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Review
. 2023 Jun;115(3):127-136.
doi: 10.32074/1591-951X-868.

The slow-paced digital evolution of pathology: lights and shadows from a multifaceted board

Alessandro Caputo  1   2 , Vincenzo L'Imperio  3 , Francesco Merolla  4 , Ilaria Girolami  5 , Eleonora Leoni  6 , Vincenzo Della Mea  7 , Fabio Pagni  3 , Filippo Fraggetta  2
Affiliations
Review

The slow-paced digital evolution of pathology: lights and shadows from a multifaceted board

Alessandro Caputo et al. Pathologica. 2023 Jun.

Abstract

Objective: The digital revolution in pathology represents an invaluable resource fto optimise costs, reduce the risk of error and improve patient care, even though it is still adopted in a minority of laboratories. Barriers include concerns about initial costs, lack of confidence in using whole slide images for primary diagnosis, and lack of guidance on transition. To address these challenges and develop a programme to facilitate the introduction of digital pathology (DP) in Italian pathology departments, a panel discussion was set up to identify the key points to be considered.

Methods: On 21 July 2022, an initial conference call was held on Zoom to identify the main issues to be discussed during the face-to-face meeting. The final summit was divided into four different sessions: (I) the definition of DP, (II) practical applications of DP, (III) the use of AI in DP, (IV) DP and education.

Results: Essential requirements for the implementation of DP are a fully tracked and automated workflow, selection of the appropriate scanner based on the specific needs of each department, and a strong commitment combined with coordinated teamwork (pathologists, technicians, biologists, IT service and industries). This could reduce human error, leading to the application of AI tools for diagnosis, prognosis and prediction. Open challenges are the lack of specific regulations for virtual slide storage and the optimal storage solution for large volumes of slides.

Conclusion: Teamwork is key to DP transition, including close collaboration with industry. This will ease the transition and help bridge the gap that currently exists between many labs and full digitisation. The ultimate goal is to improve patient care.

Keywords: artificial intelligence; computational pathology; digital pathology; education.

PubMed Disclaimer

Conflict of interest statement

The authors received fees by Roche for participation.

Fraggetta F. is one of the inventors of “Sample imaging and imagery archiving for imagery comparison Merlo PT et al. US patent 16/688/613 2020.”

All authors declare that they have no other competing interests in connection with this article.

Figures

Figure 1.
Figure 1.
The participants to the preliminary web call held in Zoom. Left to right, top to bottom: Fabio Pagni, Filippo Fraggetta, Eleonora Leoni, Alessandro Caputo, Vincenzo della Mea, Vincenzo L’Imperio, Francesco Merolla, Anna Maria Pisano (from the provider Global Studio) and Ilaria Girolami.
Figure 2.
Figure 2.
Images generated through online-available algorithms for text-to-image generation, such as DALL-E (https://labs.openai.com/) on the left and stable diffusion (https://lexica.art/) on the right, with the prompt “The lab of the future: what to expect from AI”.
Figure 3.
Figure 3.
The image summarises the different sides and possible implications of the adoption of digital pathology.
See this image and copyright information in PMC

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