Sparse Multi-Modal Graph Transformer With Shared-Context Processing for Representation Learning of Giga-Pixel Images

Processing giga-pixel whole slide histopathology images (WSI) is a computationally expensive task. Multiple instance learning (MIL) has become the conventional approach to process WSIs, in which these images are split into smaller patches for further processing. However, MIL-based techniques ignore explicit information about the individual cells within a patch. In this paper, by defining the novel concept of shared-context processing, we designed a multi-modal Graph Transformer that uses the cellular graph within the tissue to provide a single representation for a patient while taking advantage of the hierarchical structure of the tissue, enabling a dynamic focus between cell-level and tissue-level information. We benchmarked the performance of our model against multiple state-of-the-art methods in survival prediction and showed that ours can significantly outperform all of them including hierarchical vision Transformer (ViT). More importantly, we show that our model is strongly robust to missing information to an extent that it can achieve the same performance with as low as 20% of the data. Finally, in two different cancer datasets, we demonstrated that our model was able to stratify the patients into low-risk and high-risk groups while other state-of-the-art methods failed to achieve this goal. We also publish a large dataset of immunohistochemistry (IHC) images containing 1,600 tissue microarray (TMA) cores from 188 patients along with their survival information, making it one of the largest publicly available datasets in this context.