PathBench: A comprehensive comparison benchmark for pathology foundation models towards precision oncology

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Main Authors: Ma, Jiabo, Xu, Yingxue, Zhou, Fengtao, Wang, Yihui, Jin, Cheng, Guo, Zhengrui, Wu, Jianfeng, Tang, On Ki, Zhou, Huajun, Wang, Xi, Luo, Luyang, Zhang, Zhengyu, Cai, Du, Gao, Zizhao, Wang, Wei, Liu, Yueping, He, Jiankun, Cui, Jing, Li, Zhenhui, Zhang, Jing, Gao, Feng, Zhang, Xiuming, Liang, Li, Chan, Ronald Cheong Kin, Wang, Zhe, Chen, Hao
Format: Preprint
Published: 2025
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author Ma, Jiabo
Xu, Yingxue
Zhou, Fengtao
Wang, Yihui
Jin, Cheng
Guo, Zhengrui
Wu, Jianfeng
Tang, On Ki
Zhou, Huajun
Wang, Xi
Luo, Luyang
Zhang, Zhengyu
Cai, Du
Gao, Zizhao
Wang, Wei
Liu, Yueping
He, Jiankun
Cui, Jing
Li, Zhenhui
Zhang, Jing
Gao, Feng
Zhang, Xiuming
Liang, Li
Chan, Ronald Cheong Kin
Wang, Zhe
Chen, Hao
author_facet Ma, Jiabo
Xu, Yingxue
Zhou, Fengtao
Wang, Yihui
Jin, Cheng
Guo, Zhengrui
Wu, Jianfeng
Tang, On Ki
Zhou, Huajun
Wang, Xi
Luo, Luyang
Zhang, Zhengyu
Cai, Du
Gao, Zizhao
Wang, Wei
Liu, Yueping
He, Jiankun
Cui, Jing
Li, Zhenhui
Zhang, Jing
Gao, Feng
Zhang, Xiuming
Liang, Li
Chan, Ronald Cheong Kin
Wang, Zhe
Chen, Hao
contents The emergence of pathology foundation models has revolutionized computational histopathology, enabling highly accurate, generalized whole-slide image analysis for improved cancer diagnosis, and prognosis assessment. While these models show remarkable potential across cancer diagnostics and prognostics, their clinical translation faces critical challenges including variability in optimal model across cancer types, potential data leakage in evaluation, and lack of standardized benchmarks. Without rigorous, unbiased evaluation, even the most advanced PFMs risk remaining confined to research settings, delaying their life-saving applications. Existing benchmarking efforts remain limited by narrow cancer-type focus, potential pretraining data overlaps, or incomplete task coverage. We present PathBench, the first comprehensive benchmark addressing these gaps through: multi-center in-hourse datasets spanning common cancers with rigorous leakage prevention, evaluation across the full clinical spectrum from diagnosis to prognosis, and an automated leaderboard system for continuous model assessment. Our framework incorporates large-scale data, enabling objective comparison of PFMs while reflecting real-world clinical complexity. All evaluation data comes from private medical providers, with strict exclusion of any pretraining usage to avoid data leakage risks. We have collected 15,888 WSIs from 8,549 patients across 10 hospitals, encompassing over 64 diagnosis and prognosis tasks. Currently, our evaluation of 19 PFMs shows that Virchow2 and H-Optimus-1 are the most effective models overall. This work provides researchers with a robust platform for model development and offers clinicians actionable insights into PFM performance across diverse clinical scenarios, ultimately accelerating the translation of these transformative technologies into routine pathology practice.
format Preprint
id arxiv_https___arxiv_org_abs_2505_20202
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle PathBench: A comprehensive comparison benchmark for pathology foundation models towards precision oncology
Ma, Jiabo
Xu, Yingxue
Zhou, Fengtao
Wang, Yihui
Jin, Cheng
Guo, Zhengrui
Wu, Jianfeng
Tang, On Ki
Zhou, Huajun
Wang, Xi
Luo, Luyang
Zhang, Zhengyu
Cai, Du
Gao, Zizhao
Wang, Wei
Liu, Yueping
He, Jiankun
Cui, Jing
Li, Zhenhui
Zhang, Jing
Gao, Feng
Zhang, Xiuming
Liang, Li
Chan, Ronald Cheong Kin
Wang, Zhe
Chen, Hao
Computer Vision and Pattern Recognition
The emergence of pathology foundation models has revolutionized computational histopathology, enabling highly accurate, generalized whole-slide image analysis for improved cancer diagnosis, and prognosis assessment. While these models show remarkable potential across cancer diagnostics and prognostics, their clinical translation faces critical challenges including variability in optimal model across cancer types, potential data leakage in evaluation, and lack of standardized benchmarks. Without rigorous, unbiased evaluation, even the most advanced PFMs risk remaining confined to research settings, delaying their life-saving applications. Existing benchmarking efforts remain limited by narrow cancer-type focus, potential pretraining data overlaps, or incomplete task coverage. We present PathBench, the first comprehensive benchmark addressing these gaps through: multi-center in-hourse datasets spanning common cancers with rigorous leakage prevention, evaluation across the full clinical spectrum from diagnosis to prognosis, and an automated leaderboard system for continuous model assessment. Our framework incorporates large-scale data, enabling objective comparison of PFMs while reflecting real-world clinical complexity. All evaluation data comes from private medical providers, with strict exclusion of any pretraining usage to avoid data leakage risks. We have collected 15,888 WSIs from 8,549 patients across 10 hospitals, encompassing over 64 diagnosis and prognosis tasks. Currently, our evaluation of 19 PFMs shows that Virchow2 and H-Optimus-1 are the most effective models overall. This work provides researchers with a robust platform for model development and offers clinicians actionable insights into PFM performance across diverse clinical scenarios, ultimately accelerating the translation of these transformative technologies into routine pathology practice.
title PathBench: A comprehensive comparison benchmark for pathology foundation models towards precision oncology
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2505.20202