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Report on the 2025 DICOM WSI Connectathon.

David A Clunie1, Brian Napora2, John Groth3

  • 1PixelMed Publishing, Bangor, PA, USA.

Journal of Pathology Informatics
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

Digital Imaging and Communications in Medicine (DICOM) standard implementation is crucial for whole-slide imaging interoperability. Practical testing demonstrated its successful application in clinical workflows, identifying areas for improvement.

Keywords:
Anatomical Pathology Laboratory Information System (AP-LIS) integrationAnnotationsConnectathonConnectivityDICOMwebDigital Imaging and Communications in Medicine (DICOM)Digital Pathology Image Acquisition (DPIA) integration profileDigital pathology interoperabilityHealth Level Seven (HL7)Image Management System (IMS)Integrating the Healthcare Enterprise (IHE)Picture Archiving and Communication System (PACS)Systemized Nomenclature of Medicine - Clinical Terms (SNOMED CT)Virtual microscopyWhole-slide imaging (WSI)

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Area of Science:

  • Medical Imaging
  • Digital Pathology
  • Health Informatics

Background:

  • Interoperability in whole-slide imaging is essential for clinical deployment.
  • Standardization, particularly using Digital Imaging and Communications in Medicine (DICOM), is key to achieving this.
  • Practical testing is needed to validate specific features and identify implementation gaps.

Purpose of the Study:

  • To practically test and demonstrate DICOM standard features for whole-slide imaging.
  • To guide clinical deployment and select appropriate feature profiles.
  • To identify gaps and opportunities for improvement in DICOM for digital pathology.

Main Methods:

  • A virtual Connectathon event involving 32 implementers across various roles (AP-LIS, scanner, archive, viewer, annotation).
  • Utilized HL7 V2 metadata with DICOM whole-slide microscopy images encoded using the TILED_FULL pattern.
  • Employed standard DICOM protocols for image transfer and DICOMweb for metadata/frame query and retrieval.

Main Results:

  • Successful integration of HL7 V2 metadata with DICOM whole-slide images.
  • Demonstrated DICOM image transfer to archives and retrieval via DICOMweb for virtual microscopy.
  • Showcased the storage and retrieval of both human and algorithm-generated annotations in DICOM format.

Conclusions:

  • The Connectathon successfully demonstrated the practical application of DICOM standards in whole-slide imaging.
  • The event highlighted the feasibility of DICOMweb for accessing annotated whole-slide images in clinical settings.
  • Further refinements based on practical testing will enhance DICOM's role in digital pathology interoperability.