Whole-slide imaging in hematopathology: Current state, challenges and future opportunities

Whole-slide imaging (WSI) is gradually being adopted for primary diagnosis in many pathology subspecialties. The benefits of WSI for the pathology workflow are numerous and include the use of artificial intelligence (AI) tools to support WSI analysis. However, digitization of hematopathology workflows has remained a challenge, in part due to the complexity of the hematopathology workflow and the unique characteristics of blood and bone marrow smears. Although AI applications to support hematopathology tasks, such as nucleated differential counts, are well-described, general implementation of these tools has been limited due to the lack of widely available WSIs. Consequently, there is an unmet need for new and innovative solutions to WSI in hematopathology. This review focuses on WSI of hematopathology cytological specimens, particularly, peripheral blood and bone marrow smears, and summarizes unique challenges and AI solutions to support WSI analysis in this area. We also discuss future opportunities for hematopathologist-driven innovation in AI and WSI in hematopathology.