Benchmarking Vision-Language Models for Automated Pathology Diagnosis and Report Generation
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arXiv:2609.00866v1 Announce Type: cross Abstract: The rapid advancement of vision-language models (VLMs) has accelerated progress in computational pathology; however, whole-slide image (WSI)-based pa...
SCOUT is a concept‑grounded multimodal transformer that generates whole‑slide pathology reports by integrating local histological patterns, whole‑slide context, and expert‑curated diagnostic concepts. It uses evolving visual representations and recursively updated slide‑ and concept‑conditioned representations, with separate attention pathways during decoding that are fused adaptively for each token. Evaluated on TCGA‑BRCA, HistAI, and REG‑2025, SCOUT outperformed existing methods, improving BLEU, METEOR, and ROUGE‑L scores and raising the Clinical Report Quality Score on REG‑2025.
LanGuSTE is a patch‑selection framework for whole slide image analysis that uses vision‑language models and large language model knowledge. It introduces Cross‑Scale Visual Prompt Tuning to align low‑resolution and high‑resolution patches, and a coarse‑to‑fine selection module that encodes only informative high‑resolution patches. Experiments show LanGuSTE cuts overall processing time to about one‑third of the baseline while matching or surpassing diagnostic performance of exhaustive and state‑of‑the‑art methods.
The paper introduces Locked Image Multiple Instance PreTraining (LIMIT), a method that aligns slide‑level pathology reports with patch‑level visual features by freezing a vision encoder and fine‑tuning a text encoder. LIMIT uses report embeddings as cross‑attention queries over bags of patch features, optimizing slide representations via InfoNCE. Applying LIMIT, the authors create CONCH‑Z, which achieves state‑of‑the‑art zero‑shot performance on 22 pathology tasks, outperforming vision‑language encoders trained on curated caption datasets and narrowing the gap with larger slide‑level foundation models.
PathLang is a new, language‑centered benchmark for vision‑language models in computational pathology. It keeps the underlying pathology slides, ground‑truth labels, and image‑text evaluation direction constant while systematically varying the diagnostic language used in prompts, reflecting how pathologists actually rephrase diagnoses. The benchmark covers four task families—zero‑shot classification with image‑text alignment, cross‑modal retrieval, paraphrase robustness, and open‑vocabulary diagnosis retrieval—and evaluates nine VLMs across five public datasets spanning four organs.
Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations.