DP4ALL: A Resource-Efficient Platform for Whole Slide Imaging in Low Resource Settings

Pathology services are essential to providing high quality cancer care. However, critical barriers to providing timely, accurate, and reliable cancer diagnoses in low and middle income countries (LMICs) include having an insufficient number of pathologists are primarily concentrated at only a few major referral hospitals, and having limited access subspeciality training opportunities. Digital pathology overcomes these barriers by disseminating access to pathology services to regional levels of care and enabling access to pathology experts across the globe through telepathology. Whole slide imaging (WSI) is especially critical for telepathology because it allows for dynamic analysis of histologic slides at multiple magnifications and best simulates how pathologists review glass slides on microscopes. The creation of digital pathology archives can also facilitate quality assurance programs and multi-disciplinary tumor board discussions, enhance research capacity and provide valuable, well-annotated material for educational programs. Digital pathology also opens the opportunity for multi-modal biobanks that will build key infrastructure for clinical trials as well as artificial-intelligence-assisted workflows that help address knowledge gaps and even conserve resources by stratifying patients who would most benefit from predictive marker testing and treatment. However, setting up slide digitization infrastructure is costly, requiring the need for expensive scanners, reliable high speed internet, and extensive local digital storage capacity. To overcome these barriers, we have developed a free robust end-to-end pipeline called Digital Pathology for All (DP4ALL) that creates digitized slides from standard smartphone videos which can then be viewed and shared using a cloud-based viewer. DP4ALL solution requries no specialized hardware and slide videos can be captured using standard smartphone cameras with a simple, inexpensive adapter.

Learning Objectives:

1. Introduce how one can turn a microscope into a scanner using standard smartphone camera
2. Showcase an intuitive/free simple-to-use interface that converts microscope slide videos into digitized whole-slide images
3. Demonstrate robust DP4ALL performance across smartphones, microscopes, resolutions (10X and 20X), and different stain types