Application of Foundation Models for Colorectal Cancer Tissue Classification in Mass Spectrometry Imaging

Colorectal cancer (CRC) remains a leading global health challenge, with early and accurate diagnosis crucial for effective treatment. Histopathological evaluation, the current diagnostic gold standard, faces limitations including subjectivity, delayed results, and reliance on well-prepared tissue slides. Mass spectrometry imaging (MSI) offers a complementary approach by providing molecular-level information, but its high dimensionality and the scarcity of labeled data present unique challenges for traditional supervised learning. In this study, we present the first implementation of foundation models for MSI-based cancer classification using desorption electrospray ionization (DESI) data. We evaluate multiple architectures adapted from other domains, including a spectral classification model known as FACT, which leverages audio–language pretraining. Compared to conventional machine learning approaches, these foundation models achieved superior performance, with FACT achieving the highest cross-validated balanced accuracy (93.27%±3.25%) and AUROC (98.4%±0.7%). Ablation studies demonstrate that these models retain strong performance even under reduced data conditions, highlighting their potential for generalizable and scalable MSI-based cancer diagnostics. Future work will explore the integration of spatial and multi-modal data to enhance clinical utility.