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Volume 7,Issue 2

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26 June 2026

VirtualST: Morphology- and Cell-Composition-Conditioned Diffusion for Predicting Spatial Gene Expression from H&E Images

Yuping Liang1 Siwen Xu1*
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1 School of Medical Information and Engineering, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
CBR 2026 , 7(2), 46–51; https://doi.org/10.18063/CBR.v7i2.1919
© 2026 by the Author. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Spatial transcriptomics (ST) measures gene expression while preserving tissue spatial information, but its high cost and limited throughput restrict large-scale application. In contrast, hematoxylin and eosin (H&E)-stained histology images are widely available in routine pathology. We propose VirtualST, a conditional diffusion model for predicting spot-level spatial gene expression from H&E images. The model integrates histological features extracted by a pathology foundation model, local cell-type composition derived from nuclei segmentation, and spatial information from neighboring spots. VirtualST was evaluated on multiple cancer cohorts from HEST-bench and compared with representative histology-to-expression prediction methods. The results showed that VirtualST achieved competitive performance across different cancer types and performed well for representative colorectal cancer marker genes. These findings suggest that VirtualST provides an effective approach for spatial gene-expression prediction from routine histology images.

Keywords
spatial transcriptomics
spatial gene expression prediction
computational pathology
conditional diffusion
cell composition
spatial graph refinement
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