Cascaded Cross-Attention Networks for Data-Efficient Whole-Slide Image
  Classification Using Transformers
Firas Khader Jakob Nikolas Kather Tianyu Han Sven Nebelung Christiane Kuhl Johannes Stegmaier Daniel Truhn
Whole-Slide Imaging allows for the capturing and digitization of
high-resolution images of histological specimen. An automated analysis of such
images using deep learning models is therefore of high demand. The transformer
architecture has been proposed as a possible candidate for effectively
leveraging the high-resolution information. Here, the whole-slide image is
partitioned into smaller image patches and feature tokens are extracted from
these image patches. However, while the conventional transformer allows for a
simultaneous processing of a large set of input tokens, the computational
demand scales quadratically with the number of input tokens and thus
quadratically with the number of image patches. To address this problem we
propose a novel cascaded cross-attention network (CCAN) based on the
cross-attention mechanism that scales linearly with the number of extracted
patches. Our experiments demonstrate that this architecture is at least on-par
with and even outperforms other attention-based state-of-the-art methods on two
public datasets: On the use-case of lung cancer (TCGA NSCLC) our model reaches
a mean area under the receiver operating characteristic (AUC) of 0.970 $\pm$
0.008 and on renal cancer (TCGA RCC) reaches a mean AUC of 0.985 $\pm$ 0.004.
Furthermore, we show that our proposed model is efficient in low-data regimes,
making it a promising approach for analyzing whole-slide images in
resource-limited settings. To foster research in this direction, we make our
code publicly available on GitHub: XXX.