Pathological anatomy: digital slide in only one in three laboratories, hi-tech breakthrough needed

In Italy, only 35% of pathology laboratories are fully digital and able to prepare diagnoses on the monitor. The exclusive use of the 'digital slide' is therefore not yet guaranteed throughout the country. Modernisation can no longer be postponed as new technologies, starting with Artificial Intelligence, are rapidly transforming the work of specialists. Pathological anatomy reports are also becoming increasingly important in clinical practice for directing therapies, providing precise prognoses, and thus fostering precision medicine. This is one of the main topics at the centre of the 10th Triennial Congress of the Italian Society of Pathological Anatomy and Diagnostic Cytology (SIAPeC-IAP). The event opens in Milan on 3 December and brings together over 900 specialists from all over Italy for four days.

"Until a few years ago, we were limited to detecting the disease by analysing tissue and cell samples taken from the body,' emphasises Filippo Fraggetta, president of SIAPeC-IAP. 'Now we are able to associate a whole series of parameters with the pathology, allowing greater personalisation of both diagnosis and treatment. Precision medicine is already being used for solid and blood cancers, chronic inflammatory bowel diseases, autoimmune and rheumatological diseases or organ transplants. Our activity is no longer limited to simple laboratory analyses performed under the microscope. Some pathology laboratories are taking advantage of the resources provided by the NRP to modernise their technologies and finally switch from analogue to digital. However, we need to accelerate the implementation of digitisation in all healthcare facilities that must be able to accommodate the innovations brought by AI'.

"Anatomo-pathologists have to respond to the ever-increasing demands for information that come from day-to-day clinical practice," Fraggetta continues, "However, we encounter not only technological shortcomings in our work, but also limited human resources. The number of specialists is insufficient, which can make the work of entire hospital departments more difficult. There have been academic years in the medical faculties in which only 30 per cent of the specialisation school places were actually filled. In 2025-26 there has been a positive reversal of this trend and we have now reached almost 70 per cent. The shortage of professionals can only be partly filled by the use of new technologies'.

'We must make our discipline more attractive, starting with medical schools,' continues Angelo Paolo Dei Tos, SIAPeC-IAP President-elect. 'Another priority, in the coming years, must be to increase the automation of pathological anatomy services throughout the country. Robotics, and other automated systems, can streamline and improve the entire process of tissue sample preparation and analysis. The ultimate goal remains that of generating more accurate reports that enable the best selection of treatments and therapies. A concrete example of this indispensable innovation is precision oncology. The characterisation of genetic alterations in tumours and the individual are cornerstones in the battle against cancer. As anatomo-pathologists, we are at the centre of multidisciplinary teams and constantly interface with other clinicians throughout the entire course of treatment. Through discussion with the different professionals, we provide the correct interpretation of morphological and molecular data and facilitate a more appropriate choice of therapeutic strategies'.

At the end of the congress in Milan there will be the election of the new national board that will lead the SIAPeC-IAP for the next three years. There will also be reports from the 24 different study groups of the Scientific Society that will present updates on their work in recent years. "Ample space in the event is dedicated to young specialists," concludes Emanuela Bonoldi of the Organising Committee of the 10th SIAPeC-IAP National Congress. "They represent, in fact, a valuable resource for the SIAPeC-IAP and for the entire national health system. Not only in daily clinical practice but also in medical-scientific research, the anatomo-pathologist can make a fundamental contribution. New methods and technologies allow very specific data to emerge for a more detailed study of each individual case of pathology. This is all valuable information for refining the diagnostic-therapeutic tools available to date or creating new, more efficient ones'.