In plain words: AI models borrowed from photos and language fail on tissue slides, so this analysis traces the failures to design flaws, not tuning. Squeezing tissue into one vector and training like natural images cannot capture its mix-and-match complexity, so pathology needs models built for biology.
Abstract · Beyond the Failures: Rethinking Foundation Models in Pathology
Despite their successes in vision and language, foundation models have stumbled in pathology, revealing low accuracy, instability, and heavy computational demands. These shortcomings stem not from tuning problems but from deeper conceptual mismatches: dense embeddings cannot represent the combinatorial richness of tissue, and current architectures inherit flaws in self-supervision, patch design, and noise-fragile pretraining. Biological complexity and limited domain innovation further widen the gap. The evidence is clear-pathology requires models explicitly designed for biological images rather than adaptations of large-scale natural-image methods whose assumptions do not hold for tissue.
Hamid R. Tizhoosh
arXiv:2510.23807 · cs.AI, cs.CV · submitted Oct 27, 2025 · updated Apr 20, 2026
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