{"id":"https://openalex.org/W7207763200","doi":"https://doi.org/10.48550/arxiv.2609.02390","title":"Seeing Beyond the Lesion: Disease Recognition from Reactive CNS Tissue","display_name":"Seeing Beyond the Lesion: Disease Recognition from Reactive CNS Tissue","publication_year":2026,"publication_date":"2026-09-02","ids":{"openalex":"https://openalex.org/W7207763200","doi":"https://doi.org/10.48550/arxiv.2609.02390"},"language":"en","primary_location":{"id":"pmh:oai:arXiv.org:2609.02390","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2609.02390","pdf_url":"https://arxiv.org/pdf/2609.02390","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["arxiv","datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://arxiv.org/pdf/2609.02390","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5129424243","display_name":"Jan Schnorrenberg","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210103666","display_name":"University Hospital M\u00fcnster","ror":"https://ror.org/01856cw59","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210103666"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Schnorrenberg, Jan","raw_affiliation_strings":["Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I4210103666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5047848421","display_name":"Jan Ernsting","orcid":"https://orcid.org/0000-0003-4649-2111","observed_orcids":["https://orcid.org/0000-0003-4649-2111"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ernsting, Jan","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046128741","display_name":"Enrico G. Kuellenberg","orcid":"https://orcid.org/0000-0002-9898-7100","observed_orcids":["https://orcid.org/0000-0002-9898-7100"]},"institutions":[{"id":"https://openalex.org/I4210103666","display_name":"University Hospital M\u00fcnster","ror":"https://ror.org/01856cw59","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210103666"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"K\u00fcllenberg, Enrico","raw_affiliation_strings":["Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I4210103666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5149821369","display_name":"Tim Hahn","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I22465464","display_name":"University of M\u00fcnster","ror":"https://ror.org/00pd74e08","country_code":"DE","type":"education","lineage":["https://openalex.org/I22465464"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Hahn, Tim","raw_affiliation_strings":["Institute for Machine Learning in Medicine (Focus Area Psychiatry) , University of M\u00fcnster , M\u00fcnster , Germany","University of M\u00fcnster , Institute for Translational Psychiatry , M\u00fcnster , Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute for Machine Learning in Medicine (Focus Area Psychiatry) , University of M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I22465464"]},{"raw_affiliation_string":"University of M\u00fcnster , Institute for Translational Psychiatry , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I22465464"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003115770","display_name":"Benjamin Risse","orcid":"https://orcid.org/0000-0001-5691-4029","observed_orcids":["https://orcid.org/0000-0001-5691-4029"]},"institutions":[{"id":"https://openalex.org/I22465464","display_name":"University of M\u00fcnster","ror":"https://ror.org/00pd74e08","country_code":"DE","type":"education","lineage":["https://openalex.org/I22465464"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Risse, Benjamin","raw_affiliation_strings":["Faculty of Mathematics and Computer Science , University of M\u00fcnster , M\u00fcnster , Germany","Institute for Geoinformatics , University of M\u00fcnster , M\u00fcnster , Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Mathematics and Computer Science , University of M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I22465464"]},{"raw_affiliation_string":"Institute for Geoinformatics , University of M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I22465464"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5104044947","display_name":"Christian Thomas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210103666","display_name":"University Hospital M\u00fcnster","ror":"https://ror.org/01856cw59","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210103666"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Thomas, Christian","raw_affiliation_strings":["Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Neuropathology , University Hospital M\u00fcnster , M\u00fcnster , Germany","institution_ids":["https://openalex.org/I4210103666"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.9887999892234802,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.9887999892234802,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.002300000051036477,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.0015999999595806003,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/disease-classification","display_name":"disease classification","score":0.5559999942779541},{"id":"https://openalex.org/keywords/frozen-section-pathology","display_name":"frozen section pathology","score":0.45500001311302185},{"id":"https://openalex.org/keywords/foundation-models","display_name":"foundation models","score":0.48100000619888306},{"id":"https://openalex.org/keywords/multiple-instance-learning","display_name":"multiple instance learning","score":0.7570000290870667},{"id":"https://openalex.org/keywords/whole-slide-images","display_name":"whole slide images","score":0.7269999980926514},{"id":"https://openalex.org/keywords/sampling-bias","display_name":"sampling bias","score":0.6060000061988831},{"id":"https://openalex.org/keywords/weakly-supervised-learning","display_name":"weakly supervised learning","score":0.6439999938011169}],"concepts":[{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.5900999903678894},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4936000108718872},{"id":"https://openalex.org/C196822366","wikidata":"https://www.wikidata.org/wiki/Q270524","display_name":"Parenchyma","level":2,"score":0.4526999890804291},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.4503999948501587},{"id":"https://openalex.org/C2986936838","wikidata":"https://www.wikidata.org/wiki/Q492038","display_name":"Brain tissue","level":2,"score":0.43459999561309814},{"id":"https://openalex.org/C21308566","wikidata":"https://www.wikidata.org/wiki/Q7169365","display_name":"Permutation (music)","level":2,"score":0.4050000011920929},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.39469999074935913},{"id":"https://openalex.org/C185798385","wikidata":"https://www.wikidata.org/wiki/Q1161707","display_name":"Benchmark (surveying)","level":2,"score":0.3619999885559082},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.33980000019073486},{"id":"https://openalex.org/C198082294","wikidata":"https://www.wikidata.org/wiki/Q3399648","display_name":"Position (finance)","level":2,"score":0.3262999951839447},{"id":"https://openalex.org/C188198153","wikidata":"https://www.wikidata.org/wiki/Q1613840","display_name":"Limiting","level":2,"score":0.3140000104904175},{"id":"https://openalex.org/C153180895","wikidata":"https://www.wikidata.org/wiki/Q7148389","display_name":"Pattern recognition (psychology)","level":2,"score":0.31290000677108765},{"id":"https://openalex.org/C169760540","wikidata":"https://www.wikidata.org/wiki/Q207011","display_name":"Neuroscience","level":1,"score":0.30880001187324524},{"id":"https://openalex.org/C140779682","wikidata":"https://www.wikidata.org/wiki/Q210868","display_name":"Sampling (signal processing)","level":3,"score":0.30709999799728394},{"id":"https://openalex.org/C82157600","wikidata":"https://www.wikidata.org/wiki/Q2671652","display_name":"Diagnostic test","level":2,"score":0.3052000105381012},{"id":"https://openalex.org/C160798450","wikidata":"https://www.wikidata.org/wiki/Q4230870","display_name":"Concordance","level":2,"score":0.30489999055862427},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.2865000069141388},{"id":"https://openalex.org/C2987315675","wikidata":"https://www.wikidata.org/wiki/Q1773974","display_name":"Disease control","level":2,"score":0.27889999747276306},{"id":"https://openalex.org/C51632099","wikidata":"https://www.wikidata.org/wiki/Q3985153","display_name":"Training set","level":2,"score":0.2766000032424927},{"id":"https://openalex.org/C2779843651","wikidata":"https://www.wikidata.org/wiki/Q7390335","display_name":"SIGNAL (programming language)","level":2,"score":0.2750999927520752},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.26440000534057617},{"id":"https://openalex.org/C50965678","wikidata":"https://www.wikidata.org/wiki/Q2724302","display_name":"Abnormality","level":2,"score":0.250900000333786}],"mesh":[],"locations_count":2,"locations":[{"id":"pmh:oai:arXiv.org:2609.02390","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2609.02390","pdf_url":"https://arxiv.org/pdf/2609.02390","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},{"id":"doi:10.48550/arxiv.2609.02390","doi":"https://doi.org/10.48550/arxiv.2609.02390","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2609.02390","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"pmh:oai:arXiv.org:2609.02390","doi":null,"is_oa":true,"landing_page_url":"https://arxiv.org/abs/2609.02390","pdf_url":"https://arxiv.org/pdf/2609.02390","source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"text"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.5683000087738037}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7207763200.pdf","grobid_xml":"https://content.openalex.org/works/W7207763200.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7204227548","https://openalex.org/W7162338847","https://openalex.org/W7204804916","https://openalex.org/W7221547511","https://openalex.org/W4416021363","https://openalex.org/W7136096397","https://openalex.org/W7223113727","https://openalex.org/W4408777880","https://openalex.org/W4414035452","https://openalex.org/W7106301771"],"abstract_inverted_index":{"Sampling":[0],"error":[1],"yields":[2],"exclusively":[3],"reactive,":[4],"non-lesional":[5],"brain":[6],"parenchyma":[7,136],"in":[8,160],"a":[9,35,153,157],"significant":[10],"proportion":[11],"of":[12],"intracranial":[13],"biopsies,":[14],"leaving":[15],"the":[16],"underlying":[17],"disease":[18,86,176],"undiagnosed.":[19],"We":[20,52],"benchmark":[21],"four":[22],"pathology":[23],"foundation":[24],"models":[25,173],"(UNI2-h,":[26],"Virchow2,":[27],"Prov-GigaPath,":[28],"H-optimus-0)":[29],"as":[30,156,182],"frozen":[31],"patch":[32,120],"encoders":[33],"within":[34,75],"shared":[36],"attention-based":[37],"multiple-instance":[38],"learning":[39],"framework":[40],"using":[41],"245":[42],"whole-slide":[43],"images":[44],"from":[45,63,178],"186":[46],"patients":[47],"with":[48],"confirmed":[49],"downstream":[50],"diagnoses.":[51],"first":[53],"show":[54],"that":[55,109,166,170],"coarse":[56],"disease-category":[57],"prediction":[58],"can":[59],"be":[60],"reproduced":[61],"largely":[62],"slide":[64],"size":[65],"alone.":[66],"After":[67],"restricting":[68],"classification":[69],"to":[70,134],"three":[71],"finer":[72],"diagnostic":[73],"distinctions":[74],"common":[76],"tissue":[77,145,179],"categories,":[78],"this":[79],"confound":[80,167],"no":[81],"longer":[82],"explains":[83],"performance,":[84],"yet":[85],"labels":[87],"remain":[88],"predictable":[89],"above":[90],"chance":[91],"under":[92],"permutation":[93],"testing":[94],"(p":[95],"$\\le":[96],"10^{-4}$":[97],"throughout).":[98],"Surprisingly,":[99],"performance":[100],"is":[101,115,168],"statistically":[102],"indistinguishable":[103],"across":[104],"all":[105],"foundation-model":[106],"encoders,":[107],"suggesting":[108],"recovering":[110],"these":[111],"weak":[112],"morphological":[113],"signatures":[114],"not":[116],"limited":[117],"by":[118],"current":[119],"representations.":[121],"Signed":[122],"instance-contribution":[123],"maps":[124],"and":[125,163],"expert":[126],"review":[127],"further":[128],"test":[129],"whether":[130],"predictive":[131],"evidence":[132],"localizes":[133],"reactive":[135],"rather":[137],"than":[138],"sampling-induced":[139],"bias":[140],"like":[141],"blood":[142],"introduced":[143],"during":[144],"sampling.":[146],"These":[147],"results":[148],"position":[149],"acquisition-shortcut":[150],"auditing":[151],"via":[152],"provenance-only":[154],"baseline":[155],"necessary":[158],"control":[159],"computational-pathology":[161],"benchmarks,":[162],"show,":[164],"once":[165],"removed,":[169],"weakly":[171],"supervised":[172],"still":[174],"recover":[175],"signal":[177],"conventionally":[180],"regarded":[181],"non-diagnostic.":[183]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-09-04T00:00:00"}