AdvMIL: Adversarial Multiple Instance Learning for the Survival Analysis on Whole-Slide Images

The survival analysis on histological whole-slide images (WSIs) is one of the most important means to estimate patient prognosis. Although many weakly-supervised deep learning models have been developed for gigapixel WSIs, their potential is generally restricted by classical survival analysis rules and fully-supervision requirements. As a result, these models provide patients only with a completely-certain point estimation of time-to-event, and they could only learn from the well-annotated WSI data currently at a small scale. To tackle these problems, we propose a novel adversarial multiple instance learning (AdvMIL) framework. This framework is based on adversarial time-to-event modeling, and it integrates the multiple instance learning (MIL) that is much necessary for WSI representation learning. It is a plug-and-play one, so that most existing WSI-based models with embedding-level MIL networks can be easily upgraded by applying this framework, gaining the improved ability of survival distribution estimation and semi-supervised learning. Our extensive experiments show that AdvMIL could not only bring performance improvement to mainstream WSI models at a relatively low computational cost, but also enable these models to learn from unlabeled data with semi-supervised learning. Our AdvMIL framework could promote the research of time-to-event modeling in computational pathology with its novel paradigm of adversarial MIL.