Recent accelerations in multi-modal applications have been made possible with the plethora of image and text data available online.

MIL has become particularly popular in histopathology, where gigapixel microscopy slides are cut into patches representing small tissue regions.

Multiple instance learning (MIL) is an effective and widely used approach for weakly supervised machine learning. In histopathology, MIL models have achieved remarkable success in tasks like tumor detection, biomarker prediction, and outcome prognostication. However, MIL explanation methods are still lagging behind, as they are limited to small bag sizes or disregard instance interactions. We revisit MIL through the lens of explainable AI (XAI) and introduce xMIL, a refined framework with more general assumptions. We demonstrate how to obtain improved MIL explanations using layer-wise relevance propagation (LRP) and conduct extensive evaluation experiments on three toy settings and four real-world histopathology datasets. Our approach consistently outperforms previous explanation attempts with particularly improved faithfulness scores on challenging biomarker prediction tasks. Finally, we showcase how xMIL explanations enable pathologists to extract insights from MIL models, representing a significant advance for knowledge discovery and model debugging in digital histopathology.

We present DiffInfinite, a hierarchical diffusion model that generates arbitrarily large histological images while preserving long-range correlation structural information. Our approach first generates synthetic segmentation masks, subsequently used as conditions for the high-fidelity generative diffusion process. The proposed sampling method can be scaled up to any desired image size while only requiring small patches for fast training. Moreover, it can be parallelized more efficiently than previous large-content generation methods while avoiding tiling artifacts. The training leverages classifier-free guidance to augment a small, sparsely annotated dataset with unlabelled data.

Recent accelerations in multi-modal applications have been made possible with the plethora of image and text data available online. However, the scarcity of analogous data in the medical field, specifically in histopathology, has slowed comparable progress. To enable similar representation learning for histopathology, we turn to YouTube, an untapped resource of videos, offering $1,087$ hours of valuable educational histopathology videos from expert clinicians.From YouTube, we curate QUILT: a large-scale vision-language dataset consisting of $802, 144$ image and text pairs.QUILT was automatically curated using a mixture of models, including large language models, handcrafted algorithms, human knowledge databases, and automatic speech recognition.In comparison, the most comprehensive datasets curated for histopathology amass only around $200$K samples.We combine QUILT with datasets from other sources, including Twitter, research papers, and the internet in general, to create an even larger dataset: QUILT-1M, with $1$M paired image-text samples, marking it as the largest vision-language histopathology dataset to date. We demonstrate the value of QUILT-1M by fine-tuning a pre-trained CLIP model. Our model outperforms state-of-the-art models on both zero-shot and linear probing tasks for classifying new histopathology images across $13$ diverse patch-level datasets of $8$ different sub-pathologies and cross-modal retrieval tasks.

Multimodal deep learning (MDL) has emerged as a transformative approach in computational pathology. By integrating complementary information from multiple data sources, MDL models have demonstrated superior predictive performance across diverse clinical tasks compared to unimodal models. However, the assumption that combining modalities inherently improves performance remains largely unexamined. We hypothesise that multimodal gains depend critically on the predictive quality of individual modalities, and that integrating weak modalities may introduce noise rather than complementary information. We test this hypothesis on a prostate cancer dataset with histopathology, radiology, and clinical data to predict time-to-biochemical recurrence. Our results confirm that combining high-performing modalities yield superior performance compared to unimodal approaches. However, integrating a poor-performing modality with other higher-performing modalities degrades predictive accuracy. These findings demonstrate that multimodal benefit requires selective, performance-guided integration rather than indiscriminate modality combination, with implications for MDL design across computational pathology and medical imaging.

For doctors to truly trust artificial intelligence, it can't be a black box. They need to understand its reasoning, almost as if they were consulting a colleague. We created HistoLens1 to be that transparent, collaborative partner. It allows a pathologist to simply ask a question in plain English about a tissue slide--just as they would ask a trainee. Our system intelligently translates this question into a precise query for its AI engine, which then provides a clear, structured report. But it doesn't stop there. If a doctor ever asks, "Why?", HistoLens can instantly provide a 'visual proof' for any finding--a heatmap that points to the exact cells and regions the AI used for its analysis. We've also ensured the AI focuses only on the patient's tissue, just like a trained pathologist would, by teaching it to ignore distracting background noise. The result is a workflow where the pathologist remains the expert in charge, using a trustworthy AI assistant to verify their insights and make faster, more confident diagnoses.

Complex medical decision-making involves cooperative workflows operated by different clinicians. Designing AI multi-agent systems can expedite and augment human-level clinical decision-making. Existing multi-agent researches primarily focus on language-only tasks, yet their extension to multimodal scenarios remains challenging. A blind combination of diverse vision-language models (VLMs) can amplify an erroneous outcome interpretation. VLMs in general are less capable in instruction following and importantly self-reflection, compared to large language models (LLMs) of comparable sizes. This disparity largely constrains VLMs' ability in cooperative workflows. In this study, we propose MedOrch, a mediator-guided multi-agent collaboration framework for medical multimodal decision-making. MedOrch employs an LLM-based mediator agent that enables multiple VLM-based expert agents to exchange and reflect on their outputs towards collaboration. We utilize multiple open-source general-purpose and domain-specific VLMs instead of costly GPT-series models, revealing the strength of heterogeneous models. We show that the collaboration within distinct VLM-based agents can surpass the capabilities of any individual agent. We validate our approach on five medical vision question answering benchmarks, demonstrating superior collaboration performance without model training. Our findings underscore the value of mediator-guided multi-agent collaboration in advancing medical multimodal intelligence.