Practical considerations for pathologists when selecting digital pathology systems: an ESDIP guide

The Journal of Pathology, vol. 270, pp. 328–341

Abstract

The implementation of digital pathology (DP) has been reported across academic, public, and private laboratory settings, providing valuable insights into workflow transformation. However, comparatively little guidance exists on how DP systems should be evaluated prior to acquisition and deployment. Given the substantial financial investment and long-term strategic implications of DP infrastructure, a structured and context-aware evaluation process is essential. In this practical guide, developed by the European Society of Digital and Integrative Pathology (ESDIP) https://www.esdipath.org/, we outline a comprehensive approach for the pre-deployment assessment of DP systems. Drawing on collective experience from multiple institutions and supported by relevant literature, we describe key parameters to consider when evaluating the core components of the DP ecosystem: whole slide scanners, image management systems, workstations, storage infrastructure, and laboratory information systems. We highlight methodological differences between large-scale multisite procurement processes and single-institution implementations, emphasising realistic workload testing, interoperability, and long-term scalability. By integrating technical and clinical perspectives, this guide aims to support pathology departments, IT teams, and institutional decision-makers in selecting DP solutions aligned with their specific institutional needs, infrastructure capabilities, and the future integration of computational pathology. © 2026 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Authors 10

1. Diana Montezuma

   IPO Porto · Centro de Investigação do Instituto Português de Oncologia do Porto Francisco Gentil · IMP Diagnostics (Portugal) · RISE - Health Research Network

   Affiliation as printed

   Cancer Biology and Epigenetics Group, Research Center of IPO Porto (CI‐IPOP), Portuguese Oncology Institute of Porto, Comprehensive Cancer Center Raquel Seruca (Porto.CCC) & CI‐IPOP@RISE (Health Research Network) Porto Portugal

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   Research & Development Unit IMP Diagnostics Porto Portugal

2. Vincenzo L’Imperio

   University of Milano-Bicocca

   Affiliation as printed

   Department of Pathology Fondazione IRCCS San Gerardo dei Tintori Monza Italy

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   School of Medicine and Surgery University of Milano‐Bicocca Milan Italy

3. David Ameisen
   Affiliation as printed

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   ImginIT Paris France

4. Rita Carvalho

   Helios Klinikum Emil von Behring

   Affiliation as printed

   Department of Pathology, Medizinische Versorgungszentren (MVZ) Helios Klinikum Emil von Behring Berlin Germany

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

5. Peter Boor Aachen Institute of Pathology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   Institute of Pathology University Hospital Aachen, RWTH Aachen University Hospital Aachen Germany

6. Sara P. Oliveira

   The Netherlands Cancer Institute

   Affiliation as printed

   Computational Pathology group The Netherlands Cancer Institute Amsterdam The Netherlands

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

7. Nadieh Khalili

   Radboud University Nijmegen · Radboud University Medical Center

   Affiliation as printed

   Computational Pathology Group, Department of Pathology Radboud University Medical Center Nijmegen The Netherlands

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

8. Inti Zlobec

   University of Bern

   Affiliation as printed

   Department of Digital Medicine University of Bern Bern Switzerland

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   Institute of Tissue Medicine and Pathology (ITMP) University of Bern Bern Switzerland

9. Norman Zerbe Aachen Institute of Pathology

   Humboldt-Universität zu Berlin · Universitätsklinikum Aachen · Charité - Universitätsmedizin Berlin · RWTH Aachen University

   Affiliation as printed

   Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Medical Informatics Berlin Germany

   European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

   Institute of Pathology University Hospital Aachen, RWTH Aachen University Hospital Aachen Germany

10. Jordi Temprana‐Salvador

    Vall d'Hebron Hospital Universitari

    Affiliation as printed

    European Society of Digital and Integrative Pathology (ESDIP) Lisbon Portugal

    Pathology Department Vall Hebron University Hospital Barcelona Spain