Traditional image-based survival prediction models rely on discriminative patch labeling which make those methods not scalable to extend to large datasets. Recent studies have shown Multiple Instance Learning (MIL) framework is useful for histopathological images when no annotations are available in classification task. Different to the current image-based survival models that limit to key patches or clusters derived from Whole Slide Images (WSIs), we propose Deep Attention Multiple Instance Survival Learning (DeepAttnMISL) by introducing both siamese MI-FCN and attention-based MIL pooling to efficiently learn imaging features from the WSI and then aggregate WSI-level information to patient-level. Attention-based aggregation is more flexible and adaptive than aggregation techniques in recent survival models. We evaluated our methods on two large cancer whole slide images datasets and our results suggest that the proposed approach is more effective and suitable for large datasets and has better interpretability in locating important patterns and features that contribute to accurate cancer survival predictions. The proposed framework can also be used to assess individual patient's risk and thus assisting in delivering personalized medicine. Codes are available at https://github.com/uta-smile/DeepAttnMISL_MEDIA.

此研究提出了一种名为DeepAttnMISL的多实例深度学习方法，通过引入两种方式（siamese MI-FCN 和 attention-based MIL pooling）从WSI中高效地学习图像特征，然后将WSI级别的信息聚合到患者级别。该方法适用于大型数据集，并具有更好的可解释性，可用于癌症患者风险评估和个性化医疗。

基于全切片图像的肿瘤生存预测：基于注意力引导的深度多示例学习网络