Carcinoma
MAPLE: Multi-scale Attribute-enhanced Prompt Learning for Few-shot Whole Slide Image Classification
Prompt learning has emerged as a promising paradigm for adapting pre-trained vision-language models (VLMs) to few-shot whole slide image (WSI) classification by aligning visual features with textual representations, thereby reducing annotation cost and enhancing model generalization. Nevertheless, existing methods typically rely on slide-level prompts and fail to capture the subtype-specific phenotypic variations of histological entities (e.g., nuclei, glands) that are critical for cancer diagnosis. To address this gap, we propose Multi-scale Attribute-enhanced Prompt Learning (MAPLE), a hierarchical framework for few-shot WSI classification that jointly integrates multi-scale visual semantics and performs prediction at both the entity and slide levels. Specifically, we first leverage large language models (LLMs) to generate entity-level prompts that can help identify multi-scale histological entities and their phenotypic attributes, as well as slide-level prompts to capture global visual descriptions. Then, an entity-guided cross-attention module is proposed to generate entity-level features, followed by aligning with their corresponding subtype-specific attributes for fine-grained entity-level prediction. To enrich entity representations, we further develop a cross-scale entity graph learning module that can update these representations by capturing their semantic correlations within and across scales. The refined representations are then aggregated into a slide-level representation and aligned with the corresponding prompts for slide-level prediction. Finally, we combine both entity-level and slide-level outputs to produce the final prediction results. Results on three cancer cohorts confirm the effectiveness of our approach in addressing few-shot pathology diagnosis tasks.
MTBBench: AMultimodal Sequential Clinical Decision-Making Benchmark in Oncology
Multimodal Large Language Models (LLMs) hold promise for biomedical reasoning, but current benchmarks fail to capture the complexity of real-world clinical workflows. Existing evaluations primarily assess unimodal, decontextualized question-answering, overlooking multi-agent decision-making environments such as Molecular Tumor Boards (MTBs). MTBs bring together diverse experts in oncology, where diagnostic and prognostic tasks require integrating heterogeneous data and evolving insights over time. Current benchmarks lack this longitudinal and multimodal complexity. We introduce MTBBench, an agentic benchmark simulating MTB-style decision-making through clinically challenging, multimodal, and longitudinal oncology questions. Ground truth annotations are validated by clinicians via a co-developed app, ensuring clinical relevance. We benchmark multiple open and closed-source LLMs and show that, even at scale, they lack reliability--frequently hallucinating, struggling with reasoning from time-resolved data, and failing to reconcile conflicting evidence or different modalities. To address these limitations, MTBBench goes beyond benchmarking by providing an agentic framework with foundation model-based tools that enhance multi-modal and longitudinal reasoning, leading to task-level performance gains of up to 9.0% and 11.2%, respectively. Overall, MTBBench offers a challenging and realistic testbed for advancing multimodal LLM reasoning, reliability, and tool-use with a focus on MTB environments in precision oncology.
Horseshoe Forests for High-Dimensional Causal Survival Analysis
Jacobs, Tijn, van Wieringen, Wessel N., van der Pas, Stรฉphanie L.
We develop a Bayesian tree ensemble model to estimate heterogeneous treatment effects in censored survival data with high-dimensional covariates. Instead of imposing sparsity through the tree structure, we place a horseshoe prior directly on the step heights to achieve adaptive global-local shrinkage. This strategy allows flexible regularisation and reduces noise. We develop a reversible jump Gibbs sampler to accommodate the non-conjugate horseshoe prior within the tree ensemble framework. We show through extensive simulations that the method accurately estimates treatment effects in high-dimensional covariate spaces, at various sparsity levels, and under non-linear treatment effect functions. We further illustrate the practical utility of the proposed approach by a re-analysis of pancreatic ductal adenocarcinoma (PDAC) survival data from The Cancer Genome Atlas.
Into the Single Cell Multiverse: an End-to-End Dataset for Procedural Knowledge Extraction in Biomedical Texts
Here we describe the additional details of FlaMBรฉ's curation including structured guidelines for each annotation task, corpus curation, and file assembly. All manual curation in FlaMBรฉ was conducted by three annotators who have doctorate level expertise in computational biology. For named entity tagging annotations a set of structured guidelines were followed to ensure consistency. The guidelines given to reviewers are in the annotator guidelines section below. B.1 Tissue and cell type entities Generally, all terms, related synonyms, and text entities that can be mapped to an entry from the tissue, organ, body part, fluid, and cell type branches of the NCI thesaurus were labeled. Instead of a rigid vocabulary fixed on exact matches of NCIThesaurus (NCIT) terms and synonyms, annotators were encouraged to tag any word with the same meaning as an ontology term. For example, "Pancreatic ductal adenocarcinoma" describes cancer of the pancreas, which can be related back to the NCI Thesaurus, and thus was tagged as a "TISSUE". An initial set of rules was provided to each annotator. When one annotator encountered a corner case (e.g., "is neuron a tissue or cell type?") all annotators discussed, reached a consensus, then added the corner case to the set of annotation rules.
Assessing the Feasibility of Early Cancer Detection Using Routine Laboratory Data: An Evaluation of Machine Learning Approaches on an Imbalanced Dataset
The development of accessible screening tools for early cancer detection in dogs represents a significant challenge in veterinary medicine. Routine laboratory data offer a promising, low-cost source for such tools, but their utility is hampered by the non-specificity of individual biomarkers and the severe class imbalance inherent in screening populations. This study assesses the feasibility of cancer risk classification using the Golden Retriever Lifetime Study (GRLS) cohort under real-world constraints, including the grouping of diverse cancer types and the inclusion of post-diagnosis samples. A comprehensive benchmark evaluation was conducted, systematically comparing 126 analytical pipelines that comprised various machine learning models, feature selection methods, and data balancing techniques. Data were partitioned at the patient level to prevent leakage. The optimal model, a Logistic Regression classifier with class weighting and recursive feature elimination, demonstrated moderate ranking ability (AUROC = 0.815; 95% CI: 0.793-0.836) but poor clinical classification performance (F1-score = 0.25, Positive Predictive Value = 0.15). While a high Negative Predictive Value (0.98) was achieved, insufficient recall (0.79) precludes its use as a reliable rule-out test. Interpretability analysis with SHapley Additive exPlanations (SHAP) revealed that predictions were driven by non-specific features like age and markers of inflammation and anemia. It is concluded that while a statistically detectable cancer signal exists in routine lab data, it is too weak and confounded for clinically reliable discrimination from normal aging or other inflammatory conditions. This work establishes a critical performance ceiling for this data modality in isolation and underscores that meaningful progress in computational veterinary oncology will require integration of multi-modal data sources.
Transformation of Biological Networks into Images via Semantic Cartography for Visual Interpretation and Scalable Deep Analysis
Mostafa, Sakib, Xing, Lei, Islam, Md. Tauhidul
Complex biological networks are fundamental to biomedical science, capturing interactions among molecules, cells, genes, and tissues. Deciphering these networks is critical for understanding health and disease, yet their scale and complexity represent a daunting challenge for current computational methods. Traditional biological network analysis methods, including deep learning approaches, while powerful, face inherent challenges such as limited scalability, oversmoothing long-range dependencies, difficulty in multimodal integration, expressivity bounds, and poor interpretability. We present Graph2Image, a framework that transforms large biological networks into sets of two-dimensional images by spatially arranging representative network nodes on a 2D grid. This transformation decouples the nodes as images, enabling the use of convolutional neural networks (CNNs) with global receptive fields and multi-scale pyramids, thus overcoming limitations of existing biological network analysis methods in scalability, memory efficiency, and long-range context capture. Graph2Image also facilitates seamless integration with other imaging and omics modalities and enhances interpretability through direct visualization of node-associated images. When applied to several large-scale biological network datasets, Graph2Image improved classification accuracy by up to 67.2% over existing methods and provided interpretable visualizations that revealed biologically coherent patterns. It also allows analysis of very large biological networks (nodes > 1 billion) on a personal computer. Graph2Image thus provides a scalable, interpretable, and multimodal-ready approach for biological network analysis, offering new opportunities for disease diagnosis and the study of complex biological systems.