Whole Slide Imaging (WSI) in Pathology: Current Perspectives and Future Directions

Whole slide imaging (WSI), ever since its first introduction about two decades ago, has been validated for a number of applications in the field of pathology. The recent approval of US FDA to a WSI system for use in primary surgical pathology diagnosis has opened avenues for wider acceptance and application of this technology in routine practice. The ongoing technological advances in digital scanners, image visualization methods, and the integration of artificial intelligence-derived algorithms with these systems provide opportunities of its newer applications. Its benefits are innumerable such as ease of access through internet, avoidance of physical storage space, and no risk of deterioration of staining quality or breakage of slides to name a few. Various barriers such as the high cost, technical glitches, and professional hesitation to adopt a new technology have hindered its use in pathology. This review article summarizes the technical aspects of WSI, its applications in diagnostic pathology, training, and research along with future perspectives. It highlights the benefits, limitations, and challenges delaying the use of this technology in routine practice. The review is targeted at students, residents, and budding pathologists to better acquaint them with the key aspects of state-of-the-art technology and enable them to implement WSI judiciously.