Evidence map›Paper›PMID 41735241›Full record

ArticleThe journal of pathology. Clinical research2026

Impact of tissue staining and scanner variation on the performance of pathology foundation models: a study of sarcomas and their mimics.

Binghao Chai, Jianan Chen, Paul Cool, Fatine Oumlil, Anna Tollitt, David F Steiner, Tapabrata Chakraborti, Adrienne M Flanagan

Abstract read
In one paragraph

Article in The journal of pathology. Clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Binghao Chai *Research Department of Pathology, UCL Cancer Institute, University College London, London, UK.ORCID https://orcid.org/0009-0003-3292-5614
Jianan Chen *Research Department of Pathology, UCL Cancer Institute, University College London, London, UK.
Paul CoolThe Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, UK.
Fatine OumlilResearch Department of Pathology, UCL Cancer Institute, University College London, London, UK.
Anna TollittCellular and Molecular Pathology, Royal National Orthopaedic Hospital, Stanmore, UK.
David F SteinerGoogle Health, Mountain View, CA, USA.
Tapabrata ChakrabortiResearch Department of Pathology, UCL Cancer Institute, University College London, London, UK.ORCID https://orcid.org/0000-0002-5597-908X
Adrienne M FlanaganResearch Department of Pathology, UCL Cancer Institute, University College London, London, UK.ORCID https://orcid.org/0000-0002-2832-1303

Funding

Bone Cancer Research Trust BCRT/5717Engineering and Physical Sciences Research Council EP/Y020030Royal National Orthopaedic Hospital ResearchSarcoma UK SUKRI.2023
6 · The paper itself

Abstract

Histopathological analysis is considered the gold standard for the diagnosis and prognostication of cancer. Recent advances in AI, driven by large-scale digitisation and pan-cancer foundation models, are opening new opportunities for clinical integration. However, it remains unclear how robust these foundation models are to real-world sources of variability, particularly in H&E staining and scanners produced by different manufacturers. In this study, we use soft tissue tumours, a rare and morphologically diverse tumour type, as a challenging test case to systematically investigate the colour-related robustness and generalisability of seven AI models. Controlled staining and scanning experiments were utilised to assess model performance across diverse real-world data sources. Foundation models, particularly UNI-v2, Virchow and TITAN, demonstrated encouraging robustness to staining and scanning variation, particularly when a small number of stain-varied slides were included in the training loop, highlighting their potential as adaptable and data-efficient tools for real-world digital pathology workflows.

Indexed as

Image Interpretation, Computer-AssistedSarcomaSoft Tissue NeoplasmsStaining and LabelingArtificial IntelligenceHumanscancer diagnosisclinical artificial intelligencedigital pathologyhistology stainingsarcomasoft tissue tumourswhole slide images

Identifiers

PMID41735241
PMCPMC12932120

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.