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Universal and Transferable Attacks on Pathology Foundation Models

Published 18 Oct 2025 in cs.CV, cs.LG, and physics.med-ph | (2510.16660v1)

Abstract: We introduce Universal and Transferable Adversarial Perturbations (UTAP) for pathology foundation models that reveal critical vulnerabilities in their capabilities. Optimized using deep learning, UTAP comprises a fixed and weak noise pattern that, when added to a pathology image, systematically disrupts the feature representation capabilities of multiple pathology foundation models. Therefore, UTAP induces performance drops in downstream tasks that utilize foundation models, including misclassification across a wide range of unseen data distributions. In addition to compromising the model performance, we demonstrate two key features of UTAP: (1) universality: its perturbation can be applied across diverse field-of-views independent of the dataset that UTAP was developed on, and (2) transferability: its perturbation can successfully degrade the performance of various external, black-box pathology foundation models - never seen before. These two features indicate that UTAP is not a dedicated attack associated with a specific foundation model or image dataset, but rather constitutes a broad threat to various emerging pathology foundation models and their applications. We systematically evaluated UTAP across various state-of-the-art pathology foundation models on multiple datasets, causing a significant drop in their performance with visually imperceptible modifications to the input images using a fixed noise pattern. The development of these potent attacks establishes a critical, high-standard benchmark for model robustness evaluation, highlighting a need for advancing defense mechanisms and potentially providing the necessary assets for adversarial training to ensure the safe and reliable deployment of AI in pathology.

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