Order-Aware 2.5D Multiple Instance Learning for Preoperative MRI-Based Perineural Invasion Risk Assessment in Intrahepatic Cholangiocarcinoma — Paper

Abstract

Perineural invasion (PNI) is an adverse histopathologic marker in intrahepatic cholangiocarcinoma (ICC), but it is usually confirmed only after resection. Preoperative T2-weighted MRI may provide noninvasive imaging cues predictive of PNI, although labels are available only at the patient level without slice- or voxel-level annotations. We propose Order-Aware Slab Multiple Instance Learning (OAS-MIL), a weakly supervised framework for patient-level PNI prediction. Each tumor-centered MRI crop is represented as an ordered sequence of overlapping 2.5D slabs formed from contiguous axial slices. A shared encoder extracts slab-level features, which are aggregated by a permutation-invariant set-attention branch and a bidirectional sequence-attention branch. Using five-fold label-stratified cross-validation at the patient level, OAS-MIL achieved a mean AUROC of 0.770, outperforming the evaluated volumetric and MIL baselines. These results suggest that axial order provides a useful inductive bias for weakly supervised PNI prediction from MRI.

Authors 14

Hyunsu Go, Youngung Han, Kyeonghun Kim, Jinyong Jun, Junbeom Lee, Dohyun Kweon, Yului Jeong, Suah Park, Sungha Park, Anna Jung, Woo Kyoung Jeong, Ken Ying-Kai Liao, Hyuk-Jae Lee, Nam-Joon Kim

Specification

Official page: arxiv.org/abs/2609.11271
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Arxiv announce type: new
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
arXiv id: 2609.11271
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Categories: cs.CV
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
PDF: arxiv.org/pdf/2609.11271
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Primary category: cs.CV
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Published: 11 Sept 2026
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh

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T19

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2 h ago

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Authors: Hyunsu Go, Youngung Han, Kyeonghun Kim

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Claim history · Abstract

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Claim history for Abstract
Value	Valid from → to	Status	Source	Confidence	Extractor
Perineural invasion (PNI) is an adverse histopathologic marker in intrahepatic cholangiocarcinoma (ICC), but it is usually confirmed only after resection. Preoperative T2-weighted MRI may provide noninvasive imaging cues predictive of PNI, although labels are available only at the patient level without slice- or voxel-level annotations. We propose Order-Aware Slab Multiple Instance Learning (OAS-MIL), a weakly supervised framework for patient-level PNI prediction. Each tumor-centered MRI crop is represented as an ordered sequence of overlapping 2.5D slabs formed from contiguous axial slices. A shared encoder extracts slab-level features, which are aggregated by a permutation-invariant set-attention branch and a bidirectional sequence-attention branch. Using five-fold label-stratified cross-validation at the patient level, OAS-MIL achieved a mean AUROC of 0.770, outperforming the evaluated volumetric and MIL baselines. These results suggest that axial order provides a useful inductive bias for weakly supervised PNI prediction from MRI.	11 Sept 2026 21:03 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →

11 Sept 2026
New paperPaperOrder-Aware 2.5D Multiple Instance Learning for Preoperative MRI-Based Perineural Invasion Risk Assessment in Intrahepatic Cholangiocarcinoma
New paper: Order-Aware 2.5D Multiple Instance Learning for Preoperative MRI-Based Perineural Invasion Risk Assessment in Intrahepatic Cholangiocarcinoma
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Source	Document	Type	Tier	Last observed	Snapshots
arXiv (Atom API + RSS)	rss.arxiv.org/rss/cs.CV	feed	T1· Official	1 min ago	1

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