Digital Pathology: Advantages, Limitations and Emerging Perspectives

Abstract

Digital pathology is on the verge of becoming a mainstream option for routine diagnostics. Faster whole slide image scanning has paved the way for this development, but implementation on a large scale is challenging on technical, logistical, and financial levels. Comparative studies have published reassuring data on safety and feasibility, but implementation experiences highlight the need for training and the knowledge of pitfalls. Up to half of the pathologists are reluctant to sign out reports on only digital slides and are concerned about reporting without the tool that has represented their profession since its beginning. Guidelines by international pathology organizations aim to safeguard histology in the digital realm, from image acquisition over the setup of work-stations to long-term image archiving, but must be considered a starting point only. Cost-efficiency analyses and occupational health issues need to be addressed comprehensively. Image analysis is blended into the traditional work-flow, and the approval of artificial intelligence for routine diagnostics starts to challenge human evaluation as the gold standard. Here we discuss experiences from past digital pathology implementations, future possibilities through the addition of artificial intelligence, technical and occupational health challenges, and possible changes to the pathologist’s profession.

HistoClean: Open-source Software for Histological Image Pre-processing and Augmentation to Improve Development of Robust Convolutional Neural Networks

“…This is particularly true in the field of clinical pathology that traditionally has utilised fewer technological aids in spite of a depleting workforce (36,37). Digital pathology, involves the acquisition and review of ultrahigh-resolution whole slide images using a computer monitor in place of a microscope [40].…”

“…This is particularly true in the field of clinical pathology that traditionally has utilised fewer technological aids in spite of a depleting workforce (36,37). Digital pathology, involves the acquisition and review of ultrahigh-resolution whole slide images using a computer monitor in place of a microscope [40]. Digitisation of histological slides benefits from remote access for diagnostic reporting, providing a quick and easy means of recourse for diagnoses of complex pathology though ease of sharing virtual slides to consultant histopathologists with sub-specialist interest (38,39).…”

The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?

“…Furthermore, artificial reality can certainly be of support by providing tools to navigate around cellular and/or tissue elements. Furthermore, the AI, as discussed for the DR, is breaking into the world of the DP, and also in this case affecting many scholars both in the world of innovative technologies [ 10 ] and bioethics.…”

“…For example, medical records are mostly kept in an unstructured text format. AI is helping to integrate information from these multiple sources [ 5 , 6 , 10 ]. Natural language processing, a branch of AI, is being used, for example, to extract pertinent details from written notes from the entire slide representation.…”

Evaluating the success of the tele-pathology system in governmental hospitals in Kuwait: an explanatory sequential mixed methods design

“…On the other hand, possible drawbacks have been identified for telepathology, which are pertaining to user experience, costs and efficiency gains, and general compatibility within routine work and with other systems, such as the laboratory information system (LIS) [ 6 ]. Therefore, evaluating the telepathology system after implementation to assess the impact on practitioners and practice is considered a crucial step to prove the success, as the greater the benefits of the system, the greater the impact on clinical productivity.…”