Digital pathology is not just evolving; it is undergoing a technological revolution. As caseloads surge, pathologist shortages loom, and the demand for rapid, accurate diagnoses intensifies, laboratories are turning to innovation to meet these challenges head-on. From enabling seamless remote collaboration to dramatically accelerating turnaround times, digital pathology solutions are transforming the field, offering the potential to alleviate these problems and enhance patient care.

This article examines the 10 most sought-after features in digital pathology, identified through extensive installations, commissioning, and demonstrations of digital pathology systems and components. These features are transforming whole slide imaging scanners in 2024, significantly enhancing workflow efficiency, diagnostic accuracy, and the overall practice of pathology.

1. High-Resolution Macro Camera: While high-resolution macro imaging is not a new concept, its importance in digital pathology has grown significantly in recent years. A high-resolution macro camera acts as the pathologist’s first lens, capturing detailed macroscopic images of slides that are essential for case identification, quality control, and a swift visual overview of the specimen before navigating the whole slide image (WSI). This not only streamlines the diagnostic workflow but also allows pathologists to quickly assess the case, focusing their expertise where it matters most. Furthermore, a quality macro image aids in identifying subtle details, bolstering diagnostic confidence, and enhancing the overall quality of the digital slide. While a 5MP resolution is generally sufficient for most applications, the latest scanners offer resolutions up to 20MP or higher, delivering unparalleled detail and clarity for a truly comprehensive specimen overview
2. Barcode and Label Recognition: Advanced barcode and label recognition technology seamlessly identifies and track slides during scanning. This automation eliminates manual data entry errors, ensuring accurate association of slides with patient and case information. The result is improved traceability, optimized workflow efficiency, and reduced risk of misidentification or misplacement, enhancing the overall quality and reliability of digital pathology processes.
3. Speed: In the fast-paced world of medicine, turnaround time is critical, and digital pathology is no exception. Despite the promise of efficiency, many labs struggle to meet the demands for rapid results. Newer generation high-speed scanners have significantly increased efficiency, reducing scanning time from 75 seconds for a 15mm-by-15mm area to around 25 seconds per area. This increased speed, combined with the use of interoperable slide baskets (such as Sakura baskets) that seamlessly transition between instruments throughout the histology workflow (including coverslipping, processing, staining, and scanning), optimizes workflow, minimizes delays, and ensures timely diagnoses, particularly in high throughput and automated environments.
4. Continuous Loading: In busy digital pathology labs, continuous loading is an essential feature. This capability allows for uninterrupted scanning by enabling the loading and unloading of slides without pausing the scanner. This minimizes downtime, maximizes efficiency, and ensures a smooth workflow.
5. Intelligent Scanning/Multi-Selection with Advanced Tissue Detection: This feature utilizes pattern recognition and edge-detection algorithms, to analyze high-resolution macro images of slides. By accurately identifying and isolating relevant tissue sections, it eliminates the need for manual intervention, significantly reducing scanning time and increasing throughput. This capability is particularly valuable for challenging specimens with low cellularity or uneven tissue distribution, where precise tissue detection is crucial for accurate diagnosis.
6. Image Optimization: As the adage goes, “garbage in, garbage out.” To ensure pathologists receive the highest quality digital images for accurate diagnosis and research, the scanner’s integrated algorithms continuously monitor and optimize image quality during scanning. This includes real-time adjustments to focus, lighting, and exposure, as well as detection and correction of artifacts (dust, debris, staining inconsistencies).
7. Serial Scanning: In high volume anatomic pathology labs, maximizing efficiency is paramount. Serial scanning, the ability to scan multiple slides concurrently, is a great new feature for achieving this goal. By significantly increasing throughput and reducing processing time, it ensures that pathologists receive scanned images promptly, enabling improved case turnaround time
8. Fluorescent Whole Slide Imaging: This emerging technology holds immense potential for cancer research and diagnostics. By leveraging fluorescent dyes to label specific biomarkers, it allows for the visualization and quantification of structures and cellular details not visible with standard brightfield scanning. In the context of renal oncology, fluorescent WSI are particularly promising, as it enables researchers and, increasingly, pathologists to identify and quantify biomarkers associated with specific tumor types across the whole slide specimen. While not yet fully integrated into routine diagnostics, advancements in this technology are rapidly bringing us closer to a future where whole slide fluorescent imaging plays a pivotal role in accurate diagnosis, subtyping of tumors, prognosis determination, and personalized treatment strategies.
9. Integrated Onboard PC: In information-critical environments like pathology laboratories, the security and reliability of integrated onboard PCs, often running on the Linux operating system, make them a superior choice. Linux, known for its robust stability and open-source nature, is less susceptible to malware and viruses compared to other operating systems. By eliminating the need for a separate computer, these all-in-one solutions not only free up valuable bench space but also mitigate the risk of unauthorized access and malware infections. Furthermore, the tightly integrated hardware and software components, optimized for Linux, contribute to enhanced performance and reliability, ensuring a streamlined and secure digital pathology workflow
10. Augmented Reality (AR) Integration: AR at the scanner level represents a promising advancement in digital pathology, offering the potential to optimize workflow efficiency and diagnostic precision. A key benefit of AR scanners is the ability to incorporate measurement and metadata placement directly into the digital record during scanning. This automated data collection eliminates the need for manual annotation, saving valuable time and mitigating potential errors while offering pathologists immediate information about the slide. This feature contributes to a more comprehensive and efficient workflow, ultimately enhancing accuracy and informed clinical decision-making.

The features discussed in this article represent a significant step forward in diagnostic service, promising to streamline workflows, elevate accuracy, and ultimately revolutionize the practice of pathology. As artificial intelligence, augmented reality, and other innovative technologies continue to advance, we can anticipate even greater advancements in automation, accuracy, and efficiency.

These advancements hold immense potential, extending far beyond the conventional slide-scanning paradigm. Imagine a future where advanced scanners not only seamlessly integrate with cloud-based platforms for global collaboration but also possess the capability to autonomously classify tissue types and tumor grades, bypassing the need for preliminary IMS or LIS involvement. Envision a robotic scanner traversing the laboratory, intelligently identifying, and scanning slides in real time at their precise locations, optimizing workflow efficiency and resource allocation.

Delving further into this transformative landscape, we may envision a future where scanners possess the capability to perform virtual staining, eliminating the need for traditional chemical reagents and further accelerating turnaround times. Building upon this, a single, integrated platform could revolutionize the field by analyzing specimens for spatial comprehension, conducting microbiome testing, performing 3D grossing scans, and executing virtual sectioning and staining – all in a streamlined, automated process.

Ultimately, this integrated platform could be incorporated into a robotic assistant, serving as a laboratory or surgical aide, providing real-time pathology and spatial data during procedures, thereby enhancing surgical precision, and informing critical decision-making in the operating room. This fusion of technologies including AI, robotics, and advanced imaging modalities promise to reshape the future of pathology, driving a new era of diagnostic accuracy, personalized medicine, and enhanced patient care.

By staying informed, embracing innovation, and actively participating in the ongoing conversation, we can collectively shape the future of digital pathology and unlock its full potential to improve patient care and revolutionize the field of diagnostic medicine.

To learn more about how digital pathology can transform your practice, we invite you to contact DigitCells for a free digital maturity assessment. Our team of experts can help you assess your current capabilities, identify areas for improvement, and develop a customized roadmap for success.

Author

Scott Kilcoyne
DigitCells Cofounder & COO