Joining forces for pathology diagnostics with AI assistance: The EMPAIA initiative

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Norman Zerbe - , Charité – Universitätsmedizin Berlin (Author)
  • Lars Ole Schwen - , Fraunhofer Institute for Digital Medicine (Author)
  • Christian Geißler - , Technical University of Berlin (Author)
  • Katja Wiesemann - , Quality in Pathology (QuIP) (Author)
  • Tom Bisson - , Charité – Universitätsmedizin Berlin (Author)
  • Peter Boor - , RWTH Aachen University (Author)
  • Rita Carvalho - , Charité – Universitätsmedizin Berlin (Author)
  • Michael Franz - , Charité – Universitätsmedizin Berlin (Author)
  • Christoph Jansen - , Charité – Universitätsmedizin Berlin (Author)
  • Tim Rasmus Kiehl - , Charité – Universitätsmedizin Berlin (Author)
  • Björn Lindequist - , Charité – Universitätsmedizin Berlin (Author)
  • Nora Charlotte Pohlan - , Charité – Universitätsmedizin Berlin (Author)
  • Sarah Schmell - , Institute of Pathology (Author)
  • Klaus Strohmenger - , Charité – Universitätsmedizin Berlin (Author)
  • Falk Zakrzewski - , Institute of Pathology (Author)
  • Markus Plass - , Medical University of Graz (Author)
  • Michael Takla - , Vitagroup AG (Author)
  • Tobias Küster - , Technical University of Berlin (Author)
  • André Homeyer - , Fraunhofer Institute for Digital Medicine (Author)
  • Peter Hufnagl - , Charité – Universitätsmedizin Berlin (Author)

Abstract

Over the past decade, artificial intelligence (AI) methods in pathology have advanced substantially. However, integration into routine clinical practice has been slow due to numerous challenges, including technical and regulatory hurdles in translating research results into clinical diagnostic products and the lack of standardized interfaces. The open and vendor-neutral EMPAIA initiative addresses these challenges. Here, we provide an overview of EMPAIA's achievements and lessons learned. EMPAIA integrates various stakeholders of the pathology AI ecosystem, i.e., pathologists, computer scientists, and industry. In close collaboration, we developed technical interoperability standards, recommendations for AI testing and product development, and explainability methods. We implemented the modular and open-source EMPAIA Platform and successfully integrated 14 AI-based image analysis apps from eight different vendors, demonstrating how different apps can use a single standardized interface. We prioritized requirements and evaluated the use of AI in real clinical settings with 14 different pathology laboratories in Europe and Asia. In addition to technical developments, we created a forum for all stakeholders to share information and experiences on digital pathology and AI. Commercial, clinical, and academic stakeholders can now adopt EMPAIA's common open-source interfaces, providing a unique opportunity for large-scale standardization and streamlining of processes. Further efforts are needed to effectively and broadly establish AI assistance in routine laboratory use. To this end, a sustainable infrastructure, the non-profit association EMPAIA International, has been established to continue standardization and support broad implementation and advocacy for an AI-assisted digital pathology future.

Details

Original languageEnglish
Article number100387
JournalJournal of pathology informatics
Volume15
Publication statusPublished - Dec 2024
Peer-reviewedYes

Keywords

Keywords

  • Artificial intelligence, Digital pathology, Explainability, Interoperability, Standardization, Validation of algorithms