Training-Time Domain Transfer for Generator-Free Diagnostics on Novel Modalities in Computational Pathology

Julia A. Mielcarz, Andrea Camilloni, Nita Mulliqi, Jessica A. Frank, Anders Blilie +3

Novel imaging modalities promise improved diagnostics, but AI development is constrained by scarce training data. Inference-time domain transfer can address this by mapping novel modalities to established ones, enabling reuse of existing diagnostic models. However, this introduces hallucination risks, computational overhead, and regulatory complexity. Inspired by sim-to-real transfer, we propose training-time domain transfer, generating synthetic target-domain training data from archived routine samples to enable direct diagnosis on real inputs without inference-time generation. Using unstained prostate histopathology as a proof-of-concept, we compare this approach with inference-time virtual staining and conventional H&E-based cancer detection. Training-time transfer achieved higher concordance with the conventional benchmark than virtual staining for both raw (Cohen's $κ$=0.59 vs. 0.37; Gwet's AC1=0.73 vs. 0.29) and deparaffinized tissue ($κ$=0.66 vs. 0.61; AC1=0.73 vs. 0.64), supporting its potential for emerging diagnostic modalities.