Digital pathology delivers several advantages that improve human health. The ability to view, share, and interpret images of specimens on screens anywhere in the world enables faster and better diagnoses, improved quality, and greater learning. Broader collaboration through data sharing improves the rate of research and the ability to teach and train new pathologists. Novel artificial intelligence (AI) tools are rapidly enhancing the accuracy and efficiency of these analyses through faster and more precise pattern recognition.

Collaborative technologies to enhance digital pathology 

Powerful collaborations, like the one between Agilent, Hamamatsu, PathAI, Proscia, and Visiopharm revolutionize digital pathology by integrating cutting-edge technologies into a seamless, end-to-end solution. This alliance combines Agilent’s automated pathology staining, Visiopharm’s AI-driven precision software, PathAI’s AI-powered precision pathology solutions, Proscia’s robust digital pathology platform, and Hamamatsu’s advanced whole slide imaging systems.

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Unique AI solutions drive unprecedented accuracy and efficiency in this digital pathology process. Visiopharm’s AI-powered software meticulously analyzes tissue samples, uncovering patterns and anomalies that might elude human detection. Proscia’s platform harnesses AI to manage and interpret vast amounts of pathology data, enabling faster and more precise diagnoses. PathAI’s AI-powered solutions leverage deep computational and medical expertise to optimize tissue sample analysis and support clinical trials and diagnostics. Hamamatsu’s digital pathology solution incorporates AI through its collaboration with Proscia, integrating Hamamatsu’s NanoZoomer whole-slide imaging systems with Proscia’s AI-enabled Concentriq platform, which allows for seamless image and data management. This unified solution leverages AI to enhance the accuracy and efficiency of pathology workflows, ensuring high-quality diagnostic outcomes.

 Lab Manager had the unique opportunity to speak with leaders in this innovative collaboration. Below, Alayn Byrne (AB), product marketing director for Agilent, Scott Blakely (SB), business development manager, whole slide imaging and digital pathology for the Hamamatsu Corporation, Michael Grunkin (MG), chief executive officer for Visiopharm, Eric Walk (EW) chief medical officer at PathAI, and David West (DW) chief executive officer for Proscia, provide more insight into their company’s role and technology in revolutionizing digital pathology workflows.

End to end digital pathology workflows

How are AI and automation improving cancer diagnostics, streamlining workflows, and advancing personalized medicine?

AB: The rise in cancer incidence and the steep increase in testing complexity is putting pathology labs under pressure. Along with a decreasing number of pathologists, many laboratories are experiencing a demand for a change in work routine. AI and digital automation are clear ways to overcome challenges in resources and complexity and pathology is beginning to transform into a digital process.

Digital pathology is advancing personalized medicine from multiple fronts. Digital pathology can aid pharma throughout all stages of drug development. With biomarker identification now a standard to any oncology therapeutic’s development, early phases of development can be accelerated and optimized with AI assisted digital pathology. Digital pathology can assist with identifying optimal clones, relevant indications, determining critical scoring criteria, and cutoff determination.

EW: In the era of precision medicine, the concept of matching patients to therapies based on protein and molecular biomarkers, pathologists are now responsible for answering the question: “Are there specific drugs that will be effective for this patient?” In addressing this question, pathologists must select and interpret biomarker and companion diagnostic tests. Digital and computational pathology promises to help pathologists improve both the reproducibility and accuracy of diagnostic interpretations and quantitative biomarker assessments as part of the precision medicine model. 

AI also has the power to drive significant operational improvements in pathology labs and support pathologists with complex quantitative tasks. Specifically, AI algorithms like ArtifactDetect and TumorDetect from PathAI, which are natively embedded within the AISight platform, help reduce inefficiencies in a digital pathology workflow. These algorithms can also be leveraged to output a case complexity score, enabling the auto-assignment of cases to an organization's pathologists in a more equitable manner based on AI-identified case complexity vs. simply number of cases read by each pathologist.

Whole slide imaging

What are some revolutionary developments in imaging for digital pathology?

SB: Virtual staining, whole tissue imaging, and AI implementation in digital pathology workflows. Hamamatsu produces best-in-class products to generate digital slides to enable the interoperability of digital pathology.

Workflow improvements to digital pathology

What have been key improvements in workflow that are driving better quantitative digital pathology?

MG: We’ve contributed three key improvements to the workflow to enable precision pathology at scale to drive better outcomes in the era of targeted therapies:

1. Zero-click automation for slide and stain quality control, which are seamlessly integrated prior to image quantification.
2. Advanced quantification capabilities for robust identification, classification, and measurement of microstructural content to support robust diagnostic decisions.
3. Interoperable plug-in architecture, which are agnostic to scanners, PACS, and staining platforms to meet pathologists at any stage of their digital transformation.

AI-powered digital pathology software

How are labs able to implement AI tools into digital pathology?

EW: The AISight image management system is a cloud-based, AI-native digital pathology solution that empowers laboratories to harness and implement computational pathology to improve workflows and generate value for histotechnicians, lab managers, and pathologists. Serving as a central hub for case and image management, AISight integrates seamlessly with major laboratory information systems and supports various scanners. Its user-friendly, cloud-based architecture enables rapid activation and scalability without requiring additional infrastructure investments. Designed in partnership with pathologists, AISight offers built-in image analysis and collaboration tools, providing an intuitive user experience. The platform also features an open AI environment, incorporating AI algorithms from PathAI and third-party partners to support multiple histopathology applications.

Manage and interpret vast amounts of data

What is Proscia’s role in this collaboration?

DW: Concentriq, our enterprise pathology platform, powers the world’s pathology from discovery to diagnosis—it’s where data lives, workflows happen, and AI applications are built and run.

How are AI and improved software overcoming the challenges in digital pathology workflows and improving patient care?

DW: Let’s consider improved software to be a platform that offers a robust feature set and is interoperable, AI-enabled, and pathologist-centric. Such a platform enables laboratories to first adopt digital pathology at scale, to fully realize its benefits, such as quality and efficiency gains that help patients receive better diagnoses faster. It also serves as the foundation for deploying a wide variety of AI applications into routine workflows. 

AI both augments the benefits of digital pathology and introduces new sources of value. It can tap into the billions of pixels contained in each whole slide image to provide an even better picture of disease, and help the pathologist arrive at a more accurate diagnosis. Among its other advantages, it can automate many routine tasks, such as quality control, to increase efficiency. More recently, we’re increasingly seeing the introduction of image-based companion diagnostics that can help match patients with targeted therapies by quantifying biomarkers, for example. 

Industry collaboration on digital pathology

How is industry collaboration driving the future of digital pathology?

SB: End-to-end solutions using world class hardware and software to both identify and address the challenges of full interoperability. At Hamamatsu, we prioritize market-based R&D, which enables us to design scanners that best support our up- and downstream partners to enable a top-tier digital pathology experience for our customers. 

MG: The adoption of standards like DICOM and open systems architecture is transforming integration and interoperability between best-of-breed solutions across the diagnostic value chain. Visiopharm actively contributes to ensuring these standards translate into real-world impact. We collaborate with leading PACS/IMS and scanner providers to deliver optimal interoperability between products.

EW: Industry collaboration will continue to be critical in the establishment of a robust digital and AI pathology ecosystem that covers all use cases and needs across the field of anatomic pathology.  Our partnership with Agilent has been critical to ensuring that pathology labs across the globe are able to gain access to PathAI’s cutting edge technology. PathAI has also recently established partnerships with several third-party AI application developers. Through these collaborations, PathAI will provide algorithms from these developers directly within its AISight IMS, reinforcing its commitment to offering the most versatile, reliable, and interoperable IMS on the market.

DW: Interoperability is what typically gets the most attention, as it should. Adopting digital pathology at scale to fully realize its benefits requires implementing a wide range of hardware, software, and AI solutions. It’s critical that these systems integrate, which is why we’ve designed our Concentriq platform to be open from day one. 

Agilent is pushing this one step further with its end-to-end solution. It has bundled together a set of best-in-class solutions with proven interoperability to streamline the decision-making process for laboratories and help them rapidly get up and running to achieve their goals.

What’s also important, but tends to receive less attention, is the work partners are doing in areas like innovation and policy. For example, the DICOM Working Group 26 is playing a key role in driving forward the imaging standard, with representation from many industry vendors. Industry players were also involved with CMS in the introduction of the digital pathology CPT codes and are working on securing reimbursement. Vendors’ input in these situations is incredibly helpful, as they offer a unique perspective on what’s feasible from a technology perspective and a broad view of what will be most meaningful in practice from their customer bases.

Advancing precision medicine with digital pathology

The innovative solutions driven by this end-to-end collaboration support the advancement of precision medicine by offering a unique, scalable, and open approach to digital pathology. By integrating these advanced AI capabilities, the complete digital pathology solution enhances diagnostic accuracy and efficiency, streamlines workflows, minimizes human error, significantly improving cancer diagnostics and patient care, and propels the advancement of personalized medicine. 

Agilent will present two compelling sessions that showcase cutting-edge advancements in digital pathology, powered by artificial intelligence and seamless collaboration among industry leaders on February 5, 2025. Register now to watch live or on demand: https://www.labmanager.com/ai-enhanced-digital-pathology-diagnostics-series-precision-in-focus-33369