# A whole-slide foundation model for digital pathology from real-world data

Article · Xu H, Usuyama N, Bagga J, Zhang S, Rao R, Naumann T, Wong C, Gero Z, González J, Gu Y, Xu Y, Wei M, Wang W, Ma S, Wei F, Yang J, Li C, Gao J, Rosemon J, Bower T, Lee S, Weerasinghe R, Wright BJ, Robicsek A, Piening B and 3 more

- Archive id: doi:10.1038/s41586-024-07441-w
- Published: 2024-05-22
- Venue: Nature
- DOI: https://doi.org/10.1038/s41586-024-07441-w
- PMID: 38778098
- PMCID: PMC11153137
- Citations: 578
- Source URL: https://doi.org/10.1038/s41586-024-07441-w
- PDF: https://europepmc.org/articles/PMC11153137/pdf
- Provenance: europepmc

## Abstract

Digital pathology poses unique computational challenges, as a standard gigapixel slide may comprise tens of thousands of image tiles 1-3 . Prior models have often resorted to subsampling a small portion of tiles for each slide, thus missing the important slide-level context 4 . Here we present Prov-GigaPath, a whole-slide pathology foundation model pretrained on 1.3 billion 256 × 256 pathology image tiles in 171,189 whole slides from Providence, a large US health network comprising 28 cancer centres. The slides originated from more than 30,000 patients covering 31 major tissue types. To pretrain Prov-GigaPath, we propose GigaPath, a novel vision transformer architecture for pretraining gigapixel pathology slides. To scale GigaPath for slide-level learning with tens of thousands of image tiles, GigaPath adapts the newly developed LongNet 5 method to digital pathology. To evaluate Prov-GigaPath, we construct a digital pathology benchmark comprising 9 cancer subtyping tasks and 17 pathomics tasks, using both Providence and TCGA data 6 . With large-scale pretraining and ultra-large-context modelling, Prov-GigaPath attains state-of-the-art performance on 25 out of 26 tasks, with significant improvement over the second-best method on 18 tasks. We further demonstrate the potential of Prov-GigaPath on vision-language pretraining for pathology 7,8 by incorporating the pathology reports. In sum, Prov-GigaPath is an open-weight foundation model that achieves state-of-the-art performance on various digital pathology tasks, demonstrating the importance of real-world data and whole-slide modelling.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [AI in Clinical Medicine](https://space-kitty.com/topics/ai-medicine)

Cited in dossiers:
- [AI in Clinical Medicine: State of the Field (October 2026)](https://space-kitty.com/dossiers/ai-medicine)

---
Space Kitty Archive · https://space-kitty.com · API: https://space-kitty.com/api/v1 · MCP: https://space-kitty.com/mcp · Premium: $0.20/request via x402 (Base Sepolia (testnet)). Metadata: arXiv (CC0), OpenAlex (CC0), Europe PMC (CC BY/CC0 works), ClinicalTrials.gov.