SUMMARY: The examination of high-risk cells and regions in tissue samples from spatially resolved transcriptomics platforms offers meaningful insights into specific disease processes. For existing methods, while cell types or clusters can be identified and associated with disease attributes, individual cells are unable to be associated in the same manner. METHOD: Diagnostic Evidence Gauge of Single-Cells and Spatial Transcriptomics (DEGAS) solves the above problem by employing latent representations of gene expression data and domain adaptation to transfer disease attributes from patients to individual cells from single-cell RNA sequencing datasets. In this research, we present and evaluate DEGAS's versatility in adapting to data arising from various single-cell spatially resolved transcriptomics (scSRT) platforms. DEGAS successfully identified high-risk cells and regions in liver hepatocellular carcinoma and skin cutaneous melanoma, which were validated through known markers. Additionally, DEGAS was applied to our newly generated Type II Diabetes Xenium dataset, revealing high-risk cells within the tissue samples. AVAILABILITY AND IMPLEMENTATION: The DEGAS software can be accessed at https://github.com/tsteelejohnson91/DEGAS. For the updated smoothing functions and associated codes, visit https://github.com/dchatter04/DEGAS-Spatial-Smoothing, which is archived at https://doi.org/10.5281/zenodo.18510221. Sources for the datasets reviewed are detailed in their respective sections. A description of some datasets, along with extra tables and figures, is provided in the Supplementary Materials file. Our newly generated Xenium data for Type II Diabetes can be found at https://doi.org/10.7303/syn68699752.

Recent advances in Spatial Transcriptomics (ST) pair histology images with spatially resolved gene expression profiles, enabling predictions of gene expression across different tissue locations based on image patches. This opens up new possibilities for enhancing whole slide image (WSI) prediction tasks with localized gene expression. However, existing methods fail to fully leverage the interactions between different tissue locations, which are crucial for accurate joint prediction. To address this, we introduce MERGE (Multi-faceted hiErarchical gRaph for Gene Expressions), which combines a multi-faceted hierarchical graph construction strategy with graph neural networks (GNN) to improve gene expression predictions from WSIs. By clustering tissue image patches based on both spatial and morphological features, and incorporating intra- and inter-cluster edges, our approach fosters interactions between distant tissue locations during GNN learning. As an additional contribution, we evaluate different data smoothing techniques that are necessary to mitigate artifacts in ST data, often caused by technical imperfections. We advocate for adopting gene-aware smoothing methods that are more biologically justified. Experimental results on gene expression prediction show that our GNN method outperforms state-of-the-art techniques across multiple metrics.