Journal of Pathology Informatics Journal of Pathology Informatics
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J Pathol Inform 2017,  8:37

Review of “Digital Pathology” by Liron Pantanowitz and Anil V Parwani

Department of Pathology, University of Illinois at Chicago, Chicago, USA

Date of Submission17-Apr-2017
Date of Acceptance21-Jun-2017
Date of Web Publication07-Sep-2017

Correspondence Address:
Tushar Patel
Department of Pathology, University of Illinois at Chicago, Chicago, IL 60612
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpi.jpi_33_17

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How to cite this article:
Patel T. Review of “Digital Pathology” by Liron Pantanowitz and Anil V Parwani. J Pathol Inform 2017;8:37

How to cite this URL:
Patel T. Review of “Digital Pathology” by Liron Pantanowitz and Anil V Parwani. J Pathol Inform [serial online] 2017 [cited 2022 Jun 26];8:37. Available from:

Pantanowitz L and Parwani AV
Digital Pathology
ASCP Press 2017
Pages: 304 pages
ISBN In: 978-08189-6104

A number of books, chapters, or articles on the continued digital transformation of pathology have been written. It is an encouraging trend that reflects the accelerating interest and technical advancements of hardware and software technology in our field. The latest entry in this category is Digital Pathology, edited by Drs. Pantanowitz and Parwani. This book is a comprehensive catalog of digital pathology across the wide spectrum of applications; each chapter authored by respective experts in the field. The goal of the book was to “provide readers with a comprehensive and contemporary reference that was easy to read and practical.”

There may be some disagreement regarding what constitutes “digital pathology.” If the term is taken broadly, there is no question pathologists have been practicing digital pathology for decades. With a narrower perspective, the term is sometimes used to simply refer to telepathology. Regardless of interpretation, there is growing consensus that “today's pathologist must understand various imaging technologies and how best to utilize these tools, appreciate their potential pitfalls and limitations, and be familiar with the rules and regulations when applying them in clinical practice.” In this context, a book that aims to comprehensively inform the reader on the latest advances in the field is timely. This book serves to highlight the work of these leaders, on which readers and future leaders may build on.

The book is organized into seventeen chapters. Many of the chapters, and in particular, the first couple, appeal to the relatively uninitiated. They introduce foundational topics in language that is approachable and allows the reader to more fully understand the more complex chapters further along. Chapter 2 introduces the basics of digital imaging – a must read for anyone wondering what a pixel represents, the difference between DPI and PPI or between TIFF and JPEG. Chapter 3 continues the discussion and introduces image acquisition and processing. The chapter includes the coverage of cutting-edge/experimental technologies such as virtual reality headsets. Chapters 4 through 8 discuss telepathology, including whole-slide imaging, and the wide array of currently suitable applications (continued in chapters 12 and 13). Included are helpful, evidence-based case illustrations of institutions that have successfully incorporated digital pathology into the workflow. For example, some readers may be surprised to learn that the overall costs of fully integrated whole-slide imaging (WSI) workflow in a large academic hospital can reach up to $2M. As the regulatory hurdles become overcome, readers will be anxious to learn about applications in primary diagnosis. Chapters 9–10 dive into image analysis and applications. These topics may be seen as inherently difficult due to mathematical underpinnings, but the authors do an excellent job of easing the reader into the complicated topics. The chapter on the implementation of WSI in surgical pathology (chapter 11) is particularly well-written, comprehensive, and practical to those considering such an endeavor. Chapters 14–16 touch on some of the less well-known, but very exciting applications of digital pathology. These include rapidly emerging and evolving technologies such as optical coherence tomography and spectral imaging. Along with these hardware advancements, the authors include discussions on the algorithmic processing required for these images. Finally, acknowledging that digital pathology does not exist in a vacuum, chapter 17 discusses imaging standards allowing for interoperability. This also is an exciting and increasingly important aspect of pathology, especially in the era of integrated workflows, information exchanges, and patient portals.

It is important to note that the knowledge aggregated by this book is relevant to all members of the multidisciplinary team within which we work, not just informaticists. The introductory chapters would be required reading for pathology residents and fellows, as well as those simply not understanding the vocabulary and language of digital imaging. Educators would find the introductory chapters on WSI (chapters 5, 6) and its applications in teaching (chapter 7) helpful. For administrators and managers, unaware of medicolegal implications, there is a discussion in chapter 7. Although surgical pathology often dominates the discussions on digital imaging, the book includes topics relevant to forensic and clinical pathologists (chapter 8 and 13, respectively).

Each chapter is authored by experts in the respective subject. In a way, this is akin to creating a “best-of-breed” book, in which each section serves its purpose exquisitely well. A minor downside to this approach (as it is in systems design) is that there is potential for overlap. For example, image compression is covered in several chapters (2.1.6, 8.3.1, 9.5.3, and 17.3.1). This occurs infrequently, and when present, does offer multiple perspectives on otherwise difficult to understand topics.

On a more practical level, the book is deceptively lightweight and compact. The old adage of not judging a book by its cover certainly applies here. There is a wealth of knowledge contained within the hard cover. To clarify items that may have been difficult to understand, there are high-quality images, well-organized tables, and colorful diagrams illustrating each author's message.

The technology that we use, just like the laboratory tests that we perform, have certain capabilities and limitations. This book brings up-to-date awareness of these realities to a broad and diverse audience. Whether you are trying to understand why your macroscopic photograph is blurry or implementing whole-slide imaging into the surgical pathology workflow, the concepts explored in this book are foundational to our practice. As desired, the book is a comprehensive and contemporary reference that was largely easy to read and will be unequivocally practical to both experts and novices alike.

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