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arXiv Machine Learning By Anirudh Choudhary, Mosbah Aouad, Krishnakant Saboo, Angelina Hwang, Jacob Kechter, Blake Bordeaux, Puneet Bhullar, David DiCaudo, Steven Nelson, Nneka Comfere, Emma Johnson, Olayemi Sokumbi, Jason Sluzevich, Leah Swanson, Dennis Murphree, Aaron Mangold, Ravishankar Iyer

RACR-MIL: Rank-aware contextual reasoning for weakly supervised grading of squamous cell carcinoma using whole slide images

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RACR-MIL is a weakly‑supervised method for grading squamous cell carcinoma (SCC) from whole‑slide images, using an attention‑based multiple‑instance learning framework. It introduces a hybrid WSI graph to capture local tissue context and non‑local phenotypic dependencies, and applies rank‑ordering constraints on attention to prioritize higher‑grade tumor regions, mirroring pathologists’ diagnostic reasoning. The approach achieves state‑of‑the‑art performance, improving SCC grading accuracy by 3–9% over existing methods and up to 10% in tumor localization, and a pilot study showed pathologists reported increased grading efficiency in 60% of cases.

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