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基于数字和人工智能的病理学:并非适用于每个实验室——关于其实施的益处与陷阱的小型综述

Digital and Artificial Intelligence-based Pathology: Not for Every Laboratory - A Mini-review on the Benefits and Pitfalls of Its Implementation.

作者信息

Shen Iris Z, Zhang Lanjing

机构信息

The Winsor School, Boston, MA, USA.

Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA.

出版信息

J Clin Transl Pathol. 2025 Jun;5(2):79-85. doi: 10.14218/jctp.2025.00007. Epub 2025 Apr 3.


DOI:10.14218/jctp.2025.00007
PMID:40823629
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12356165/
Abstract

BACKGROUND AND OBJECTIVES: With the increasing use of artificial intelligence (AI) in diagnostics, AI algorithms have shown great potential in aiding diagnostics. As more of these algorithms are developed, there is overwhelming enthusiasm for implementing digital and artificial intelligence-based pathology (DAIP), but doubts and pitfalls are also emerging. However, few original or review articles address the limitations and practical aspects of implementing DAIP. In this review, we briefly examine the evidence related to the benefits and pitfalls of DAIP implementation and argue that DAIP is not suitable for every clinical laboratory. METHODS: We searched the PubMed database using the following keywords: "digital pathology," "digital AI pathology," and "AI pathology.". Additionally, we incorporated personal experiences and manually searched related papers. RESULTS: Ninety-two publications were found, of which 24 met the inclusion criteria. Many advantages of DAIP were discussed, including improved diagnostic accuracy and equity. However, several limitations of implementing DAIP exist, such as financial constraints, technical challenges, and legal/ethical concerns. CONCLUSIONS: We found a generally favorable but cautious outlook for the implementation of DAIP in the pathology workflow. Many studies have reported promising outcomes in using AI for diagnosis and analysis; however, there are also several noteworthy limitations in implementing DAIP. Therefore, a balance between the benefits and pitfalls of DAIP must be thoroughly articulated and examined in light of the institution's needs and goals before making the decision to implement DAIP. Approaches for mitigating machine learning biases were also proposed, and the adaptation and growth of the pathology profession were discussed in light of DAIP development and advances.

摘要

背景与目的:随着人工智能(AI)在诊断领域的应用日益增加,AI算法在辅助诊断方面展现出了巨大潜力。随着越来越多此类算法的开发,人们对实施基于数字和人工智能的病理学(DAIP)充满了极大热情,但疑虑和问题也不断涌现。然而,很少有原创或综述文章涉及实施DAIP的局限性和实际问题。在本综述中,我们简要审视了与实施DAIP的益处和问题相关的证据,并认为DAIP并不适用于每个临床实验室。 方法:我们使用以下关键词在PubMed数据库中进行搜索:“数字病理学”、“数字人工智能病理学”和“人工智能病理学”。此外,我们纳入了个人经验并手动搜索了相关论文。 结果:共找到92篇出版物,其中24篇符合纳入标准。讨论了DAIP的许多优点,包括提高诊断准确性和公平性。然而,实施DAIP存在一些局限性,如资金限制、技术挑战以及法律/伦理问题。 结论:我们发现对于在病理学工作流程中实施DAIP,总体前景乐观但需谨慎。许多研究报告了使用AI进行诊断和分析的良好结果;然而,实施DAIP也存在一些值得注意的局限性。因此,在决定实施DAIP之前,必须根据机构的需求和目标,全面阐明并审视DAIP利弊之间的平衡。还提出了减轻机器学习偏差的方法,并根据DAIP的发展和进步讨论了病理学专业的适应和发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c0/12356165/0687367ba3ca/nihms-2100700-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c0/12356165/0687367ba3ca/nihms-2100700-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c0/12356165/0687367ba3ca/nihms-2100700-f0001.jpg

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[1]
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[2]
Using Generative AI to Extract Structured Information from Free Text Pathology Reports.

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[3]
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[4]
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[5]
ChatGPT-4 Performance on German Continuing Medical Education-Friend or Foe (Trick or Treat)? Protocol for a Randomized Controlled Trial.

JMIR Res Protoc. 2025-2-6

[6]
Bridging the gap: Evaluating ChatGPT-generated, personalized, patient-centered prostate biopsy reports.

Am J Clin Pathol. 2025-5-17

[7]
Mitigating bias in AI mortality predictions for minority populations: a transfer learning approach.

BMC Med Inform Decis Mak. 2025-1-17

[8]
Automated Pathologic TN Classification Prediction and Rationale Generation From Lung Cancer Surgical Pathology Reports Using a Large Language Model Fine-Tuned With Chain-of-Thought: Algorithm Development and Validation Study.

JMIR Med Inform. 2024-12-20

[9]
Large language model answers medical questions about standard pathology reports.

Front Med (Lausanne). 2024-9-18

[10]
Unveiling the risks of ChatGPT in diagnostic surgical pathology.

Virchows Arch. 2025-4

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