Dual-stream attention-guided learning for weakly supervised whole slide image classification

Abstract

Whole slide images (WSIs) play a crucial role in cancer diagnosis due to their ultra-high resolution and rich morphological information, and multiple instance learning (MIL) has become a prevalent paradigm to solve the massive size of WSIs and the scarcity of fine-grained annotations of instance. However, most existing MIL methods struggle to accurately identify diagnostically critical local regions (instance) using only slide-level labels, and suffer from modelling the relationship of instances efficiently. To address these defects, we propose a Dual-Stream Attention-Guided Learning (DSAGL) framework. DSAGL bridges slide-level supervision and instance-level learning through a teacher-student dual-stream architecture, and mitigates instance ambiguity by generating attention-guided pseudo labels. The framework employs a shared lightweight encoder to efficiently model long-range dependencies and an attention-based fusion mechanism to enhance sensitivity to sparse, informative regions. Extensive experiments on synthetic benchmarks and real-world pathological WSI datasets demonstrate that DSAGL consistently outperforms state-of-the-art MIL methods, achieving superior discriminative performance and robustness under weak supervision.