165: How AI Is Changing Cancer Diagnosis Insights from PathVision 2025

Live from Pathology Visions 2025 in beautiful San Diego, I sat down with Imogen Fitt from Signify Research to explore how AI, digital pathology, and interoperability are transforming the way we diagnose cancer and deliver patient care.

The conference theme, “From Pixels to Patients,” perfectly captures this year’s shift — from theoretical discussions about AI to real-world implementation and measurable outcomes.

We’re no longer just asking “what can AI do?” — we’re seeing how it’s actually improving accuracy, reducing barriers, and connecting pathologists and labs worldwide.

What We Discuss

1️⃣ From Hype to Application
This year, the buzz wasn’t about AI’s potential — it was about how it’s being used. We highlight case studies showing how digital tools are reducing diagnostic errors, improving collaboration, and even helping smaller labs digitize faster and more affordably.

2️⃣ PathPresenter’s Expanding Role
We dive into PathPresenter’s innovative model that gives users access to digital pathology at no initial cost, opening the door for over 75,000 professionals across 62 institutions. I share why I personally use PathPresenter for teaching and how it’s helping lower the barrier to entry for education, consultations, and patient care.

3️⃣ New Scanning Technology and Accessibility
We talk about compact scanners like Grundium’s four-slide scanner and new miniature models that make digitization possible even in smaller labs. The message is clear: you don’t need a massive system to start going digital.

4️⃣ Collaboration and AI in Action
Imogen shares updates from across Europe and Asia, including how hospitals are tackling storage, AI regulation, and workflow efficiency. We discuss emerging partnerships—Fujifilm, Voicebrook, Dolby, and others—that are making voice dictation, chat agents, and real-time AI insights part of the modern pathology cockpit.

5️⃣ The Human Side of AI Adoption
We also reflect on how digital pathology is changing careers and training. Younger pathologists expect digital tools as part of their workflow — and many won’t settle for less. We discuss how this new generation is driving adoption and pushing institutions to modernize.

My Reflections

I still remember when digital pathology felt intimidating — when only a few people were “allowed” to touch the scanner. But today, that’s changed completely.

Now, we’re living in an era where AI and digital pathology are not optional — they’re essential. The technology has matured, and so has the mindset around it. What excites me most is seeing how collaboration and accessibility are becoming central to innovation.

Key Takeaways

• AI in pathology is moving from hype to practice — focused on improving patient outcomes.
• Accessibility matters: smaller, affordable scanners and open platforms are democratizing digital pathology.
• Collaboration between vendors, clinicians, and technologists is key to faster, smoother adoption.
• The next generation of pathologists expects — and demands — a digital-first workflow.

Listen Now to Learn:

• How AI is reshaping cancer diagnosis
• The tools driving real change in labs today
• How collaboration fuels digital transformation in pathology

Transcript

How AI Is Changing Cancer Diagnosis: Insights from PathVision 2025

Aleks: [00:00:00] Welcome my digital pathology trailblazers. Welcome my AI in Medicine trailblazers. Live streaming from Path Visions. So here we are at Pathology Visions and today, so at Path Visions, well at different conferences you can get these little badges. So I have, we are ground truth, I color outside the lines and I break.

Yeah. Hi break. Welcome. The conference started today and I have already seen a bunch of digital pathology trailblazers. Some of them are my, where my guests on the podcast. And obviously if you are listening live to this and I see there are a few people, lemme know in the comments the question, you can join me, you know where I am.[00:01:00] 

Here. Welcome, Emma. Oh, not yet, but we can turn around the camera in a second here. I'm gonna mic you off. So here, if you have seen our live stream from from where? From Utah. Right? From Utah, yeah. I'm my tracking close to me, and we're looking at this one. Yeah, you need to already, always. Let's see. Very good now.

Okay, so image fit from, do you have here signify research? Signify research here? Let's show market intelligence. Like real intelligence? Yeah. Level of intelligence for digital pathology. And we already did a live stream together in at the Digital diagnostic Summit. That was like what, a couple of days ago.

You didn't go back like a no, I did not. No I did go home because she lives in the uk so that was a little bit too much hassle. [00:02:00] But I live in Pennsylvania, so I went back home and we're at Path Visions 25. And the topic, the through line as I like to call it. Is from patient, from pixels to patients.

To patients. Yeah. And it's, how should I put it? It's like some kind of distant kind of thing because at the last conference we were we were talking. Like, how can you empower patients to drive digital pathology? Is there a place to do it, even in the, like, quite country area of life, which is medicine and medical liability?

Can you, yeah, obviously, yeah, you wanna, but to which extent, how, what role does it play? This is the topic of the conference. Stop playing with this. The conference, the path vision. Yeah. Any insights that you have gotten from today's talks? Today's conversations, I think what I'm really 

Imogen: enthused by is, [00:03:00] sorry.

This year there's definitely a change in the dialogue from worrying about what the call exciting like far. Bits and pieces that can eventually do in pathology are, this year we're focusing on examples, case studies. How do you stop making mistakes? SIM is in here and sort of going, you know, we, there are lessons that pathologists can learn from radiology to reach out and do things. I think. Pixels to patients essentially means let's focus on what we wanna do with digital pathology, which is improve patient care. But now we're looking at, in terms of topics of conversations, it's how do we directly do that today? 10, 15 years time. So yes, 

Aleks: very much.

And I see, so obviously I went to, I sneaked into the exhibit hole before they opened, but I got kicked out. You kicked out. I did. So I don't think I'm gonna be showing that footage because I wanna come. As well. I'm the media partner, [00:04:00] so let's be a compliant media partner, but I can tell the story, right?

Anyway. But couple of, so one presentation that I kind of got in private because I missed several because I came late again, so I have my helpers here who comes on time. But no all like in all seriousness one company, path presenter I'm and you analyze them, right? My like outside perspective, they're not even my sponsor, but I see like what they're doing.

And by my sponsor, I mean the sponsor on Digital pathology place, I like see the pace that they're going at. It's very fast paced. And like what they were presenting today, and Dr. Rasing was showing me the slides that I missed in the official presentation was how basically they empowered, empower everybody who wants to take advantage of digital pathology for patient care, to do it at no initial cost.

Which is like a big part of the [00:05:00] discussion because like. I even a couple of years ago, it was like, okay, such a big investment, such a cost center, and now people are figuring out their way to make it profitable. Lowers the 

Imogen: barrier to entry. Makes it as easy, well easy so that they can just pop on and use it for free.

And I think they have an impressive number of users as well. I dunno, you oh goodness. 70,000 

Aleks: people. 75. 75,000 people are using path presenter in one way or another. 62 institutions that are using their like official version. Yes. And I'm a user as well for the educational content. Like whenever I like teach histology or anything path presenters might go to go to platform.

It's just easy to use. You log in and like. 

Imogen: I dunno whether Raj mentioned were about an end where they get more,

see.[00:06:00] 

Their customer sort of term pathology into more of a than center.

Aleks: Yes. So he showed like, and obviously we're talking about a specific presentation from a specific vendor, but each of these presentations is a representation of a trend that is going on. And in the, like previous episode we were mentioning other vendors that are doing something similar. He mentioned three, like areas where they're doing it.

One is, consultations. So consultations. So the barrier to entry, you mentioned lowering barrier to entry is very much with consultations because this is not in the primary workflow. It's something additional that you as a healthcare provider can charge for. And if you have a setup for this, [00:07:00] then basically everybody who does not have a setup can tap into your setup.

Yeah, that's on the software level and partnered. Which like I just went to their booth. You need to go because they have like four diff little, I like did, 

Imogen: they've done some funny marketing as well because did you see the octopus version that they did? Oh yes. 

Aleks: First last time. Oh my goodness is called oc and they did this funny thing that it was octopus, I dunno what it was, but it was so funny and it was like so on brand.

Imogen: I like it. I like it when like companies come. One year did like a ghost, but it was a pathology image and looked a little bit like a ghost and they stained it properly and yeah, it was very halloweeny. 

Aleks: Cool. Yeah, so the brand is partner of path presenter, so they have these little scanners, right? Is. It can be put anywhere.

So I currently have one at home because I just finished making a [00:08:00] video about it. Yes. See, you need to join my list. If you don't get my emails, you try. I'm trying. Maybe. Maybe she just doesn't read them. Maybe she can. Them because I always start with a good head on. So they always catch them. Yeah. So I still have this thing and by this thing, I mean the scanner at home, the one that scans four slides they came up with a new product and this is like, it's literally like this size, right?

You can put it anywhere and if you don't have like space in your lab, you'll find space for this because it's smaller. Yeah, it's less than the microscope. Exactly. So their model is, okay, whoever cannot digitize can place this little thing wherever they wanna digitize. And usually the consult, it's not like you don't need a scanner that holds like hundreds of slides, right?

These are cases where you need to tap into expertise that you.[00:09:00] 

And get care for their patients. So I was impressed with that. And I love partner, like partnering is a as well have. Interoperability is not a buzzword anymore. You just have do it. If you don't do it, just need to 

Imogen: more, I think, into the market on what actually different. Institutions are able to reach different maturity because it's different way, but it just goes to show that there's not, you don't just have to go with a throughput.

There are mid through, there are thriving. Many like using it, and the tiny little ones like. 

Aleks: Yes. And I think Ka Matsu has a small one, that S 20, which by the way, I did a video on this one as well from a conference. But that basically shows, okay, there's plenty of different scanners and you'll need more than one, because it's not like, okay, one size fits [00:10:00] all.

Once you're like. You start with something, right? Whatever it's that you need for your institution. But if you wanna then like address all the places in your workflow, and especially if you have like multi-site institutions, then not every site is gonna need the same. It's not that you're gonna be like buying 20 of the same thing.

You're gonna be seeing what are the needs come closer because you're getting outta the camera. This one is our camera. But yeah, 

Imogen: i.

AI seems to be a bit quieter this year. But it's more about regulation around AI and how to use ai which is encouraging to see. What else? I attend RS

ERs. I've just come out east. 

That was really interesting. European 

Aleks: of digital and [00:11:00] integrative 

Imogen: pathology. I, yeah they have a few very cool presentations where they had very specific information on, like, there was a pathologist from Romania who's talking about the. And how to sort of learn lessons from some of the mistakes that they've made in the past.

And that was super, super interesting. Ger there was a German pathologist who was talking about storage and how to approach that. Cost way. So Fujifilm has just partnered to help customers, their storage problems. I'm also noticing there's a load vendors that have partnered with Voice broker recently.

Have you seen? Yes. And I'm noticing that there's more like, dictation software that's coming into that's 

Aleks: like very much on the, of lms. 

Imogen: Yeah.

Aleks: And leveraging ai. I hope so. Leveraging AI for like the non-regulated activities of pathology, which is just smoother. Yeah, smoother workflow, easier, faster life for [00:12:00] pathologists. So I saw it the first time, I think, partnered with Dolby. And that was like the first instance that I learned. Oh, you can just like voice direct your pathologist cockpit.

And now it's a trend as well. I mean, makes sense. So why not? It just goes to show that you, 

Imogen: yeah. 

Aleks: Yeah. And also these so that was already integrated in.

The chats within your pathology viewing software, like, tho those mini agents that go and VE chats are coming. Yeah, chatbots, like these agents that go and retrieve information for you for the cases. So that's, that was like more last year's high. I was. Think now people are used to using chat gpt, so they kind of expect this to be in.

How many pathologists do you think use chat gpt? Well, I use it. How many use? I think for work less than for private stuff. Yeah. [00:13:00] I know that people who are active in this space online, on LinkedIn, they play with it a lot. They test it. I tested sometimes there was a Wait who did this? Angio ov. Oh yeah.

He's in Japan and he did a poster on this and I did make a video about it as well. I actually found this poster at home. He gave me the poster. He didn't wanna take it back to Japan, and that was. In Baltimore last year. So he had a survey, let's see if I can pull out the data. But now it's like two or three, three years more.

Yeah. No, that's really cool. What did I wanna say? We talked about AI enabling. That maybe are not like fully unable to provide care. Ah, yeah. I wanted to talk about the trend that it's like, I think because new people are coming into the workflow, workforce, new pathologists, they are used [00:14:00] to all the digital modalities.

They've been through path visions and I love that they like don't settle for no digital path. I'm like, yes. And they are not afraid to change where they work, to be able to work digitally. What did you think when you first sort of heard about digital pathology as a concept? You know what? I was intimidated you.

Yes, because I heard about it the first time when I was doing my residency and we had this scanner that only was used by a certain person that only she could touch it. And this was like this. That we only could use. Like I wouldn't even come close. Right. They wouldn't. And I was like, okay. So that's like for the elites maybe?

.: Yeah. 

Aleks: But also in parallel, I felt like, how can I put it disadvantaged because but it was just in my head. Lemme explain. So I came I did my residency in Germany. [00:15:00] And we had to teach students and Right, they had this like web portal where they could go and look at slides and everything was labeled.

And I'm like, why didn't have that when I studied in Poland and I felt like, oh, I didn't have access to this technology. And then I'm like. But it's online. Like, go and have access to this technology today if you feel so disadvantaged. So it was like, you know, a funny thing, like funny feeling that, oh, I didn't grow up with this, but hey, go and Google it and you can get access to this right now.

Stop whining. That was that. These were a couple of my first experiences. One more thing is when I actually became a user. I was studying for my board for the, yeah. Board certification. And I failed. The first attempt. I failed because of histology. So you had to Yes. That's not a good thing if you wanna be a pathologist to fail histology and histopathology.

Right. You had to [00:16:00] look at slides under the microscope. Describe them. Failed. I failed miserably and then I like developed this aversion to the microscope. Did you And I also was traveling, so I like didn't have the glass slides and I'm like, okay, let's just focus on the content and not on the technology because my exam was still on the microscope.

Yeah. But I'm like, okay, it's not about what I'm looking like, what tool I'm using. It's about the content of the image. So then I actually was. Studying with a friend from uk. And we were doing virtual sessions on virtual slides, and I said, okay, screw the microscope. Let's do it on digital. And let's see.

And I passed. 

Imogen: Yeah, I, well, I did biomedical sciences. There was a bit of we had a bit of like a histology module and I remember. Twiddling and trying to use the microscope and thinking this is so hard and getting past it and you know, doing the module and being like, fine at the end and going, I'm not gonna become, not gonna try and do any medicine or become a pathologist.

And then I remember joining signify research and we were covering digital pathology and looking at these [00:17:00] beautiful pictures and just going, hang on a minute, you can do this digital

learn. 

Aleks: I know I can relate to this. I did a video on how to use a microscope and people are still searching for it, very much looking to, for tutorials on how to use a microscope. Yeah. So you can skip that tutorial if you're digital. But yeah so I like that the workforce is driving the adoption because you're basically not competitive anymore if you don't offer this.

And also there are companies and labs that, that wanna hire pathologists that work remotely, wanna do this stuff digitally, very much driven by the outpatient facilities. 

Imogen: Yeah. And it means that businesses can sort of move across states without actually having to physically move their pathologists as well.

Yes. So they can expand so commercially it makes sense for them as well. And the next generation, I think [00:18:00] one of who was it? Somebody said last week that they put a job posting out one for digital, one for non-digital. And then the digital one got like 10 times the applications. Duh.

Yeah. 

Aleks: Get the grand And you can like hire digital pathologist. Like, I dunno, how many slides does a pathologist read a day? Like an MD pathologist I know for many toxicology. Gonna comment on this time. We had a problem. We didn't know name of something. How many slides?

In the comments, or if you watch the replay, 

Imogen: I think at the LA conference a year, somebody did like six, I wanna say prostate biopsies, but not in a day. Not a day. That's like a year divided by 12. But would they need to 

Aleks: read? It's like, it's so funny because that was supposed [00:19:00] massively high. You're gonna have like, it's so funny because like pathologists, right?

You're gonna have a dermatopathologist that reads different amount of slides. You're gonna have the biopsy people who read like a lot more slides than the people that read resections and they're like, and a toxicologic pathologist reads a different Without as well. Exactly. So anyway, different work.

But let's say the big, the grand that scans four could easily scan a workload for one pathologist if you wanted. 

Imogen: It looks relatively simple. 

Aleks: Yeah, I think it's not a big deal. And if not, then 20 slide scanner. There's a couple.

Yeah, press the point wherever like there are affordable scanners that basically if you're already investing in hiring a pathologist, then you might as well invest in making it a digital position because you're gonna have a lot more applicants [00:20:00] and, they often send me messages, where can they work digitally.

So if you're looking for some, lemme know, I'm gonna connect you. So today we're wrapping up. We're gonna go to the exhibit hall and tomorrow I will be very diligent and I'm gonna go to those talks and make notes and, but you can join me anyway. And what, do you have any specific plans, any meetings with, I've got back to back meeting with vendors just to learn 

Imogen: about where they're going in terms of the market, how they're, what they're experiencing, what their customer they think their customer challenges are.

I'm always interested talking to as well, and hearing it from side just to ate. You need both to really.

Yeah, there's different vendors in the ecosystem. I've noticed this year there's this new display company. There's orchard is this year with Premises. I was a guest on their podcast recently, like on the attendee list as well. [00:21:00] Podcast. Nice. Yes. Yes. And I've noticed Siemens is here, so obviously radiology, world, wider healthcare, it, what the film is 

Aleks: there.

Imogen: Yeah. It's really worth going through the attendee lists. Just Barco, 

Aleks: I just recorded the podcast not the podcast posts social media posts. So if you see any social media with any of us, like comment. Like, comment and share. Always share only if the picture is a good thing. Some shocking ones.

Yeah she's a little concerned about how she looks on camera, but the more you go in front of camera, the camera, the less you care. And it's all about digital pathology. In the end, it's all about, I mean, you know, if I was about makeup or stuff, I would be more self-conscious about. Just showing up showing up, but we're not about makeup, which is good because it makes kmar appearances easier.

I'm interested for the keynote, see, 

Imogen: so if I have a look at what I've got in my diary, because I'm that you 

Aleks: have all the notes, [00:22:00] Elizabeth, 

Imogen: you're the best. I'm here with Elizabeth Warren and we're trying to split the sessions between ourselves. 

Aleks: Okay. So of course you're invited tomorrow as well.

Tomorrow at five o'clock. I'll see if in the same place. I actually wanted to stream in front of that PV 25 thing. Maybe I can steal the table. Okay, we're gonna show around now, diagnosis to decision. Anyway, I'll let you wait. The view, yeah, the view. We're in the Bay San Diego, by the way.

It's my first time in San Diego. Have you been to San Diego before? No. And so they're behind us. Gonna see in one of the pictures, the PV 25.

Imogen: I'm excited for some of the presentations as well. The abstracts. I have another one this year. See? 

Aleks: Are you gonna, the posters, digital posters, you know, they disappear later and they put new digital posters because already, like a year ago, I wanna go, I'm gonna go to the poster sessions, even [00:23:00] if there's nobody there.

Well, if nobody's there, they're no posters. So if you're planning. Do it. If we are walking around, feel free to just wave at us. If I'm walking around with a camera, always wave at the camera. And 17 o'clock Pacific time tomorrow, there is gonna be another live stream. If you're online, tune in online. If you're live here at Path Visions it's gonna be somewhere around the reception you can join for the live stream.

So if you wanna bring. Colleague you can bring her as well. Then we're gonna discuss, I.