Stain shifts are prevalent in histopathology images, and typically dealt with by normalization or augmentation. Considering training-time methods are limited in dealing with unseen stains, we propose a test-time stain adaptation method (TT-SaD) with diffusion models that achieves stain adaptation by solving a nonlinear inverse problem during testing. TT-SaD is promising in that it only needs a single domain for training but can adapt well from other domains during testing, preventing models from retraining whenever there are new data available. For tumor classification, stain adaptation by TT-SaD outperforms state-of-the-art diffusion model-based test-time methods. Moreover, TT-SaD beats training-time methods when testing on data that are inaccessible during training. To our knowledge, the study of stain adaptation in diffusion model during testing time is relatively unexplored.
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