Agent-Driven Generative Priors for Pathology Image Synthesis and Segmentation

Deep learning methods for pathology are constrained by the limited availability and high cost of large-scale pixel-level annotations. Synthetic data can alleviate this limitation, but existing pipelines often lack reliable quality control and remain weakly connected to downstream analysis. To address these issues, we propose a three-stage framework that integrates automated data screening, generative representation learning, and efficient adaptation to downstream tasks. First, we develop a pathology agent system to assess image quality and filter samples, resulting in TCGA-200K, a dataset containing 217,030 pathology patches selected from the public TCGA repository. Second, we train a generative model on the screened data. In addition to image synthesis, its backbone learns structural and semantic representations that can be transferred to downstream tasks. Third, we adapt the pretrained generative backbone to semantic segmentation using a lightweight task-specific head. We further introduce PathSeg-380K, a semantic segmentation dataset with expert annotations for approximately 380,000 cells across 12 cell types. Experiments on multiple pathology datasets show that the proposed framework achieves state-of-the-art segmentation performance. Our code is publicly available at https://github.com/script-Yang/Agent-GenPath.