Table 2 Model accuracy reported on holdout TCGA data

Hist. Diag.	WHO21 Diag.	Count	UM-MRI	UM-WSI	MoE-MRI	MoE-WSI	MoE-MM
gbm	gbm	78	0.87 ± 0.07	0.87 ± 0.08	0.88 ± 0.07	0.88 ± 0.07	0.94 ± 0.04
astro	astro	21	0.44 ± 0.04	0.75 ± 0.11	0.40 ± 0.06	0.61 ± 0.12	0.73 ± 0.09
oligo	oligo	20	0.46 ± 0.08	0.72 ± 0.06	0.45 ± 0.05	0.69 ± 0.03	0.69 ± 0.05
consistent	consistent	119	0.73 ± 0.07	0.83 ± 0.08	0.72 ± 0.06	0.80 ± 0.07	0.86 ± 0.05
oligo	astro	13	0.71 ± 0.06	0.58 ± 0.20	0.69 ± 0.04	0.61 ± 0.18	0.71 ± 0.07
astro	oligo	9	0.80 ± 0.1	0.86 ± 0.05	0.86 ± 0.11	0.90 ± 0.06	0.97 ± 0.05
oligo	gbm	5	0.84 ± 0.08	0.76 ± 0.21	0.80 ± 0.00	0.86 ± 0.13	0.84 ± 0.16
OA	astro	21	0.53 ± 0.06	0.88 ± 0.08	0.47 ± 0.07	0.85 ± 0.10	0.86 ± 0.06
OA	gbm	3	0.83 ± 0.18	0.43 ± 0.22	0.70 ± 0.11	0.60 ± 0.14	0.50 ± 0.18
OA	oligo	1	1.00 ± 0.00	0.10 ± 0.32	1.00 ± 0.00	0.20 ± 0.42	0.9 ± 0.32
gbm	astro	0	–	–	–	–	–
gbm	oligo	0	–	–	–	–	–
astro	gbm	0	–	–	–	–	–
updated	updated	52	0.68 ± 0.06	0.75 ± 0.11	0.65 ± 0.05	0.77 ± 0.10	0.82 ± 0.07

The cohort was divided into cases where the initial histomorphological diagnosis was consistent with 2021 WHO criteria and those that had their diagnosis updated based on genomic integration. Consistent cases (70%) are those where the initial histological (pathologist visual inspection) diagnosis was correct, while the remaining 30% were initially misclassified by pathologists. gbm glioblastoma, astro astrocytoma, oligo oligodendroglioma, OA oligoastrocytoma. Our multimodal model (MoE-MM) achieves the highest overall accuracy on both consistent and updated cases. The unimodal histology model (UM-WSI) achieves the highest accuracy for histology-genomic-consistent astrocytomas and oligodendrogliomas. Multimodal improvement over unimodal is most pronounced in updated cases. The accuracy of the best model(s) for each row is displayed in bold. Accuracy reported as mean ± std over 10 folds.

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