Patterns and challenges of digital pathology implementation in Asia and continental Europe


Background: Digital pathology (DP) offers several potential benefits for clinical practice, including enhanced efficiency, accuracy, collaboration, and education. However, the adoption of DP in clinical settings is hindered by various technical and organizational factors. While reports on DP adoption and use cases are available from North America, less is known about its implementation outside the continent.

Methods: In this cross-sectional survey, we investigated 72 laboratories across 21 countries in Asia and continental Europe that have established DP workflows. The survey collected data on laboratory characteristics, equipment details, storage, integration with laboratory information systems, computer-aided diagnosis, types and purposes of DP use, implementation strategies, and perceived benefits and barriers of DP adoption. The impact of the DP workflow was also evaluated, focusing on turnaround time, specimen traceability, quality control, and overall satisfaction.

Results: Our data showed that, despite varying geographic, historical, social, and other factors, Europe and Asia did not differ significantly in most aspects of digital pathology implementation. Although most institutions started digitization by scanning biopsies for teaching or tumor boards, we observed a growing number of laboratories with a more advanced level of digitization, including full or nearly full caseload scanning and the use of AI algorithms. The study highlighted several factors influencing DP adoption, such as laboratory size and type, resource availability, infrastructure, and regulatory standards. AI algorithms were generally well-received, but their widespread adoption and use remained limited. Respondents indicated that these algorithms could be a major driver for future adoption of digital pathology. The study found that DP adoption had positive impacts on the quality and efficiency of pathology services, as well as on the collaboration and education. However, it also identified challenges and limitations, including the high cost and maintenance of DP systems, interoperability and integration issues with other systems, the need for image and algorithm validation and quality control, and ethical and legal concerns regarding data security and privacy.

Conclusions: Our data provide valuable insights to key stakeholders regarding patterns of DP adoption in clinical settings in Asia and continental Europe. This information can guide decision-making and strategy development to promote the successful implementation of DP, thereby optimizing patient care and advancing the field of pathology.



  1. Understand the key factors influencing the adoption of digital pathology (DP) in clinical settings in Asia and continental Europe: Participants will gain knowledge about the various technical and organizational factors that hinder or facilitate the implementation of DP, including preferred use cases, infrastructure, AI applications, etc.
  2. Assess the impact of DP adoption on pathology services: Participants will gain insights into the positive impacts of DP on pathology services, including improved turnaround time, specimen traceability, quality control, and overall satisfaction.
  3. Ultimately, participants from North America will be able to compare their own experience of DP-AI adoption with that in Asia and continental Europe


Presented by:


Andrey Bychkov, MD, PhD, FRCPath

Director of Digital Pathology

Kameda Medical Center


Andrey Bychkov, MD, PhD, FRCPath is a Director of Digital Pathology at Kameda Medical Center, Kamogawa, Japan and a Visiting Associate Professor at Nagasaki University. Dr. Bychkov graduated with an M.D. from Russia where he also completed residency training and practiced in anatomic pathology. Later, he earned a Ph.D. in molecular medicine in Nagasaki, Japan and supervised research projects at Chulalongkorn University, Thailand. Dr. Bychkov is deeply involved in the development of the Kameda Digital Pathology Network, which is one the few Asian facilities successfully adopted digital pathology and AI for primary diagnosis. Dr. Bychkov has published extensively and has authored more than 100 articles in peer reviewed journals and book chapters. He is an academic editor for several international journals and regularly presents at various conferences and pathology meetings, including top-ranked events, such as USCAP, IAP, IAC, and others.