MUSTANG: Multi-Stain Self-Attention Graph Multiple Instance Learning Pipeline for Histopathology Whole Slide Images

Whole Slide Images (WSIs) present a challenging computer vision task due to their gigapixel size and presence of numerous artefacts. Yet they are a valuable resource for patient diagnosis and stratification, often representing the gold standard for diagnostic tasks. Real-world clinical datasets tend to come as sets of heterogeneous WSIs with labels present at the patient-level, with poor to no annotations. Weakly supervised attention-based multiple instance learning approaches have been developed in recent years to address these challenges, but can fail to resolve both long and short-range dependencies. Here we propose an end-to-end multi-stain self-attention graph (MUSTANG) multiple instance learning pipeline, which is designed to solve a weakly-supervised gigapixel multi-image classification task, where the label is assigned at the patient-level, but no slide-level labels or region annotations are available. The pipeline uses a self-attention based approach by restricting the operations to a highly sparse k-Nearest Neighbour Graph of embedded WSI patches based on the Euclidean distance. We show this approach achieves a state-of-the-art F1-score/AUC of 0.89/0.92, outperforming the widely used CLAM model. Our approach is highly modular and can easily be modified to suit different clinical datasets, as it only requires a patient-level label without annotations and accepts WSI sets of different sizes, as the graphs can be of varying sizes and structures.

GitHub repo: [https://github.com/AmayaGS/MUSTANG]

Bibtex citation:

@inproceedings{Gallagher-Syed_2023_BMVC,
author    = {Amaya Gallagher-Syed and Luca Rossi and Felice Rivellese and Costantino Pitzalis and Myles Lewis and Michael Barnes and Gregory Slabaugh},
title     = {Multi-Stain Self-Attention Graph Multiple Instance Learning Pipeline for Histopathology Whole Slide Images},
booktitle = {34th British Machine Vision Conference 2023, {BMVC} 2023, Aberdeen, UK, November 20-24, 2023},
publisher = {BMVA},
year      = {2023},
url       = {https://papers.bmvc2023.org/0789.pdf}
}