The evolving role of DICOM in digital pathology
This is a summary of the full-text article by Cornish et al., which can be accessed at
https://www.sciencedirect.com/science/article/pii/S2153353926001161
Published in JPI on 30 April 2026
Overview
- Digital Imaging and Communications in Medicine (DICOM) is a global standard that is used for interpreting digital images without the need to use proprietary vendor-specific images
- More than 90% of the medical images in radiology are exchanged using DICOM
- The need for DICOM use in digital pathology has increased due to the requirement for a more streamlined vendor-neutral data exchange
- In 2024, Leica Biosystems, through Aperio GT 450 DX scanner, became the first company to get FDA approval to produce native DICOM images
- A DICOM whole slide image (WSI) is stored as a pyramidical structure
- A WSI is stored in a multilevel, multiresolution form
- Each level’s image resolution is divided into sub-regions or tiles
- Each tile represents an image frame
- Each frame/tile can be retrieved by the user, enabling efficient navigation
Increased Interoperability
To encourage adoption and interoperability, Leica Biosystems has chosen not to enforce restrictions on its patented DICOM compliant imaging module.
Enhanced Collaboration
DICOM implementation allows for greater collaboration among pathologists.
Embeds with Computational Pathology
DICOM facilitates AI annotation and supports digital pathology and computation pathology integration.
Challenges
- A survey study reported only 11% (16/137) users utilizing DICOM, suggesting low adoption of this file format.
- Only a handful of scanners supporting native DICOM output.
Opportunities
- Growing pathologist interest in implementing this new technology for ease of information exchange.
- Uptick in approval of DICOM-compliant digital pathology scanners.
Leica Biosystems is helping shape the official policy for DICOM implementation by being a part of working groups, connectathons, and conferences.
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Concerted effort is needed by the stakeholders for increased awareness of DICOM in digital pathology, which may lead to accurate and quicker case diagnosis turnaround time, thereby improving patient care.
About the presenter
Shubham Dayal is a Senior Medical Writer at Leica Biosystems and has over 10 years of experience in regulatory/preclinical/clinical writing for studies that are at different stages of the product lifecycle. Shubham has a PhD in Cell and Molecular Biology from the University of Toledo and a Master's in Regulatory Affairs from Northeastern University and has co-authored multiple peer-reviewed articles and poster presentations. He is an active member of the Regulatory Affairs Professional Society and American Medical Writers Association and holds certifications related to scientific writing. In his current role, Shubham's goal is to create awareness for our customers in ways that can advance scientific communication and ultimately improve patient outcomes.
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