We have tested recently published foundation models for histopathology for image retrieval. We report macro average of F1 score for top-1 retrieval, majority of top-3 retrievals, and majority of top-5 retrievals. We perform zero-shot retrievals, i.e., we do not alter embeddings and we do not train any classifier. As test data, we used diagnostic slides of TCGA, The Cancer Genome Atlas, consisting of 23 organs and 117 cancer subtypes. As a search platform we used Yottixel that enabled us to perform WSI search using patches.

Digital pathology and the integration of artificial intelligence (AI) models have revolutionized histopathology, opening new opportunities. With the increasing availability of Whole Slide Images (WSIs), there's a growing demand for efficient retrieval, processing, and analysis of relevant images from vast biomedical archives. However, processing WSIs presents challenges due to their large size and content complexity. Full computer digestion of WSIs is impractical, and processing all patches individually is prohibitively expensive. In this paper, we propose an unsupervised patching algorithm, Sequential Patching Lattice for Image Classification and Enquiry (SPLICE). This novel approach condenses a histopathology WSI into a compact set of representative patches, forming a "collage" of WSI while minimizing redundancy. SPLICE prioritizes patch quality and uniqueness by sequentially analyzing a WSI and selecting non-redundant representative features. We evaluated SPLICE for search and match applications, demonstrating improved accuracy, reduced computation time, and storage requirements compared to existing state-of-the-art methods. As an unsupervised method, SPLICE effectively reduces storage requirements for representing tissue images by 50%. This reduction enables numerous algorithms in computational pathology to operate much more efficiently, paving the way for accelerated adoption of digital pathology.

The surge in adoption of digital pathology has the potential to revolutionize medical diagnosis by allowing computerized analysis of tissue images (Pantanowitz 2010; Aljanabi 2012; Hanna2020). Central to this technology is the digitization of formalin-fixed, paraffin-embedded (FFPE) tissue sections mounted on glass slides. This process converts physical tissue samples into high-resolution, gigapixel digital images called whole slide images (WSIs) (Kumar2020; Evans2022). These WSI files contain detailed patterns of tissue morphology, enabling the application of computer-vision algorithms in diagnostic pathology. Pathologists can now analyze tissue images seamlessly on computer screens at various magnifications (Griffin2017). This shift from light microscopes to digital displays allows for easier visual inspection of anatomic clues that may indicate specific diseases.

Pathology images of histopathology can be acquired from camera-mounted microscopes or whole slide scanners. Utilizing similarity calculations to match patients based on these images holds significant potential in research and clinical contexts. Recent advancements in search technologies allow for nuanced quantification of cellular structures across diverse tissue types, facilitating comparisons and enabling inferences about diagnosis, prognosis, and predictions for new patients when compared against a curated database of diagnosed and treated cases. In this paper, we comprehensively review the latest developments in image search technologies for histopathology, offering a concise overview tailored for computational pathology researchers seeking effective, fast and efficient image search methods in their work.

Chen et al. [Chen2022] recently published the article "Fast and scalable search of whole-slide images via self-supervised deep learning" in Nature Biomedical Engineering. The authors call their method "self-supervised image search for histology", short SISH. The paper is not easily readable, and many important details are buried under ambiguous descriptions. Incremental modification of Yottixel - Yottixel introduced the concept of "mosaic" through a customized clustering and selection process [Kalra2020a]. While Chen et al. frequently mention "Yottixel" and "mosaic," they only acknowledge once that they have followed the Yottixel's mosaic generation process.

The expanding adoption of digital pathology has enabled the curation of large repositories of histology whole slide images (WSIs), which contain a wealth of information. Similar pathology image search offers the opportunity to comb through large historical repositories of gigapixel WSIs to identify cases with similar morphological features and can be particularly useful for diagnosing rare diseases, identifying similar cases for predicting prognosis, treatment outcomes and potential clinical trial success. A critical challenge in developing a WSI search and retrieval system is scalability, which is uniquely challenging given the need to search a growing number of slides that each can consist of billions of pixels and are several gigabytes in size. Such systems are typically slow and retrieval speed often scales with the size of the repository they search through, making their clinical adoption tedious and are not feasible for repositories that are constantly growing. Here we present Fast Image Search for Histopathology (FISH), a histology image search pipeline that is infinitely scalable and achieves constant search speed that is independent of the image database size, while being interpretable and without requiring detailed annotations. FISH uses self-supervised deep learning to encode meaningful representations from WSIs and a Van Emde Boas tree for fast search, followed by an uncertainty-based ranking algorithm to retrieve similar WSIs. We evaluated FISH on multiple tasks and datasets with over 22,000 patient cases spanning 56 disease subtypes. We additionally demonstrate that FISH can be used to assist with the diagnosis of rare cancer types where sufficient cases may not be available to train traditional supervised deep models.