Lee, Yumi, Oh, Harim, Kim, Hyoryung, Kim, Minji, Kim, Eunsu, Lee, Hyeseong, Fukuoka, Junya, Bychkov, Andrey, Munkhdelger, Jijgee, Kaushal, Rajiv Kumar, Sahay, Ayushi, Yadav, Rajni, Prabakaran, Bharathi, Sarioglu, Sulen, Balcı, Serdar, Turkmen, Ilknur, Tolkach, Yuri, Harder, Christian, Westerdorf, Julian, Buettner, Reinhard, Henriksen, Audun Ljone, De Raedt, Sepp, Lee, Byung Hyun, Lim, Sungjin, Lee, Joohoon, Kim, Gwanghyun, Chun, Se Young, Singh, Suryakant, Kapse, Saarthak, Prasanna, Prateek, Kim, Kyung A, Kang, Yousun, Yoo, Sehwan, Hong, Sungman, Innani, Shubham, Feldman, Michael, Bakas, Spyridon, Baid, Ujjwal, Dutande, Prasad, Gajare, Suhas, Baheti, Bhakti, Sökmen, Serkan, Cebeci, Ece Tuğba, Halıcı, Ahmet, Balcı, Musa, Peçenek, Kardelen, Sainath, Srividhya, Jang, Kyongseok, Lee, Messi H. J., Wahab, Noorul, Du, Bodong, Zhang, Jiaming, Zhang, Qixiang, Choi, Jang-Hwan, Ahn, Sangjeong
Abstract
The rapid advancement of vision-language models (VLMs) has accelerated progress in computational pathology; however, whole-slide image (WSI)-based pathology report generation remains limited by the scarcity of large-scale WSI--report datasets and the complexity of mapping spatially distributed visual patterns to structured clinical text. To address this, we introduce a clinically curated Pan-Asia WSI--report dataset of approximately 10,500 pairs from five institutions and establish the REG 2025 benchmark through a MICCAI challenge for systematic evaluation of multimodal models. We analyze submitted methods spanning pretrained VLMs, multiple-instance learning frameworks, hierarchical expert models, retrieval-augmented generation, and cross-modal Transformers. Rather than indicating that VLM use alone was sufficient for superior performance, the results suggest that top-performing methods benefited from structured report representations, hierarchical diagnostic decomposition, and effective multimodal grounding. We identify key limitations, including instability in quantitative attribute estimation (e.g., numeric hallucination) and a tendency toward diagnostic overspecification, with some errors resembling known diagnostic pitfalls in routine pathology. These findings establish REG 2025 as a benchmark for evaluating WSI-based structured report generation and vision-language understanding in computational pathology, providing insights for the design of clinically grounded multimodal pathology models.
Chinese Translation
视觉-语言模型(VLMs)的快速发展加速了计算病理学的进步;然而,基于全切片图像(WSI)的病理报告生成仍受到大规模WSI-报告数据集稀缺和将空间分布的视觉模式映射到结构化临床文本的复杂性限制。为了解决这一问题,我们引入了一个临床策划的泛亚WSI-报告数据集,包含来自五个机构的大约10,500对数据,并通过MICCAI挑战建立了REG 2025基准,以系统评估多模态模型。我们分析了提交的方法,涵盖了预训练的VLMs、多实例学习框架、分层专家模型、检索增强生成和跨模态变换器。结果表明,顶尖表现的方法并非仅依赖于VLM的使用,而是受益于结构化报告表示、分层诊断分解和有效的多模态基础。我们识别出关键限制,包括定量属性估计的不稳定性(例如,数字幻觉)和对诊断过度具体化的倾向,某些错误类似于常规病理中的已知诊断陷阱。这些发现确立了REG 2025作为评估基于WSI的结构化报告生成和计算病理学中的视觉-语言理解的基准,为临床基础的多模态病理模型设计提供了见解。