The Digital Pathologist’s Cockpit: Image Management Systems (IMS) – Free Download of List of IMSes

In conventional pathology, the pathologists mostly interacted with their LIS (lab information system). Synonyms are PIS (pathology information system) or LIMS (laboratory information & management system). Conventional LISes do not contain a whole-slide-viewer or advanced capabilities for managing and organizing terabytes of whole-slide-images (WSI). This is what an Image Management System does.

The Image Management System is browser-based, so that every pathologist can access it from the thin clients in a hospital or practice. It contains a WSI-viewer that is specifically developed to view pyramidal whole-slide-images, i.e., it minimizes the amount of pixel data that is transmitted to the user by accessing the resolution level (µm/px) that is closest to the current magnification and by transmitting only those tiles that intersect with the current field of view. A synonym for an IMS that stems from the radiology world is “HistoPACS” (Picture Archiving and Communication System for Histology). In fact, many radiology PACS vendors have expanded their solutions into pathology (e.g., Sectra, Telemis, nexus | chili).

When LIS and IMS are separate systems, they should communicate with one another, ensuring that the same case is opened in both systems. Typically, the IMS is opened on one monitor and the LIS on another.

Where does AI come into the game?

The diagnostic spectrum that a pathologist covers is very broad. Clinically validated AIs, however, only have a very narrow use case such as one type of score for one indication for one stain. Consequently, an AI-assisted pathologist would need a larger 2-digit number of AIs. It is unlikely that any IMS vendor will be able to develop, validate, and offer all these AIs any time soon. Using separate applications from various AI vendors is also not a good solution — no pathologist wants to have to switch back and forth between various viewers from multiple AI vendors. Instead, IMS vendors integrate AIs from various clinical AI vendors (see Digital Pathology AI Companies — List of Commercial AIs (CE-IVDR, FDA, RUO)). Another good reason for plugging AIs into IMSes is that digital pathologists should have the freedom to select an AI from any vendor.

A simple overview of a Digital Pathology IT ecosystem could look like this:

Free Download of curated list of IMS Vendors

By now, it is clear why the IMS can be regarded as the digital pathologist’s cockpit. Selecting an IMS is an important step when going digital.

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