A pathology foundation model for cancer diagnosis and prognosis prediction

Histopathology image evaluation is indispensable for cancer diagnoses and subtype classification. Standard artificial intelligence methods for histopathology image analyses have focused on optimizing specialized models for each diagnostic task1,2. Although such methods have achieved some success, they often have limited generalizability to images generated by different digitization protocols or samples collected from different populations3. Here, to address this challenge, we devised the Clinical Histopathology Imaging Evaluation Foundation (CHIEF) model, a general-purpose weakly supervised machine learning framework to extract pathology imaging features for systematic cancer evaluation. CHIEF leverages two complementary pretraining methods to extract diverse pathology representations: unsupervised pretraining for tile-level feature identification and weakly supervised pretraining for whole-slide pattern recognition. We developed CHIEF using 60,530 whole-slide images spanning 19 anatomical sites. Through pretraining on 44 terabytes of high-resolution pathology imaging datasets, CHIEF extracted microscopic representations useful for cancer cell detection, tumour origin identification, molecular profile characterization and prognostic prediction. We successfully validated CHIEF using 19,491 whole-slide images from 32 independent slide sets collected from 24 hospitals and cohorts internationally. Overall, CHIEF outperformed the state-of-the-art deep learning methods by up to 36.1%, showing its ability to address domain shifts observed in samples from diverse populations and processed by different slide preparation methods. CHIEF provides a generalizable foundation for efficient digital pathology evaluation for patients with cancer.

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Work Title A pathology foundation model for cancer diagnosis and prognosis prediction
Access
Open Access
Creators
  1. Xiyue Wang
  2. Junhan Zhao
  3. Eliana Marostica
  4. Wei Yuan
  5. Jietian Jin
  6. Jiayu Zhang
  7. Ruijiang Li
  8. Hongping Tang
  9. Kanran Wang
  10. Yu Li
  11. Fang Wang
  12. Yulong Peng
  13. Junyou Zhu
  14. Jing Zhang
  15. Christopher R. Jackson
  16. Jun Zhang
  17. Deborah Dillon
  18. Nancy U. Lin
  19. Lynette Sholl
  20. Thomas Denize
  21. David Meredith
  22. Keith L. Ligon
  23. Sabina Signoretti
  24. Shuji Ogino
  25. Jeffrey A. Golden
  26. MacLean P. Nasrallah
  27. Xiao Han
  28. Sen Yang
  29. Kun Hsing Yu
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Nature
Publication Date October 24, 2024
Publisher Identifier (DOI)
  1. https://doi.org/10.1038/s41586-024-07894-z
Deposited February 11, 2025

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Version 1
published

  • Created
  • Added s41586-024-07894-z.pdf
  • Added Creator Xiyue Wang
  • Added Creator Junhan Zhao
  • Added Creator Eliana Marostica
  • Added Creator Wei Yuan
  • Added Creator Jietian Jin
  • Added Creator Jiayu Zhang
  • Added Creator Ruijiang Li
  • Added Creator Hongping Tang
  • Added Creator Kanran Wang
  • Added Creator Yu Li
  • Added Creator Fang Wang
  • Added Creator Yulong Peng
  • Added Creator Junyou Zhu
  • Added Creator Jing Zhang
  • Added Creator Christopher R. Jackson
  • Added Creator Jun Zhang
  • Added Creator Deborah Dillon
  • Added Creator Nancy U. Lin
  • Added Creator Lynette Sholl
  • Added Creator Thomas Denize
  • Added Creator David Meredith
  • Added Creator Keith L. Ligon
  • Added Creator Sabina Signoretti
  • Added Creator Shuji Ogino
  • Added Creator Jeffrey A. Golden
  • Added Creator MacLean P. Nasrallah
  • Added Creator Xiao Han
  • Added Creator Sen Yang
  • Added Creator Kun Hsing Yu
  • Published
  • Updated