Few radiology subspecialties can match mammography at adopting new imaging modalities to improve patient care. Consider: The past 10 to 15 years have seen the rise of digital breast tomosynthesis, automated breast ultrasound, breast MRI (with and without diffusion weighting), low-dose positron emission mammography and contrast-enhanced dual-energy digital mammography. That’s just to name a few.  

It’s been two and a half years since Microsoft completed its acquisition of Nuance Communications for a reported $19.7 billion. At the time of the March 2022 transaction, Microsoft said it liked Nuance for its core strengths—AI-powered voice recognition and related software and services—across numerous industries.

A recent 2024 PocketHealth survey of 202 U.S. hospital and imaging center decision-makers highlights the significant challenges healthcare providers face with legacy image exchange systems. The survey and conversations with industry leaders reveal that these outdated solutions impact both operational efficiency and patient satisfaction, often resulting in additional workload and increased costs.

Five years ago, two key takeaways from a survey of their pathologists sent NorthShore University HealthSystem toward the front lines of a technological revolution: digital pathology.

The team almost unanimously agreed that, first, it was time to consider AI as an aid to microscopic tissue analysis. And second, 73% wanted the flexibility to work remotely at another site or at home, at least sometimes, via telepathology.

It was about 2000 when Yale pathologist John Sinard, MD, PhD, first heard the prediction. “In five years, we won’t be using microscopes,” a respected peer quipped. “We’ll be examining all our slides as digitized images on computer monitors.”

Nearly a quarter-century later, Sinard reports: “I’m at my workstation, and my microscope is sitting right here next to me.”

With more than 7 million digitized slides on hand, the pathology department at Memorial Sloan Kettering Cancer Center in New York City represents one of the largest repositories of whole slide images in the world. It’s no surprise the library is so large, as it’s been accruing new images since 2008. And with total case volumes exceeding one million slide reads per year, the inventory continues to grow at that scale.

Remember when X-ray abandoned cumbersome film once sleek digital suitors showed up? It happened little by little, not all at once. In much the same way, radiology datasets are leaving cramped hardware spaces for the inexhaustible, ever-flexible expanse of the cloud.

Korak Sarkar, MD, vividly recalls a clinical case that clearly demonstrated the significant impact that enterprise imaging can have on healthcare delivery.