ScoreNet: Learning Non-Uniform Attention and Augmentation for Transformer-Based Histopathological Image Classification

Progress in digital pathology is hindered by high-resolution images and the prohibitive cost of exhaustive localized annotations. The commonly used paradigm to categorize pathology images is patch-based processing, which often incorporates multiple instance learning (MIL) to aggregate local patch-level representations yielding image-level prediction. Nonetheless, diagnostically relevant regions may only take a small fraction of the whole tissue, and current MIL-based approaches often process images uniformly, discarding the inter-patches interactions. To alleviate these issues, we propose ScoreNet, a new efficient transformer that exploits a differentiable recommendation stage to extract discriminative image regions and dedicate computational resources accordingly. The proposed transformer leverages the local and global attention of a few dynamically recommended high-resolution regions at an efficient computational cost. We further introduce a novel Mixup-based data-augmentation, namely ScoreMix, by leveraging the image's semantic distribution to guide the data mixing and produce coherent sample-label pairs. ScoreMix is embarrassingly simple and mitigates the pitfalls of previous augmentations, which assume a uniform semantic distribution and risk mislabeling the samples. Thorough experiments and ablation studies on three breast cancer histology datasets of Haematoxylin & Eosin (H&E) have validated the superiority of our approach over prior arts, including transformer-based models on tumour regions-of-interest (TRoIs) classification. ScoreNet equipped with proposed ScoreMix augmentation demonstrates better generalization capabilities and achieves new state-of-the-art (SOTA) results with only 50% of the data compared to other Mixup augmentation variants. Finally, ScoreNet yields high efficacy and outperforms SOTA efficient transformers, namely TransPath and SwinTransformer.