Subject to change.
Subject to change.
Matthew Cecchini is an Associate Professor and Digital Pathology Lead at London Health Sciences Centre and Western University. A pulmonary pathologist trained at Mayo Clinic, he integrates AI-driven workflows and computational biomarkers into clinical practice. Recipient of the 2025 Dean’s Award of Excellence for Research and Innovation, he works to augment the human brilliance of pathologists with advanced machine intelligence.
As digital pathology matures beyond image capture toward workflow optimization, pathologists have a timely opportunity to shape how AI is integrated into routine practice. A novel opportunity is now emerging: modern whole-slide scanners ship with meaningful on-device compute, making it possible to run AI inline during acquisition rather than after the fact in the cloud or on a separate server. We describe an edge-AI architecture built on Virchow foundation-model embeddings deployed on scanners with this local compute. Lightweight, task-specific attention heads are trained and validated entirely on-scanner; no patient data leaves the institution at any point. Because the foundation model carries most of the representational burden, each new use case can be supported with a small, locally curated slide set and a modest training run. Unsupervised clustering over the embedding space helps surface morphologic patterns and guide hard-negative selection. This architecture underpins FROST, our frozen-section triage pipeline. Basal cell carcinoma detection on frozen sections has been validated inline on the scanner, showing that a locally trained pipeline can deliver triage signals in real time without disrupting throughput or moving data off-site. Building on that foundation, we are now working to validate and deploy dysplasia detection on head-and-neck frozen sections for intraoperative triage, and are testing the same approach for colon and breast cancer triage on routine biopsies. Outputs drive prioritization and ancillary-study pre-ordering rather than autonomous diagnostic calls, keeping pathologists in control of interpretation. A guiding principle is to focus edge AI on high-value, low-risk applications: tasks where AI augments rather than replaces judgment, and where even gains in turnaround translate directly into patient benefit. Triage and prioritization sit squarely in that space, offering a practical, locally governed path to AI-augmented pathology.
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