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Life sciences · Preprint
arXiv · October 26, 2026
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Spatial transcriptomics provides spatially resolved molecular profiling, but its cost, limited throughput and experimental complexity hinder routine large-scale use. Predicting spatial gene expression from hematoxylin-and-eosin-stained histology images offers a scalable alternative, yet remains challenging because histology provides only an indirect morphological view of molecular activity. Existing methods typically decode expression from visual features in a single stage, even when enhanced with spatial aggregation, retrieval or multi-resolution fusion. This formulation is restrictive because spot-level expression reflects not only local morphology but also cellular identity, neighborhood composition and tissue-level organization. We propose BCARP, a Biology-guided Context-Aware Residual Propagation framework for histology-guided spatial transcriptomics prediction. Instead of directly predicting gene expression from histology embeddings, BCARP treats them as morphology visual priors and progressively refines spot representations in a transcriptomics-oriented latent space. Each refinement step integrates nuclei-guided local cellular context with prototype-guided global context propagation, enabling information exchange across both neighboring and spatially distant spots. A pattern-scale decoder further separates spatial expression into pattern prediction from raw expression with scale calibration. Evaluated on three ST datasets and ten HEST-1k cohorts, BCARP achieves the highest mean correlation-based performance against other baselines. Numerical results support biology-guided local-global residual propagation as an effective alternative to visual decoding for histology-to-transcriptomics prediction.