Recommendations for pathologic practice using digital pathology: consensus report of the Korean Society of Pathologists

Abstract

Digital pathology (DP) using whole slide imaging (WSI) is becoming a fundamental issue in pathology with recent advances and the rapid development of associated technologies. However, the available evidence on its diagnostic uses and practical advice for pathologists on implementing DP remains insufficient, particularly in light of the exponential growth of this industry. To inform DP implementation in Korea, we developed relevant and timely recommendations. We first performed a literature review of DP guidelines, recommendations, and position papers from major countries, as well as a review of relevant studies validating WSI. Based on that information, we prepared a draft. After several revisions, we released this draft to the public and the members of the Korean Society of Pathologists through our homepage and held an open forum for interested parties. Through that process, this final manuscript has been prepared. This recommendation contains an overview describing the background, objectives, scope of application, and basic terminology; guidelines and considerations for the hardware and software used in DP systems and the validation required for DP implementation; conclusions; and references and appendices, including literature on DP from major countries and WSI validation studies.

What is Essential is (No More) Invisible to the Eyes: The Introduction of BlocDoc in the Digital Pathology Workflow

“…The digital pathology revolution is progressively being adopted by different pathology centers, although relatively few laboratories are already fully converted for the primary diagnosis worldwide. [ 1 5 6 ] Different guidelines have been produced to manage this transition in a step-by-step fashion,[ 7 8 ] mainly focused on the validation of WSI. The different recommendations underlined the importance of assuring that all the materials present in the glass slide are also present in the WSI.…”

Understanding the ethical and legal considerations of Digital Pathology

“…The guidelines include 'strict technical measures must be in place to ensure information security and protect personal information regardless of the type of terminal being used. Therefore, measures are needed to ensure that transmitted data are not easily released outside the network and that transmitted metadata do not contain personal information to minimise the risk to personal data even if a data leak was to occur' [21] Co-operative (NPIC), and to membership of The Pathological Society of Great Britain and Northern Ireland and the British Division of the International Academy of Pathology (BDIAP). The survey was voluntary with no incentives offered.…”

“…DPrelevant guidelines, position papers, regulations, and legislation relating to the management/use of data generated through WSI (amended from García-Rojo[20] and Chong et al[21], non-exhaustive list).…”

Recent Applications of Artificial Intelligence from Histopathologic Image-Based Prediction of Microsatellite Instability in Solid Cancers: A Systematic Review

“…AI-based models are emerging in many medical fields, including radiology, dermatology, ophthalmology, and pathology, with promising results [ 36 , 37 , 38 , 39 , 40 ]. In pathology, deep learning- (DL) based models have also shown surprising results in cancer detection, classification, and grading [ 29 , 41 , 42 , 43 , 44 ]. More recently, AI models are now being applied, even to molecular subtyping and treatment response prediction that surpasses human ability and can change the whole pathology practice in the future [ 44 , 45 ].…”

“…In pathology, deep learning- (DL) based models have also shown surprising results in cancer detection, classification, and grading [ 29 , 41 , 42 , 43 , 44 ]. More recently, AI models are now being applied, even to molecular subtyping and treatment response prediction that surpasses human ability and can change the whole pathology practice in the future [ 44 , 45 ]. Pathologists have tried to find out the characteristic morphological features of MSI-H cancers such as tumor-infiltrating lymphocytes and mucinous morphology on H&E stained slides.…”