ABSTRACT Automated histopathological subtyping of lung cancer using stained whole‐slide images (WSIs) remains a pivotal yet formidable challenge, owing to pronounced tumor heterogeneity, intricate cellular morphology, and severe class imbalance within available datasets. Deep learning architectures vary in their capacity to capture diverse pathomic features, and the diagnostic efficacy of such models is heavily influenced by the quality of the tissue patches extracted from WSIs. To address these limitations, we present a novel ensemble deep learning framework enhanced by a fuzzy‐weighted patch quality assessment, which improves the selection and contribution of informative regions within WSIs. High‐quality patches are identified using a fuzzy scoring method and processed through multiple pretrained CNN and transformer models to capture diverse feature representations. These features are integrated via latent embeddings, with fuzzy scores incorporated both as auxiliary inputs and as weights in the training loss function to emphasize clinically relevant tissue regions. Our approach achieved a 1.5% and 1.4% performance gain over current state‐of‐the‐art methods, achieving 96.1% and 93.0% on the BMIRDS‐LUAD and WSSS4LUAD datasets, respectively, demonstrating improved robustness in subtype classification and potential for integration into computational pathology workflows. By weighting patches according to histologic representativeness, the method aligns with pathologist workflow and is suitable for integration into in silico decision support for patient stratification.
Hosseini et al. (Sun,) studied this question.