Application of artificial intelligence and digital tools in cancer pathology

Artificial intelligence (AI) is on the verge of reshaping cancer diagnostics through integration into digital pathology workflows. Despite the progression of AI towards real-world deployment, challenges in interpretability, validation, and clinical integration persist. AI models support the interpretation of stains including haematoxylin and eosin, enabling tumour classification, grading, and biomarker quantification, with clinical applications for targets such as HER2 and PD-L1. In addition, AI models enable the quantification of subtle microscopic patterns with prognostic and predictive values across tumour types. Herein, we provide an overview of the applications of AI in pathology and address emerging regulatory and ethical considerations. We also discuss the disparities in adoption across care settings and emphasise the importance of validation, human oversight, and post-deployment monitoring for the responsible implementation of AI in pathology-driven workflows. Furthermore, we highlight the technical advancements driving these developments, particularly the transition from hand-crafted machine learning workflows to deep learning, self-supervised learning for foundation models, multimodal models, and agentic AI.

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Publication Details

Journal
The Lancet Digital Health
Published
2025-10-01
DOI
https://doi.org/10.1016/j.landig.2025.100933
Citations
7
Primary Topic
AI in cancer detection
Type
article
Field-Weighted Citation Impact
17.37
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article

Application of artificial intelligence and digital tools in cancer pathology

Katherine Hewitt, Lawrence Shaktah, Marco Gustav, Matthew J. Cecchini et al.
7 citations
The Lancet Digital Health
AI in cancer detection
17.37
article

Application of artificial intelligence and digital tools in cancer pathology

Katherine Hewitt, Lawrence Shaktah, Marco Gustav, Matthew J. Cecchini, Zunamys I. Carrero, Sebastian Foersch, Jakob Nikolas Kather, Sabina Berezowska
article en
7 citations

Abstract

Artificial intelligence (AI) is on the verge of reshaping cancer diagnostics through integration into digital pathology workflows. Despite the progression of AI towards real-world deployment, challenges in interpretability, validation, and clinical integration persist. AI models support the interpretation of stains including haematoxylin and eosin, enabling tumour classification, grading, and biomarker quantification, with clinical applications for targets such as HER2 and PD-L1. In addition, AI models enable the quantification of subtle microscopic patterns with prognostic and predictive values across tumour types. Herein, we provide an overview of the applications of AI in pathology and address emerging regulatory and ethical considerations. We also discuss the disparities in adoption across care settings and emphasise the importance of validation, human oversight, and post-deployment monitoring for the responsible implementation of AI in pathology-driven workflows. Furthermore, we highlight the technical advancements driving these developments, particularly the transition from hand-crafted machine learning workflows to deep learning, self-supervised learning for foundation models, multimodal models, and agentic AI.

The Lancet Digital HealthVol. 7(10)
Western University (CA), Johannes Gutenberg University Mainz (DE), Heidelberg University (DE), University Hospital Heidelberg (DE), University Medical Center of the Johannes Gutenberg University Mainz (DE), University Hospital Carl Gustav Carus (DE), University of Lausanne (CH)
Openalex Percentile: Top 1%
AI in cancer detection
17.37
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