To compare pathologist review time and diagnostic performance with standard digital pathology versus AI-assisted digital pathology for breast biopsies, and to estimate potential effects on laboratory turnaround time.
Approach:
Paired-reader study: Two experienced pathologists reviewed 194 breast biopsy cases using both workflows in a randomized order, with a 2-week washout period.
Additional analysis: Researchers reviewed historical turnaround times for 3,298 cases to model the potential effect of AI-guided immunohistochemistry (IHC) preordering.
Key Findings:
Mean review time fell from 71.12 seconds with standard digital pathology to 40.18 seconds with AI assistance, a reduction of about 44%.
Cancer diagnostic agreement was 97% with standard review and 99% with AI assistance; sensitivity was 98% and 100%, respectively, and specificity was 95% and 98%.
For DCIS, agreement was 93% without AI and 99% with AI, while sensitivity was 86% and 100%; the subgroup included only 21 DCIS-positive cases.
The historical-data model estimated that AI-guided IHC preordering could reduce turnaround time by about 2.5 days for applicable true-positive cases; this was not tested prospectively.
Interpretation:
In this study, AI assistance was associated with shorter review times and high diagnostic agreement. The estimated turnaround-time reduction was modeled rather than demonstrated in clinical implementation.
Limitations:
Single-center study involving only two pathologists.
One representative slide per case was assessed, and cases with inadequate image quality were excluded.
The study was not powered to establish differences in diagnostic accuracy; the small DCIS subgroup limits precision.
The proposed turnaround-time benefit requires prospective evaluation.
Conclusion:
The authors stated that larger multicenter studies are warranted to confirm the findings.
Researchers reported that an artificial intelligence workflow maintained high interpretive accuracy while reducing urine drug test sign-out time in a supervised clinical laboratory setting.
