduce the reliance on testing using additional methods and the associated substantial delays in returning results to patients.

    “The prediction of biomarkers from standard H&E stained images can reduce the reliance on testing using additional methods and the associated substantial delays in returning results to patients (Fig. 4a).”
  • The paper relies on this without support.

    The success of such applications depends on the ability to model the diverse patterns observed in pathology images.

    “The success of such applications depends on the ability to model the diverse patterns observed in pathology images.”
  • The paper relies on this without support.

    The value of a pathology foundation model is twofold: generalizability and training data efficiency.

    “The value of a pathology foundation model is twofold: generalizability and training data efficiency.”
  • The paper relies on this without support.

    In clinical practice, most biopsy samples are benign.

    “In clinical practice, where most biopsy samples are benign, a pan-cancer detection system can prioritize cases to help reduce diagnostic turnaround.”
  • The paper relies on this without support.

    Histopathology data differs from natural image data in key ways: the long-tailed distribution of pathologic entities and histological structures, the lack of object scale diversity and the restricted color space.

    “Histopathology data differs from natural image data in key ways: the long-tailed distribution of pathologic entities and histological structures, the lack of object scale diversity and the restricted color space.”
  • The paper relies on this without support.

    Model performance critically depends on the model’s ability to capture image features.

    “This process, called transfer learning, was motivated by the observation that model performance critically depends on the model’s ability to capture image features.”
  • The paper relies on this without support.

    In-domain transfer learning was not possible given the limited availability of labeled pathology datasets.

    “In-domain transfer learning was not possible given the limited availability of labeled pathology datasets.”
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    AR amplification or overexpression is found in 30%–50% of castration-resistant prostate cancers and is associated with resistance to androgen deprivation therapy.

    “The AR amplification/overexpression was found in 30%–50% of castration resistant prostate cancers and was associated with resistance to androgen deprivation therapy.”
  • The paper relies on this without support.

    HER2 overexpression and/or amplification are more heterogeneous in gastric cancer compared to breast cancer.

    “Human epidermal growth factor receptor 2 (HER2) overexpression and/or amplification are much more heterogeneous in gastric cancer compared to breast cancer.”
  • The paper relies on this without support.

    Approximately 20% of gastric cancer patients have HER2 overexpression or high-level amplification.

    “Approximate 20% of gastric cancer patients are found to correlate with HER2 overexpression/high-level amplification, and they would be likely to benefit from treatment with an anti-HER2 antibody therapy.”
  • The paper relies on this without support.

    Gastric cancer patients with HER2 overexpression or high-level amplification would likely benefit from anti-HER2 antibody therapy.

    “Approximate 20% of gastric cancer patients are found to correlate with HER2 overexpression/high-level amplification, and they would be likely to benefit from treatment with an anti-HER2 antibody therapy.”
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    PTEN is the most frequently mutated tumor suppressor gene in endometrial cancer.

    “PTEN is the most frequently mutated tumor suppressor gene in endometrial cancer.”
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    The presence of PTEN mutation is significantly associated with poorer prognosis in survival and disease recurrence.

    “The presence of PTEN mutation showed to be significantly associated with poorer prognosis in survival and disease recurrence.”
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    RET mutations are highly associated with medullary thyroid cancer.

    “RET mutations were highly associated with medullary thyroid cancer, which accounts for about 5–10% of all thyroid cancer.”
  • The paper relies on this without support.

    Medullary thyroid cancer accounts for about 5–10% of all thyroid cancer.

    “RET mutations were highly associated with medullary thyroid cancer, which accounts for about 5–10% of all thyroid cancer.”
  • The paper relies on this without support.

    Screening RET oncogenic mutations plays an important role in diagnosis and prognosis of medullary thyroid cancer.

    “Screening RET oncogenic mutations plays an important role in diagnosis and prognosis of medullary thyroid cancer.”
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    BRAF is one of the most frequently mutated genes in melanoma.

    “BRAF is one of the most frequently mutated genes in melanoma, and V600E mutation is the most common variant, which leads to constitutive activation of the BRAF/MEK/ERK signaling pathway.”
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    V600E is the most common BRAF variant in melanoma.

    “BRAF is one of the most frequently mutated genes in melanoma, and V600E mutation is the most common variant, which leads to constitutive activation of the BRAF/MEK/ERK signaling pathway.”
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    BRAF V600E mutation leads to constitutive activation of the BRAF/MEK/ERK signaling pathway.

    “BRAF is one of the most frequently mutated genes in melanoma, and V600E mutation is the most common variant, which leads to constitutive activation of the BRAF/MEK/ERK signaling pathway.”
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    Targeted therapy with BRAF inhibitors shows better survival outcome in patients with BRAF V600-mutated melanoma.

    “Targeted therapy with BRAF inhibitors showed better survival outcome in patients with BRAF V600-mutated melanoma.”
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    High-grade serous ovarian cancer is characterized by high prevalence of TP53 mutations and genome instability with widespread genetic alteration.

    “High-grade serous ovarian cancer is characterized by high prevalence of TP53 mutations and genome instability with widespread genetic alteration.”
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  5. Casson, A. et al. Joint breast neoplasm detection and subtyping using multi-resolution network trained on large-scale H&E whole slide images with weak labels. In Proc. Medical Imaging with Deep Learning (eds Oguz, I. et al.) 18–38 (JMLR, 2024).
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Metadata

Authors
Vorontsov, E., Bozkurt, A., Casson, A., Shaikovski, G., Zelechowski, M., Severson, K., Zimmermann, E., Hall, J., Tenenholtz, N., Fusi, N., Yang, E., Mathieu, P., van Eck, A., Lee, D., Viret, J., Robert, E., Wang, Y. K., Kunz, J. D., Lee, M. C. H., Bernhard, J. H., Godrich, R. A., Oakley, G., Millar, E., Hanna, M., Wen, H., Retamero, J. A., Moye, W. A., Yousfi, R., Kanan, C., Klimstra, D. S., Rothrock, B., Liu, S., & Fuchs, T. J.
Affiliations
  • Microsoft (United States) (US)
  • Memorial Sloan Kettering Cancer Center (US)
  • St George Hospital (AU)
  • University of Rochester (US)
Corresponding author
Liu, Siqi
Venue
Nature Medicine
Published
2024-07-22
Volume
30
Issue
10
Pages
2924-2935
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W4400889241
Cited by
572
References
67
Citations by year
2026: 332 · 2025: 212 · 2024: 28
FWCI
83.87
Type
journal article
Language
en
Open access
Locations
  • Nature Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
U.S. Department of Health & Human Services | NIH | National Cancer Institute (P30CA008748)
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
Keywords
foundation models, computational pathology, histopathological images, rare tumor, Virchow, biomarker prediction, cell identification, clinical decision support, limited training data
MeSH terms
Artificial Intelligence, Humans, Neoplasms, Pathology, Clinical, ROC Curve, Biomarkers, Tumor, Computational Biology, Rare Diseases, Precision Medicine, Neoplasm Grading

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