Christoph Jansen

Norman Zerbe, Lars Ole Schwen, Christian Geißler et al.

Over the past decade, artificial intelligence (AI) methods in pathology have advanced substantially. However, integration into routine clinical practice has been slow due to numerous challenges, including technical and regulatory hurdles in translating research results into clinical diagnostic products and the lack of standardized interfaces. The open and vendor-neutral EMPAIA initiative addresses these challenges. Here, we provide an overview of EMPAIA's achievements and lessons learned. EMPAIA integrates various stakeholders of the pathology AI ecosystem, i.e., pathologists, computer scientists, and industry. In close collaboration, we developed technical interoperability standards, recommendations for AI testing and product development, and explainability methods. We implemented the modular and open-source EMPAIA platform and successfully integrated 14 AI-based image analysis apps from 8 different vendors, demonstrating how different apps can use a single standardized interface. We prioritized requirements and evaluated the use of AI in real clinical settings with 14 different pathology laboratories in Europe and Asia. In addition to technical developments, we created a forum for all stakeholders to share information and experiences on digital pathology and AI. Commercial, clinical, and academic stakeholders can now adopt EMPAIA's common open-source interfaces, providing a unique opportunity for large-scale standardization and streamlining of processes. Further efforts are needed to effectively and broadly establish AI assistance in routine laboratory use. To this end, a sustainable infrastructure, the non-profit association EMPAIA International, has been established to continue standardization and support broad implementation and advocacy for an AI-assisted digital pathology future.

Christoph Jansen

This habilitation thesis is cumulative and, therefore, is collecting and connecting research that I (together with several co-authors) have conducted over the last few years. Thus, the absolute core of the work is formed by the ten publications listed on page 5 under the name Contributions 1 to 10. The references to the complete versions of these articles are also found in this list, making them as easily accessible as possible for readers wishing to dive deep into the different research projects. The chapters following this thesis, namely Parts A to C and the concluding remarks, serve to place the articles in a larger scientific context, to (briefly) explain their respective content on a less formal level, and to highlight some interesting perspectives for future research in their respective contexts. Naturally, therefore, the following presentation has neither the level of detail nor the formal rigor that can (hopefully) be found in the papers. The purpose of the following text is to provide the reader an easy and high-level access to this interesting and important research field as a whole, thereby, advertising it to a broader audience.