Eugene Vorontsov, Alican Bozkurt, Adam Casson, George Shaikovski, Michal Zelechowski, Kristen Severson, Eric Zimmermann, James Hall, Neil Tenenholtz, Nicolo Fusi, Ellen Yang, Philippe Mathieu, Alexander van Eck, Donghun Lee, Julian Viret, Eric Robert, Yi Kan Wang, Jeremy D Kunz, Matthew C H Lee, Jan H Bernhard, Ran A Godrich, Gerard Oakley, Ewan Millar, Matthew Hanna, Hannah Wen, Juan A Retamero, William A Moye, Razik Yousfi, Christopher Kanan, David S Klimstra, Brandon Rothrock, Siqi Liu, Thomas J Fuchs
Nat Med . 2024 Oct;30(10):2924-2935. doi: 10.1038/s41591-024-03141-0. Epub 2024 Jul 22.
The analysis of histopathology images with artificial intelligence aims to enable clinical decision support systems and precision medicine. The success of such applications depends on the ability to model the diverse patterns observed in pathology images. To this end, we present Virchow, the largest foundation model for computational pathology to date. In addition to the evaluation of biomarker prediction and cell identification, we demonstrate that a large foundation model enables pan-cancer detection, achieving 0.95 specimen-level area under the (receiver operating characteristic) curve across nine common and seven rare cancers. Furthermore, we show that with less training data, the pan-cancer detector built on Virchow can achieve similar performance to tissue-specific clinical-grade models in production and outperform them on some rare variants of cancer. Virchow's performance gains highlight the value of a foundation model and open possibilities for many high-impact applications with limited amounts of labeled training data.