Prompt-guided foundation model tuning for pathology image classification

Foundation models have become pivotal in advancing computational pathology, particularly for whole slide image (WSI) classification. However, prevailing methodologies often rely on frozen, pre-trained models for feature extraction, overlooking the pronounced domain shift and task discrepancy between the pre-training and downstream tasks. To address this challenge, we propose PAMT, a novel Prompt-guided Adaptive Model Transformation framework that enables precise adaptation of general foundation models to the distinct domain of histopathology. To encapsulate the intricate distributions characteristic of histopathological data, we introduce Representative Patch Sampling (RPS) and Prototypical Visual Prompt (PVP), which reconstruct the input into compact yet highly informative representations. Further, to effectively bridge the domain gap, we incorporate Adaptive Model Transformation (AMT) via adapter modules within the feature extraction pipeline, facilitating the acquisition of domain-specific features by the foundation model. We conduct rigorous evaluation across 14 publicly available datasets and demonstrate consistent, substantial improvements in classification accuracy. These results establish PAMT as a compelling new benchmark for pathology image classification and underscore the critical value of targeted model adaptation within computational pathology.