Report on the 2025 DICOM WSI Connectathon

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.