ReaMIL: Reasoning- and Evidence-Aware Multiple Instance Learning for Whole-Slide Histopathology

Fuente: arXiv
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Autores principales: Jung, Hyun Do, Choi, Jungwon, Kim, Hwiyoung
Formato: Preprint
Publicado: 2026
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author Jung, Hyun Do
Choi, Jungwon
Kim, Hwiyoung
author_facet Jung, Hyun Do
Choi, Jungwon
Kim, Hwiyoung
contents We introduce ReaMIL (Reasoning- and Evidence-Aware MIL), a multiple instance learning approach for whole-slide histopathology that adds a light selection head to a strong MIL backbone. The head produces soft per-tile gates and is trained with a budgeted-sufficiency objective: a hinge loss that enforces the true-class probability to be $\geq τ$ using only the kept evidence, under a sparsity budget on the number of selected tiles. The budgeted-sufficiency objective yields small, spatially compact evidence sets without sacrificing baseline performance. Across TCGA-NSCLC (LUAD vs. LUSC), TCGA-BRCA (IDC vs. Others), and PANDA, ReaMIL matches or slightly improves baseline AUC and provides quantitative evidence-efficiency diagnostics. On NSCLC, it attains AUC 0.983 with a mean minimal sufficient K (MSK) $\approx 8.2$ tiles at $τ= 0.90$ and AUKC $\approx 0.864$, showing that class confidence rises sharply and stabilizes once a small set of tiles is kept. The method requires no extra supervision, integrates seamlessly with standard MIL training, and naturally yields slide-level overlays. We report accuracy alongside MSK, AUKC, and contiguity for rigorous evaluation of model behavior on WSIs.
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id arxiv_https___arxiv_org_abs_2601_10073
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle ReaMIL: Reasoning- and Evidence-Aware Multiple Instance Learning for Whole-Slide Histopathology
Jung, Hyun Do
Choi, Jungwon
Kim, Hwiyoung
Computer Vision and Pattern Recognition
Artificial Intelligence
We introduce ReaMIL (Reasoning- and Evidence-Aware MIL), a multiple instance learning approach for whole-slide histopathology that adds a light selection head to a strong MIL backbone. The head produces soft per-tile gates and is trained with a budgeted-sufficiency objective: a hinge loss that enforces the true-class probability to be $\geq τ$ using only the kept evidence, under a sparsity budget on the number of selected tiles. The budgeted-sufficiency objective yields small, spatially compact evidence sets without sacrificing baseline performance. Across TCGA-NSCLC (LUAD vs. LUSC), TCGA-BRCA (IDC vs. Others), and PANDA, ReaMIL matches or slightly improves baseline AUC and provides quantitative evidence-efficiency diagnostics. On NSCLC, it attains AUC 0.983 with a mean minimal sufficient K (MSK) $\approx 8.2$ tiles at $τ= 0.90$ and AUKC $\approx 0.864$, showing that class confidence rises sharply and stabilizes once a small set of tiles is kept. The method requires no extra supervision, integrates seamlessly with standard MIL training, and naturally yields slide-level overlays. We report accuracy alongside MSK, AUKC, and contiguity for rigorous evaluation of model behavior on WSIs.
title ReaMIL: Reasoning- and Evidence-Aware Multiple Instance Learning for Whole-Slide Histopathology
topic Computer Vision and Pattern Recognition
Artificial Intelligence
url https://arxiv.org/abs/2601.10073