DREAMER-S: Deep leaRning-Enabled Attention-based Multiple-instance approaches with Explainable Representations for...

Identifying image features that associate strongly with diagnostic or prognostic classes in large-scale, multi-channel spatial imaging is challenging without pixel-level annotations. We present DREAMER-S, an attention-based multiple-instance learning (MIL) framework that, using only image- or slide-level labels, learns spatial features within 3D imaging hypercubes that are most informative for downstream classification. We demonstrate DREAMER-S on Quantum Cascade Laser infrared (QCL-IR) tissue imaging, where attention weights are rendered spatially to highlight class-relevant spectral instances without manual annotation. Because the MIL attention layer assigns interpretable importances to spatial instances, the method is broadly transferable to spatial-biology applications that require instance-level filtering to focus towards salient regions of interest in high-content datasets. We further evaluate DREAMER-S on a chemotherapy-response task in a colorectal cancer patient-derived xenograft (PDX) model. After tuning, DREAMER-S separated spectral instances from a chemo-sensitive PDX (CRC0344) and a less responsive PDX (CRC0076) with an F1 score of ~0.95. To validate explainability, we linked model saliency to cellular physiology, observing that, (i) unsupervised UMAP embeddings of high-attention spectra stratified samples by treatment (chemotherapy, apoptosis sensitizer, combination, vehicle), and (ii) selected spectral markers correlated with pro-apoptotic proteins measured independently in the same PDX system. Together, these results support a mechanistic link between spectral signals and apoptosis pathways and position DREAMER-S as an efficient, interpretable approach for analysing high-content spatial-biology imaging datasets.