Iteratively Coupled Multiple Instance Learning from Instance to Bag Classifier for Whole Slide Image Classification

Whole Slide Image (WSI) classification remains a challenge due to their extremely high resolution and the absence of fine-grained labels. Presently, WSI classification is usually regarded as a Multiple Instance Learning (MIL) problem when only slide-level labels are available. MIL methods involve a patch embedding module and a bag-level classification module, but they are prohibitively expensive to be trained in an end-to-end manner. Therefore, existing methods usually train them separately, or directly skip the training of the embedder. Such schemes hinder the patch embedder's access to slide-level semantic labels, resulting in inconsistency within the entire MIL pipeline. To overcome this issue, we propose a novel framework called Iteratively Coupled MIL (ICMIL), which bridges the loss back-propagation process from the bag-level classifier to the patch embedder. In ICMIL, we use category information in the bag-level classifier to guide the patch-level fine-tuning of the patch feature extractor. The refined embedder then generates better instance representations for achieving a more accurate bag-level classifier. By coupling the patch embedder and bag classifier at a low cost, our proposed framework enables information exchange between the two modules, benefiting the entire MIL classification model. We tested our framework on two datasets using three different backbones, and our experimental results demonstrate consistent performance improvements over state-of-the-art MIL methods. The code is available at: https://github.com/Dootmaan/ICMIL.