Spatial mapping of lung adenocarcinoma (LUAD) growth patterns across whole slide images (WSIs) requires resolving architectural context at the region level, yet existing methods operate at the individual tile level and produce generic morphological clusters rather than clinically defined pattern maps. We propose a weakly supervised Bag-of-Visual-Words (BoVW) pipeline that learns a visual vocabulary from frozen foundation model embeddings extracted from a small set of annotated regions of interest (ROIs). Pattern prototypes are constructed as mean BoVW histograms of same-label ROIs and used for nearest-prototype classification of sliding-window regions under Jensen--Shannon divergence. The resulting predictions are projected onto the WSI tile grid to produce interpretable spatial pattern maps. We evaluate the method on 87 CPTAC-LUAD patients using three foundation model encoders and multiple vocabulary sizes on two clinically motivated tasks. For tumour/healthy classification, the best configuration achieves a balanced accuracy of $0.974$ with H-Optimus-1, approaching the $0.987$ obtained by a supervised SVM trained on mean-pooled WSI embeddings. For binary histologic grade classification, the BoVW pipeline achieves higher balanced accuracy than the supervised baseline for all encoders, suggesting that ROI-level pattern decomposition preserves grade-relevant heterogeneity that is attenuated by global mean pooling.
https://arxiv.org/abs/2608.05074
Text-conditioned human motion generation has made rapid progress with the emergence of large-scale motion--language datasets. However, even datasets with rich long-form descriptions typically provide supervision only at the clip level, without explicit temporal correspondence between motion frames and language. This limits fine-grained motion--text grounding and temporally precise generation. We propose FineMoLA, a weakly supervised framework that learns fine-grained frame--phrase correspondence directly from clip-level annotations. Our method first segments long-form descriptions into action-bearing phrases, and then formulates motion--language alignment as an optimal transport problem, which naturally models many-to-many relations between motion frames and text under global constraints. With entropic regularization and Sinkhorn iterations, FineMoLA efficiently infers pseudo frame-level alignments without human labeling. Experiments on SnapMoGen demonstrate that the learned alignments outperform baselines in motion--text grounding.
https://arxiv.org/abs/2608.01392
Despite the widespread adoption of foundation models as feature extractors for medical imaging, relatively little is understood about how different pretraining strategies influence the transferability of learned representations to weakly supervised ophthalmic imaging tasks. We investigate this question in ultra-widefield (UWF) retinal imaging by evaluating foundation model representations within a patch-based multiple instance learning (MIL) framework for disease classification on UWF images. We compare Vision Transformer encoders pretrained with supervised, Masked Autoencoder (MAE), and self-distillation objectives, while keeping the downstream aggregation architecture unchanged. Within a controlled comparison of ViT-B encoders pretrained on ImageNet-1k, the choice of pretraining objective substantially influenced frozen representation transfer, with supervised and self-distillation-based models outperforming MAE. A contemporary DINOv3 model pretrained at a larger scale achieved the strongest overall performance, with a quadratic weighted kappa of 0.863 for five-class diabetic retinopathy grading, comparable with DINOv1. Attention analysis further revealed distinct patch-aggregation behaviours associated with the different pretrained representations, while partial fine-tuning substantially reduced the performance gap for MAE. These findings suggest that pretraining strategy influences both representation transferability and the subsequent aggregation of patch-level evidence within MIL, resulting in differences in downstream classification performance.
https://arxiv.org/abs/2608.00586
Medical image segmentation heavily depends on labor-intensive and time-consuming pixel-level annotations. Eye tracking offers a cost-effective solution that can be naturally integrated into clinical workflows. Recorded by eye trackers, gaze conveys the spatial regions of clinicians' attention through fixations and the temporal context of clinicians' progressive visual perception from trajectories. Nevertheless, effective modeling of temporal trajectories remains challenging, and noise in gaze caused by exploratory fixations greatly limits segmentation performance. To overcome these limitations, we propose the Trajectory-guided Uncertainty-aware Network (TrailNet), which exploits gaze-supervised medical image segmentation from spatial semantics modeling to temporal context by jointly leveraging fixations and trajectories. Specifically, the proposed trajectory-guided spatio-temporal encoder models temporal context and establishes complementary interactions with image spatial semantics to strengthen target perception. Furthermore, the multi-scale uncertainty decoder leverages category mutual-exclusivity constraints to produce deterministic predictions and mitigate supervision uncertainty induced by noise. To enable gaze-free inference, we further introduce a cycle distillation strategy that transfers feature-level knowledge via teacher-student networks. Experimental results on two public datasets demonstrate that TrailNet outperforms state-of-the-art methods, achieving Dice scores of 81.25% and 81.85%, respectively.
https://arxiv.org/abs/2607.26542
In many classification problems, reliable instance-level labels are unavailable. However, it is often possible to construct weakly enriched unlabeled samples: datasets selected by different cuts, sources, populations, or experimental conditions that change latent class proportions without revealing them. Classification without Labels (CWoLa) shows that, in the binary case ($K=2$), a classifier trained to distinguish two impure mixtures with different class proportions can recover an optimal class discriminator without knowing the mixture proportions. We extend this principle to multiclass learning from several unlabeled mixtures ($K>2$), where the learner observes only mixture identity and neither latent class labels nor class-prior matrices. We prove that, for a multiclass mixture model, the Bayes-optimal mixture classifier $g^\star$ maps data points into a $(K-1)$-simplex embedded in mixture-posterior space. The $K$ vertices of this simplex are induced by the latent classes through the unknown mixing matrix. Leveraging this geometry, we propose prior-free procedures that train a standard classifier to distinguish mixture identities and then extract latent class structure using either post-hoc simplex fitting or a bottleneck architecture. Experiments on MNIST, CIFAR-10, and Galaxy10 DECaLS show that mixture identity alone can recover latent classes and their fractions in the mixture. By narrowing the gap between weakly supervised and fully supervised performance, we provide a mathematically grounded, scalable tool for multiclass discovery in label-scarce domains.
https://arxiv.org/abs/2607.24943
In prostate cancer histopathology, the Gleason Score is determined by the most frequent (Primary) and second most frequent (Secondary) Gleason patterns within a whole-slide image. Although these slide-level labels are routinely available in clinical practice, instance-level Gleason annotations are rarely provided, making patch-level learning challenging. We propose a Multiple Instance Learning (MIL) framework that estimates instance-level Gleason patterns from slide-level Primary and Secondary labels. The proposed method formulates instance-level learning according to the clinical definition of the Gleason Score by aggregating instance predictions into class counts and explicitly modeling the Primary pattern, Secondary pattern, and their dominance. Experimental results demonstrate that the proposed formulation enables effective instance-level learning and outperforms existing MIL approaches on the SICAP-MIL dataset.
https://arxiv.org/abs/2607.23594
Weakly supervised hierarchical models exhibit a persistent asymmetry: coarse lesion-type features are preserved under reconstruction while fine-grained malignancy cues degrade---a pattern with direct consequences for the clinical reliability of breast cancer screening pipelines. We introduce gradient-based orthogonal latent decomposition for hierarchical Variational Autoencoders~(H-VAEs) to mechanistically explain this asymmetry. The latent space is partitioned into a task-aligned component~($z_1$), shaped by coarse supervisory gradients, and an orthogonal residual~($z_{\text{res}}$) capturing remaining representational capacity. On~3,550 mammographic Regions of Interest~(ROIs) from CBIS-DDSM, only~$\sim$4.4\% of latent magnitude aligns with supervisory gradients, leaving~$\sim$95.6\% in the orthogonal residual upon which fine-grained pathology prediction primarily depends. The model achieves Stage-1~AUC~0.866 and Stage 2~AUC~0.552, with a reconstruction stability gap of $\Delta_{\text{diag}}=5\%$ ($p=0.005$) and a classification gap of $\Delta_{\text{AUC}}=0.314$ ($p{<}0.001$). Latent ablation confirms that features for both tasks reside heavily in~$z_{\text{res}}$, structurally explaining why reconstruction degrades pathology stability disproportionately. Comparisons with Multi-Instance Learning~(MIL) and Multi-Task Learning~(MTL) confirm generalization across architectures and modalities. These findings reveal that in high-dimensional spaces, a single coarse supervisory signal isolates only a sparse 1D latent direction, forcing critical fine-grained features into the vulnerable residual subspace.
https://arxiv.org/abs/2607.24835
Weakly supervised pipelines for medical imaging have become increasingly popular over the years. These systems often include multiple stages and components, such as reconstruction, generation, and localization, yet standard evaluation metrics provide limited insight into whether clinically relevant information is preserved across each stage. We present the diagnostic gap framework, a practical evaluation tool that measures decision preservation and explanation preservation as a function of measured reconstruction fidelity. To isolate the effect of reconstruction from localization, we evaluate on curated lesion ROI crops using a fidelity ladder of three class-conditional reconstructors---VQ-VAE-GAN, VAE-GAN, and diffusion (SDEdit)---spanning a twenty-fold range in perceptual distance (LPIPS 0.029--0.584). At autoencoder fidelity, both decision and explanation are preserved: AUC changes remain within $\pm$0.005 and attribution similarity (HiResCAM, Grad-CAM++) stays high. At diffusion fidelity, both collapse: pooled AUC drops by 0.253 and mass-pathology AUC falls below chance. The diagnostic gap is thus a measurable function of reconstruction fidelity rather than an intrinsic cost of reconstruction, and the framework provides an architecture-agnostic instrument for identifying when and where multi-stage pipelines lose diagnostic signal.
https://arxiv.org/abs/2607.22740
Weakly supervised segmentation relies heavily on class activation maps (CAMs) to initially localize target regions. However, CAMs are often noisy and prone to catastrophic failures. Existing remedies typically introduce additional training stages or prototype learning, increasing computational cost and reducing robustness. In this paper, we propose a training-free prototype-free framework that rectifies unreliable CAMs by exploiting temporal and structural coherence in volumetric data as a free lunch. Our approach is built on two key components. First, we introduce Variance-Reduced Activation Aggregation (VRAA) which suppresses noise and amplify coherent semantic signals. We provide a theoretical justification by modeling CAMs as high-dimensional random vectors and show that aggregation yields provable variance reduction. Second, we design a Bidirectional Extremity Rectification (BER) mechanism that detects and rectifies implausible activations through bidirectional extremity checks, effectively mitigating extreme-value failures without learning additional parameters. Our method is model-agnostic and can be seamlessly integrated with existing pipelines. Extensive experiments on multiple public benchmarks demonstrate substantial improvements over state-of-the-art weakly supervised methods, achieving up to 20% Dice and 40% mIoU gains while reducing inference time by more than 5 times. These results indicate that leveraging coherence as an implicit inductive bias yields a principled and efficient approach to stabilizing weakly supervised volumetric segmentation. Our code will be available.
https://arxiv.org/abs/2607.19877
We propose a unified variational framework for image segmentation under sparse pixel-level supervision. Our method is based on a simplex-constrained Potts model with a smooth perimeter regularizer, yielding a convex, smooth energy functional that can be used as a training loss in weakly supervised deep learning paradigms or optimized efficiently using iterative methods. Sparse labels are incorporated into the data fidelity term by constructing a fuzzy membership function via a function extension problem in a Reproducing Kernel Hilbert Space (RKHS), which can effectively capture inhomogeneous intensity statistics. The derived discrete loss for training standard networks demonstrates robustness and consistent improvements over non-training and partial cross-entropy (PCE) baselines in experiments, achieving comparable performance without requiring ground-truth segmentation images.
https://arxiv.org/abs/2607.19669
We propose a weakly supervised 18FFDG PET representation-learning framework for content based medical image retrieval, using H&E derived information during training while preserving PET-only inference. The proposed method was designed to use H&E derived information during training while maintaining PET only inference. A teacher student training strategy was used to learn the PET tumour derived voxel representations, from which global and hotspot conditioned embeddings were generated along with maps of intra tumour heterogeneity in our oesophegeal cancer test case. A progressive ablation strategy was used to evaluate the contribution of different supervision mechanisms. Retrieval performance was assessed across cross-validation folds using metrics including mean average precision, normalised discounted cumulative gain and mean reciprocal rank. Additional analyses evaluated ablation performance, hotspot faithfulness through perturbation/deletion experiments, prototype-specific PET uptake behaviour and indirect patient level concordance between learned PET prototype classes and selected histomic features. Progressive introduction of pathology informed supervision and hotspot modelling improved PET retrieval performance compared with global PET representations and conventional PET baselines. Across the ablation ladder, PET hotspot conditioned representations consistently provided stronger retrieval than global embeddings, indicating that focusing on informative tumour subregions improved sensitivity to intra tumour heterogeneity. Histopathology concordance further showed that the learned classes were not simply high uptake PET regions; instead, they demonstrated distinct heterogeneity in 18F FDG uptake.
https://arxiv.org/abs/2607.18762
Group Relative Policy Optimization (GRPO) has shown strong effectiveness in reinforcement learning from verifiable feedback, where sampled rollouts can be compared within a group using task-provided correctness signals. However, extending group-relative optimization beyond verifiable settings is challenging because success in many tasks is not captured by a single correctness criterion. We propose \textbf{Reference-Relative Policy Optimization (RRPO)}, which generalizes GRPO by replacing direct correctness-based advantage construction with reference-relative contrastive comparisons. RRPO first uses \emph{stratified conditional rollouts} to construct positive and negative anchor sets, and then trains a metric projection head with a set-contrastive objective to compare candidate rollouts against these anchors. The resulting alignment scores directly define contrastive advantages: during policy optimization, the projection head is frozen, and the scores are centered within each rollout group in a standard group-relative objective. We evaluate RRPO using anchor-based contrastive advantages throughout policy optimization, without relying on task ground-truth verifiers. Across verifiable reasoning, open-ended generation, and post-SFT settings, RRPO remains competitive with verifier-based optimization, improves over weakly supervised baselines, and provides additional gains after supervised fine-tuning.
https://arxiv.org/abs/2607.18470
All-in-one image restoration aims to recover clean images degraded by multiple corruption types using a single unified model. Existing methods typically rely on image-level prompts or shared guidance to handle diverse degradations. However, such a paradigm becomes inadequate when degradations are spatially heterogeneous or even coexist in mixed forms within a single image. Yet spatially adaptive guidance alone is not sufficient, since accurate restoration also requires each spatial query to reliably aggregate complementary information from local neighborhoods and global contexts. To this end, we propose QuReC, a unified framework for all-in-one image restoration. QuReC consists of a Degradation-Guided Query Reconstruction Module (DQRM) and a Local-Global Response Calibration Module (LGRCM). Specifically, DQRM matches each spatial query against a degradation prototype space to reconstruct a query-specific degradation-aware representation, thereby providing fine-grained spatially adaptive restoration guidance. To further stabilize this query-wise matching process, we introduce a weakly supervised prototype matching learning strategy to improve optimization stability and degradation semantic consistency. Meanwhile, LGRCM performs local-global dual-branch aggregation and calibrates the aggregated responses with learnable priors, improving the reliability of feature aggregation and the coordination between local detail modeling and global context modeling. Extensive experiments demonstrate that QuReC achieves superior performance on multiple all-in-one image restoration benchmarks. The code is released at this https URL.
https://arxiv.org/abs/2607.15097
Multiple instance learning (MIL) has become the main paradigm for whole-slide image (WSI) analysis in computational pathology. However, existing MIL aggregators are still typically trained from scratch for each downstream task, relying on limited slide-level labels to learn both aggregation mechanisms and downstream discriminative representations simultaneously. As a result, they often suffer from unstable optimization, overfitting, and limited transferability. Similar to pretrained ResNet and Vision Transformer models in natural image learning, MIL also requires reusable pretrained initialization. However, high-quality slide-level pretraining data remain scarce, and MIL models are usually lightweight and weakly supervised, making large-scale pretraining difficult in practice. To address this challenge, we propose a distillation-based pretraining framework for MIL, which leverages two slide-level foundation models, TITAN and CARE, as teachers to transfer their representational knowledge into a diverse set of MIL architectures. To effectively balance supervision from different teachers, we further introduce an angular dispersion normalized distillation loss. The distilled weights are then used as initialization for downstream adaptation. We conduct systematic evaluations on 15 benchmark datasets under both linear probing and full-parameter fine-tuning, and further validate its advantages in few-shot scenarios. Experimental results show that pretraining generally improves MIL aggregators over from scratch training, especially in linear-probing and few-shot settings, while maintaining the computational efficiency of lightweight MIL models. Code is available at this https URL.
https://arxiv.org/abs/2607.14703
Human-object interaction detection (HOID) has traditionally been formulated as a supervised detection problem over predefined interaction categories. While such paradigms achieve strong performance on closed-set benchmarks, they fundamentally entangle interaction understanding with dataset-specific supervision, limiting their ability to generalize to open-world and compositional scenarios. Recent HOI detectors attempt to leverage MLLMs through prompting strategies to transfer interaction-specific knowledge. However, such prompt-based approaches primarily focus on extracting discriminative representations from pretrained models, while underexploring their inherent multimodal reasoning capabilities. As a result, they struggle to provide informative contextual reasoning for ambiguous and open-world interaction scenarios. In this work, we present AgentHOI, a training-free, agentic framework that transfers the generalist multimodal reasoning capabilities of foundation models to HOI detection in the wild. Instead of learning interaction classifiers, AgentHOI modularly orchestrates complementary vision foundation modules to perform open-ended semantic reasoning and spatial grounding in a coordinated manner. To address the challenges of incomplete interaction discovery and ambiguous localization in complex scenes, we introduce two key mechanisms: (1) Context-aware Multi-round Reasoning, which progressively refines interaction hypotheses to ensure exhaustive and compositional HOI discovery, and (2) Multifaceted Interaction Localization, which enhances grounding precision by generating instance-specific descriptions that integrate semantic, spatial, and appearance cues. Extensive experiments demonstrate that AgentHOI achieves superior performance over state-of-the-art supervised and weakly supervised methods in real-world settings, despite requiring no HOID data for training.
https://arxiv.org/abs/2607.13881
Life-limiting congenital anomalies require accurate prenatal diagnosis for appropriate clinical decision-making. Prenatal ultrasound (US) examinations involve multiple anatomical planes, and diagnosis depends on identifying anatomical planes and selecting diagnostically relevant planes for each anomaly. Existing automated methods either rely on plane-level annotations or aggregate heterogeneous images without explicitly modeling these diagnostic capabilities. We propose AnomExpert, a prototype-driven framework for prenatal US anomaly diagnosis using only case-level supervision. AnomExpert introduces learnable plane prototypes to organize unordered images into latent representations corresponding to anatomical planes without requiring plane annotations. A disease-aware sparse selection mechanism further selects diagnostically relevant planes for each anomaly. Experiments on a multi-center dataset of 3,654 cases show that AnomExpert consistently outperforms nine representative multi-instance learning methods. Using a ViT-small backbone, it achieves 86.9% accuracy and 84.2% F1-score while maintaining parameter efficiency. These findings indicate that modeling anatomical plane identification and disease-specific plane selection improves weakly supervised multi-plane prenatal US anomaly classification. The code is available at this https URL.
https://arxiv.org/abs/2607.13409
Farm site discovery from satellite imagery is a spatiotemporal candidate ranking problem because farm evidence is distributed across pasture, field boundaries, roads, buildings, and seasonal vegetation patterns. Direct farm labels are often incomplete, which makes fully supervised detection difficult. This paper proposes a weakly supervised pipeline for ranking dairy farm candidate clusters from seasonal Sentinel imagery and open map priors. The method uses aligned spring, summer, and autumn image tiles from County Cork, Ireland, with spectral bands, vegetation indices, built area indices, and a pasture channel. A Barlow Twins encoder learns multi-season tile embeddings without farm labels. In parallel, weak OpenStreetMap farm priors are split into a prior and a held-out set. Prior features support a rule-based tile score that combines farm proximity, seasonal pasture evidence, and summer greenness, while held-out features are reserved only for proxy evaluation. The rule score is smoothed over a spatial representation graph using geographic proximity and embedding similarity, and high-scoring tiles are grouped into ranked candidate clusters. From 26,722 valid tiles, the main run selects 535 high-confidence tiles and forms 71 candidate clusters. The top 5 clusters achieve 0.60 precision within 500 m and 0.80 precision within 1000 m of held-out OpenStreetMap farm features. The top 10 clusters achieve 0.40 precision within 500 m and 0.80 precision within 1000 m. The results show that seasonal representation learning and weak geographic priors can reduce large satellite image collections into compact candidate sets for human review.
https://arxiv.org/abs/2607.12748
Weakly supervised whole-slide image (WSI) classification is widely used in computational pathology because slide-level labels are easier to obtain than dense region annotations. Existing multiple instance learning (MIL) methods often aggregate large bags of patch embeddings using mainly visual cues, which can retain many non-informative patches and provide weak alignment between instance features and class-level disease semantics. We propose Concept-Guided Pruning and Representation Learning (CGRL), a simple framework that introduces class-level concept prototypes derived from disease prompts into the MIL pipeline. First, concept-relevance pruning ranks patch instances by their similarity to class concepts and retains the top-K concept-relevant patches for downstream MIL aggregation. Second, concept-guided contrastive representation learning constructs class-wise positive and negative patch sets from the same similarity matrix and optimizes target-class, symmetric auxiliary, and cross-class separation objectives, thereby regularizing the projected concept space. We evaluate CGRL on TCGA-BRCA and TCGA-NSCLC using multiple representative MIL methods. Experimental results show that CGRL improves several model-dataset combinations, with gains depending on the downstream MIL model and dataset. It achieves particularly clear improvements in accuracy and macro-F1 while reducing computational cost through concept-relevance pruning. These findings demonstrate that class-level semantic concepts provide an effective and practical prior for patch selection and representation learning in weakly supervised computational pathology.
https://arxiv.org/abs/2607.12556
Whole-slide images (WSIs) provide rich tissue-level and cellular-level information, but storing and transmitting high-magnification pathology data is resource-intensive. Moreover, annotating WSIs at the pixel level is labor-intensive and time-consuming. Therefore, it is important to investigate whether low-magnification pathology images with limited annotations (i.e., image-level instead of pixel-level labels) can achieve performance comparable to high-magnification images. This paper presents a systematic benchmark study on weakly supervised histopathological image segmentation under different low-resolution storage settings. Starting from high-resolution image patches, we simulate lower-magnification inputs and reconstruct them to the original size using interpolation and deep learning-based reconstruction methods before applying the weakly-supervised segmentation pipeline. This framework enables a quantitative evaluation of how weakly supervised methods respond to different levels of resolution degradation. Experimental results show that reconstruction quality metrics alone are insufficient to predict downstream segmentation performance. In particular, the study identifies a critical degradation point where the localization of small-scale structures declines significantly. These findings provide practical guidance for designing efficient digital pathology storage systems while maintaining reliable automated analysis. Code is available at this https URL
https://arxiv.org/abs/2607.10783
Weakly supervised video anomaly detection relies solely on video-level labels for training, making it difficult to accurately localize anomalous events in complex scenes. In real-world videos, anomalous behaviors exhibit large variations in appearance and temporal duration, while scene appearance and action dynamics are often tightly entangled. Consequently, existing models tend to rely on scene-related statistical cues rather than true behavioral deviations, resulting in unstable detection performance. To address this challenge, we propose a Structured Evidence Selection framework (SESAD) that reformulates anomaly detection as a structured reasoning process over clip-level visual evidence. Instead of directly mapping aggregated features to anomaly scores, SESAD reorganizes clip representations into semantically structured candidate evidence and performs context-conditioned selection under scene and action constraints. This mechanism adaptively emphasizes anomaly-relevant semantics while suppressing scene interference, thereby alleviating semantic entanglement under weak supervision. Furthermore, we introduce a lightweight geometric discrimination module that constructs a dual-prototype structure in the embedding space, enabling anomaly decisions through relative geometric relations. Extensive experiments on UBnormal, ShanghaiTech, and UCF-Crime show that SESAD achieves 67.92, 97.99, and 88.46 AUC, respectively, while maintaining high computational efficiency and overall consistently stable anomaly discrimination.
https://arxiv.org/abs/2607.10298