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Christian Grashei

Publications and source records attributed to Christian Grashei.

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An end-to-end-trained vision-language model for native-language prostate pathology report generation

Prostate cancer is among the most frequently diagnosed malignancies worldwide, and structured reporting of each biopsy core burdens pathologists. Existing tools frame this as classification, leaving pathologists to assemble coherent reports, while many slide-level vision-language models rely on English-centric encoders that transfer poorly to other clinical languages. We present a slide-level framework generating prostate biopsy reports that is language-independent by construction: tokenizer and model are trained from scratch, demonstrated here in German. To address paired-data scarcity, an automated pipeline uses a locally deployed large language model to split composite reports into core-specific image-text pairs, yielding 17,344 pairs from 2,402 historical cases without manual annotation. Evaluated for clinical attributes rather than linguistic similarity, the model achieves 96.2% F1 for malignancy detection and 65.2% for Gleason grading, competitive with an FDA-cleared classifier. Grading is further validated on three external cohorts with latent-space augmentation. Institutions can thus train native-language reporting models on their own archives.

cs.CV

Paired Uterine Whole-Slide Images and Pathology Reports for Multimodal Computational Pathology

Uterine diseases represent an important category of gynecologic pathology and require accurate histopathological assessment for diagnosis and treatment planning. Whole-slide images (WSI) have enabled the digital transformation of pathology workflows and provided new opportunities for artificial intelligence (AI) in computational pathology. In particular, multimodal models that jointly analyze histopathology images and pathology reports have shown promising potential for automated pathology report generation and AI-assisted diagnosis. However, the development of such systems remains limited by the scarcity of datasets that pair whole-slide images with clinically meaningful pathology reports. Instead, existing pathology datasets focus on patch- or slide-level annotations of a single endpoint (e.g., disease class), which do not fully capture the rich information in full clinical diagnostic workflow reports. Here, we introduce TUM-Uteria, a uterine pathology dataset comprising WSIs paired with diagnostic pathology reports at both the case and slide levels, collected from a tertiary medical center. The dataset contains 216 clinical cases, comprising 455 slide-level WSI-report pairs. The dataset underwent a structured multi-stage validation procedure involving board-certified pathologists to ensure reliable annotations. TUM-Uteria supports research in computational pathology, including whole-slide image analysis, multimodal learning, and automated pathology report generation.

cs.CV

Efficient Special Stain Classification

Stains are essential in histopathology to visualize specific tissue characteristics, with Haematoxylin and Eosin (H&E) serving as the clinical standard. However, pathologists frequently utilize a variety of special stains for the diagnosis of specific morphologies. Maintaining accurate metadata for these slides is critical for quality control in clinical archives and for the integrity of computational pathology datasets. In this work, we compare two approaches for automated classification of stains using whole slide images, covering the 14 most commonly used special stains in our institute alongside standard and frozen-section H&E. We evaluate a Multi-Instance Learning (MIL) pipeline and a proposed lightweight thumbnail-based approach. On internal test data, MIL achieved the highest performance (macro F1: 0.941 for 16 classes; 0.969 for 14 merged classes), while the thumbnail approach remained competitive (0.897 and 0.953, respectively). On external TCGA data, the thumbnail model generalized best (weighted F1: 0.843 vs. 0.807 for MIL). The thumbnail approach also increased throughput by two orders of magnitude (5.635 vs. 0.018 slides/s for MIL with all patches). We conclude that thumbnail-based classification provides a scalable and robust solution for routine visual quality control in digital pathology workflows.

cs.CV

Pathryoshka: Compressing Pathology Foundation Models via Multi-Teacher Knowledge Distillation with Nested Embeddings

Pathology foundation models (FMs) have driven significant progress in computational pathology. However, these high-performing models can easily exceed a billion parameters and produce high-dimensional embeddings, thus limiting their applicability for research or clinical use when computing resources are tight. Here, we introduce Pathryoshka, a multi-teacher distillation framework inspired by RADIO distillation and Matryoshka Representation Learning to reduce pathology FM sizes while allowing for adaptable embedding dimensions. We evaluate our framework with a distilled model on ten public pathology benchmarks with varying downstream tasks. Compared to its much larger teachers, Pathryoshka reduces the model size by 86-92% at on-par performance. It outperforms state-of-the-art single-teacher distillation models of comparable size by a median margin of 7.0 in accuracy. By enabling efficient local deployment without sacrificing accuracy or representational richness, Pathryoshka democratizes access to state-of-the-art pathology FMs for the broader research and clinical community.

cs.CV

Towards Cellular-Scale Interpretability in Pathology Foundation Models for Biomarker Assessment

Molecular biomarker testing in pathology is often costly and tissue-consuming, limiting scalable clinical deployment. Artificial intelligence applied to hematoxylin and eosin (HE)-stained histology could enable rapid biomarker screening, but clinical translation requires models that are both accurate and interpretable. Here we introduce Hireca, a biomarker-focused pathology foundation model pretrained on more than 80,000 whole-slide images spanning 38 organ types from three medical centers, together with CytoMap, an interpretability module that localizes cellular-scale evidence underlying predictions. Across 10 biomarker tasks encompassing morphological, molecular, genetic, and spatial-transcriptomic-proxy readouts, Hireca ranked first in five tasks and outperformed comparable models overall. In evaluation by eight pathologists from two countries, CytoMap was consistently preferred over alternative visualization approaches and revealed error patterns in difficult cases. These results position Hireca and CytoMap as a transparent framework for clinically reviewable biomarker assessment directly from routine HE histology.

cs.CV

From Pixels to Pathology: Restoration Diffusion for Diagnostic-Consistent Virtual IHC

Hematoxylin and eosin (H&E) staining is the clinical standard for assessing tissue morphology, but it lacks molecular-level diagnostic information. In contrast, immunohistochemistry (IHC) provides crucial insights into biomarker expression, such as HER2 status for breast cancer grading, but remains costly and time-consuming, limiting its use in time-sensitive clinical workflows. To address this gap, virtual staining from H&E to IHC has emerged as a promising alternative, yet faces two core challenges: (1) Lack of fair evaluation of synthetic images against misaligned IHC ground truths, and (2) preserving structural integrity and biological variability during translation. To this end, we present an end-to-end framework encompassing both generation and evaluation in this work. We introduce Star-Diff, a structure-aware staining restoration diffusion model that reformulates virtual staining as an image restoration task. By combining residual and noise-based generation pathways, Star-Diff maintains tissue structure while modeling realistic biomarker variability. To evaluate the diagnostic consistency of the generated IHC patches, we propose the Semantic Fidelity Score (SFS), a clinical-grading-task-driven metric that quantifies class-wise semantic degradation based on biomarker classification accuracy. Unlike pixel-level metrics such as SSIM and PSNR, SFS remains robust under spatial misalignment and classifier uncertainty. Experiments on the BCI dataset demonstrate that Star-Diff achieves state-of-the-art (SOTA) performance in both visual fidelity and diagnostic relevance. With rapid inference and strong clinical alignment,it presents a practical solution for applications such as intraoperative virtual IHC synthesis.

eess.IV