Multi-Modal Foundation Models for Computational Pathology: A Survey

Foundation models have emerged as a powerful paradigm in computational pathology (CPath), enabling scalable and generalizable analysis of histopathological images. While early developments centered on uni-modal models trained solely on visual data, recent advances have highlighted the promise of multi-modal foundation models that integrate heterogeneous data sources such as textual reports, structured domain knowledge, and molecular profiles. In this survey, we provide a comprehensive and up-to-date review of multi-modal foundation models in CPath, with a particular focus on models built upon hematoxylin and eosin (H&E) stained whole slide images (WSIs) and tile-level representations. We categorize 32 state-of-the-art multi-modal foundation models into three major paradigms: vision-language, vision-knowledge graph, and vision-gene expression. We further divide vision-language models into non-LLM-based and LLM-based approaches. Additionally, we analyze 28 available multi-modal datasets tailored for pathology, grouped into image-text pairs, instruction datasets, and image-other modality pairs. Our survey also presents a taxonomy of downstream tasks, highlights training and evaluation strategies, and identifies key challenges and future directions. We aim for this survey to serve as a valuable resource for researchers and practitioners working at the intersection of pathology and AI.

A Survey on Computational Pathology Foundation Models: Datasets, Adaptation Strategies, and Evaluation Tasks

Computational pathology foundation models (CPathFMs) have emerged as a powerful approach for analyzing histopathological data, leveraging self-supervised learning to extract robust feature representations from unlabeled whole-slide images. These models, categorized into uni-modal and multi-modal frameworks, have demonstrated promise in automating complex pathology tasks such as segmentation, classification, and biomarker discovery. However, the development of CPathFMs presents significant challenges, such as limited data accessibility, high variability across datasets, the necessity for domain-specific adaptation, and the lack of standardized evaluation benchmarks. This survey provides a comprehensive review of CPathFMs in computational pathology, focusing on datasets, adaptation strategies, and evaluation tasks. We analyze key techniques, such as contrastive learning and multi-modal integration, and highlight existing gaps in current research. Finally, we explore future directions from four perspectives for advancing CPathFMs. This survey serves as a valuable resource for researchers, clinicians, and AI practitioners, guiding the advancement of CPathFMs toward robust and clinically applicable AI-driven pathology solutions.