Attention-based multiple instance learning with self-supervision to predict microsatellite instability in colorectal cancer from histology whole-slide images.

Microsatellite instability (MSI) is a clinically important characteristic of colorectal cancer. Standard diagnosis of MSI is performed via genetic analyses, however these tests are not always included in routine care. Histopathology whole-slide images (WSIs) are the gold-standard for colorectal cancer diagnosis and are routinely collected. This study develops a model to predict MSI directly from WSIs. Making use of both weakly- and self-supervised deep learning techniques, the proposed model shows improved performance over conventional deep learning models. Additionally, the proposed framework allows for visual interpretation of model decisions. These results are validated in internal and external testing datasets.