Evidence map›Paper›PMID 40420213›Full record

ArticleGenome medicine2025

Closing the gap in the clinical adoption of computational pathology: a standardized, open-source framework to integrate deep-learning models into the laboratory information system.

Miriam Angeloni, Davide Rizzi, Simon Schoen, Alessandro Caputo, Francesco Merolla, Arndt Hartmann, Fulvia Ferrazzi, Filippo Fraggetta

Abstract read
In one paragraph

Article in Genome medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
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  6. Terminally exhausted CD8Frontiers in immunology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Miriam AngeloniInstitute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Davide RizziTESI Group/GPI, Milan, Italy.
Simon SchoenInstitute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Alessandro CaputoDepartment of Pathology, University Hospital of Salerno, Salerno, Italy.
Francesco MerollaDepartment of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
Arndt HartmannInstitute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Fulvia Ferrazzi *Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. fulvia.ferrazzi@uk-erlangen.de.
Filippo Fraggetta *Unit of Pathology, Gravina Hospital, Via Portosalvo 1, Caltagirone, 95041, Italy. filippofra@hotmail.com.

Funding

Bavarian Funding Programme for the Initiation of International Projects (BayIntAn) BayIntAn_FAU_2024_19Deutsche Forschungsgemeinschaft TRR 305European Union-NextGenerationEU through the Italian Ministry of University and Research under PNRR-M4C2-I1.3 3 Project PE_00000019 "HEAL ITALIA" CUP: B33C22001030006
6 · The paper itself

Abstract

backgroundDigital pathology (DP) has revolutionized cancer diagnostics and enabled the development of deep-learning (DL) models aimed at supporting pathologists in their daily work and improving patient care. However, the clinical adoption of such models remains challenging. Here, we describe a proof-of-concept framework that, leveraging Health Level 7 (HL7) standard and open-source DP resources, allows a seamless integration of both publicly available and custom developed DL models in the clinical workflow.

methodsDevelopment and testing of the framework were carried out in a fully digitized Italian pathology department. A Python-based server-client architecture was implemented to interconnect through HL7 messaging the anatomic pathology laboratory information system (AP-LIS) with an external artificial intelligence-based decision support system (AI-DSS) containing 16 pre-trained DL models. Open-source toolboxes for DL model deployment were used to run DL model inference, and QuPath was used to provide an intuitive visualization of model predictions as colored heatmaps.

resultsA default deployment mode runs continuously in the background as each new slide is digitized, choosing the correct DL model(s) on the basis of the tissue type and staining. In addition, pathologists can initiate the analysis on-demand by selecting a specific DL model from the virtual slide tray. In both cases, the AP-LIS transmits an HL7 message to the AI-DSS, which processes the message, runs DL model inference, and creates the appropriate visualization style for the employed classification model. The AI-DSS transmits model inference results to the AP-LIS, where pathologists can visualize the output in QuPath and/or directly as slide description in the virtual slide tray.

conclusionsTaken together, the developed integration framework through the use of the HL7 standard and freely available DP resources offers a standardized, portable, and open-source solution that lays the groundwork for the future widespread adoption of DL models in pathology diagnostics.

Indexed as

Clinical Laboratory Information SystemsDeep LearningPathology, ClinicalHumansAnatomic pathology laboratory information systemComputational pathologyDeep-learning modelsDigital pathologyHL7Integration

Identifiers

PMID40420213
PMCPMC12107920

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.