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PathNavigate: A Training-Free Pathology Agent with Surprise-Guided Scan and Shared Slide Memory for Whole-Slide Image VQA

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Whole-slide image visual question answering (WSI-VQA) frames pathology as an extreme-context search problem: to answer a free-form clinical query, a system must first navigate a gigapixel slide under a strict inspection budget to locate sparse, high-resolution evidence. Existing approaches largely fall into two paradigms: i) supervised pathology multimodal large language models (MLLMs) and agents can absorb localization and reasoning into learned modules, but they often couple navigation to task-specific supervision and retraining, limiting their practicality; ii) training-free pathology agents avoid this cost by keeping core models frozen, but often follow a question-first design, constructing the initial candidate set mainly from query-conditioned relevance. This can miss decisive morphology that is not named in the question, and force heavier inference-time scaffolding. To address this challenge, we introduce PathNavigate, a training-free pathology agent built around a scan-search-readout routine. Before question matching, PathNavigate scans the current slide at low magnification with a shared online memory module over frozen pathology features, producing a slide-specific surprise field that marks an abnormal-region pool. It then applies question-conditioned PLIP relevance only within this pool to select high-magnification search targets. Finally, it extracts local high-magnification evidence and answers with a frozen perceptor-adjudicator stack, using the same online memory as slide-level context. Experiments on WSI-VQA and SlideBench-BCNB show that the proposed scan-search-readout design improves answer accuracy and yields more interpretable evidence-selection trajectories with higher efficiency.The code is available online.

Chunze Yang, Qidong Liu, Wenjie Zhao, Yue Tang, Jiusong Ge, Di Zhang, Jiashuai Liu, Lei Wu, Junbo Lu, Ni Zhang, Xian Wu, Zeyu Gao, Chen Li• 2026

Related benchmarks

TaskDatasetResultRank
Multiple-choice Question AnsweringPathMMU (val)
Overall Accuracy53.6
29
Slide-level Pathology DiagnosisSlideBench BCNB
Overall Accuracy59.42
14
Visual Question AnsweringSlideBench BCNB
Overall Accuracy59.42
14
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