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This research addresses the variability of pathology vision-language foundation models by introducing FFM-CP, a framework that fuses heterogeneous backbones using few-shot learning to enhance histopathological classification. By aligning representations via Orthogonal Procrustes transformation and enabling cross-backbone information exchange, the method consistently outperforms individually adapted models across multiple datasets with limited labeled data. The approach offers a practical pathway to mitigate annotation costs while improving robustness in medical AI applications without requiring extensive retraining.
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FFM-CP: Cross-Backbone Fusion of Vision-Language Foundation Models for Few-Shot Computational Pathology

arXiv3 min read

arXiv:2609.27710v1 Announce Type: cross Abstract: Pathology vision-language foundation models vary in performance across diseases and tasks, with no single model consistently performing best. The high cost of expert pathology annotation can also limit the labeled data available for task-specific adaptation. Combining complementary pretrained representations is a potential approach to these limitations, yet learning an effective fusion from few labeled examples remains challenging. We introduce Few-shot Fusion Foundation Models of Computational Pathology (FFM-CP), which is a framework that combines multiple pathology vision-language models in the few-shot learning setting. The framework first aligns heterogeneous representations using a closed-form Orthogonal Procrustes transformation estimated from corresponding support images. This alignment preserves within-model feature geometry without training an additional alignment network. Within the aligned space, a unified graph enables information exchange across backbones by jointly refining support-image features and visual and textual class prototypes. These refined representations support complementary text-prototype and case-retrieval branches that capture semantic class knowledge and within-class visual variation, respectively. Each branch learns to combine predictions from all ordered backbone pairs, allowing queries encoded by one model to draw on evidence represented by another. We evaluate three backbone combinations on six histopathology datasets at 4, 8, and 16 shots per class. FFM-CP achieves higher mean macro-F1 than the strongest individually adapted member of each fused set in 50 of 54 comparisons. These findings suggest that combining complementary pretrained representations can improve histopathological classification when annotations are limited.

Authors:Anh-Tien Nguyen, Trung DQ. Dang, Nghiem Tuong Diep, Bui Ngoc Han Nguyen, Tan-Ha Mai, Miriam Cindy Maurer, Phuong Hoa Nguyen, Thi Thuy Uyen Nguyen, Youngjun Park, Daniel Sonntag, Duy Minh Ho Nguyen, Anne-Christin Hauschild

Abstract:Pathology vision-language foundation models vary in performance across diseases and tasks, with no single model consistently performing best. The high cost of expert pathology annotation can also limit the labeled data available for task-specific adaptation. Combining complementary pretrained representations is a potential approach to these limitations, yet learning an effective fusion from few labeled examples remains challenging. We introduce Few-shot Fusion Foundation Models of Computational Pathology (FFM-CP), which is a framework that combines multiple pathology vision-language models in the few-shot learning setting. The framework first aligns heterogeneous representations using a closed-form Orthogonal Procrustes transformation estimated from corresponding support images. This alignment preserves within-model feature geometry without training an additional alignment network. Within the aligned space, a unified graph enables information exchange across backbones by jointly refining support-image features and visual and textual class prototypes. These refined representations support complementary text-prototype and case-retrieval branches that capture semantic class knowledge and within-class visual variation, respectively. Each branch learns to combine predictions from all ordered backbone pairs, allowing queries encoded by one model to draw on evidence represented by another. We evaluate three backbone combinations on six histopathology datasets at 4, 8, and 16 shots per class. FFM-CP achieves higher mean macro-F1 than the strongest individually adapted member of each fused set in 50 of 54 comparisons. These findings suggest that combining complementary pretrained representations can improve histopathological classification when annotations are limited.

Computer Vision and Pattern Recognition (cs.CV); Machine Learning (cs.LG)

arXiv:2609.27710 [cs.CV]

(or arXiv:2609.27710v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2609.27710 arXiv-issued DOI via DataCite (pending registration)

Full text under the publisher's open licence · 288 words

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