Digitalization is transforming nearly every aspect of medicine, ushering in a new era marked by greater efficiency, precision, and accessibility in healthcare. From electronic health records and telemedicine to artificial intelligence and data analytics, digital tools are changing how healthcare professionals work [13].

In this context, the introduction of digital technology for acquiring stained tissue sections on glass slides has profoundly impacted the pathology field. Nowadays, increasingly more pathology diagnosis and research services worldwide consider WSIs the mainstream option in daily caseload management [14].

WSIs, often called digital or virtual pathology, is a technique that captures high-resolution digital images of entire stained tissue sections from glass slides using high-technology dedicated scanners. These images can then be viewed on a computer with a dedicated monitor for reporting, characterized by high resolution, tone balancing systems, and a high refresh rate, enabling pathologists to examine WSIs with magnification and spatial navigation similar to traditional microscopy [10]. This technique, combined with other digital tools such as barcoding, specimen tracking, and digital dictation, can significantly improve a pathology department’s safety, quality, and efficiency [15].

Considering the unique potential of this technique, the scarcity of literature on WSIs in forensic pathology, and the lack of formal validation in this specialty, our study represents the first multicenter effort to evaluate the application of WSIs in the forensic pathologist’s workflow.

Our findings revealed consistently high-performance ratings from all participating pathologists, notably in terms of glass slide reliability, digital image quality, and the efficiency and ease of digital slide navigation. These results highlight a strong endorsement from practitioners for integrating this technology into routine forensic pathology practice.

Further, the CSUQ Version 3 indicated a high level of satisfaction among all pathologists, underscoring excellent usability perceptions.

Finally, side-by-side comparisons of diagnoses performed on the microscope versus WSIs on a widescreen showed excellent concordance, aligning with the diagnostic accuracy standards established by the College of American Pathologists [10, 11].

Overall, our findings demonstrate the positive reception of WSIs among practitioners and their non-inferiority to traditional microscopy for diagnostic accuracy. Thus, this validation study supports the adoption of WSIs in forensic pathology, with promising implications for advancing service efficiency, research, and educational opportunities in the field.

In service delivery, digital forensic histopathology brings transformative efficiencies to forensic workflows. High-quality digital slides can provide detailed images that can be quickly shared with specialists in different locations, breaking down geographical barriers and enabling real-time consultations. This instant sharing capability is invaluable in forensic pathology, where time-sensitive cases such as legal inquiries, public health risks, or criminal investigations require fast and accurate conclusions. Pathologists can instantly share digital images of tissue samples with experts in specialized fields, such as neuropathology, allowing for a more comprehensive assessment of complex cases. This collaboration may accelerate the diagnostic process and improve the accuracy of conclusions drawn, as multiple experts can provide insights without the delays that traditionally accompany physical sample transfers [16]. Digital forensic histopathology can support a more robust, accurate, and efficient diagnostic process. Integrating digital sharing, automated analysis, and detailed documentation into routine practice may enable forensic pathology services to provide faster and more reliable results, an essential feature in the context of legal and public health inquiries where accuracy and efficiency are paramount.

In the research field, digital forensic histopathology offers a way to study specific features of forensic cases, especially in large-scale data analysis and retrospective studies. This capability is particularly beneficial in forensic science, where reanalyzing older cases may provide new insights.

In addition, advanced algorithms and machine learning models, being at the heart of current digital pathology research, may allow researchers to analyze forensic histopathological patterns in ways traditional microscopy cannot. For example, artificial intelligence (AI) models can be trained to detect tissue abnormalities or specific markers of disease or injury. These models can also quantify cellular density, tissue architecture, or inflammatory responses. This quantitative analysis reduces human subjectivity and introduces statistical rigor into forensic histopathology, making findings more reproducible and reliable [17].

Moreover, such findings can have broader implications, influencing public health policies or legal standards. Thus, the ability to analyze vast amounts of data with digital tools may accelerate forensic research, opening new avenues for discovery and improving the scientific rigor underpinning forensic pathology practices.

Finally, digital forensic histopathology may reshape forensic pathology education by harnessing the power of digital imaging and interactive learning tools. The first advantage is the standardization of digital images, which avoids discrepancies in student, resident, and fellow testing and scores.

In addition, WSIs can allow students and trainees to access high-resolution images without being physically present in a laboratory. Indeed, traditional histopathology teaching relies heavily on in-person observation through microscopes, which limits accessibility and can be challenging for students who cannot physically be on-site. With digital platforms, students can remotely access these materials, enabling flexible learning and reaching a more diverse range of learners. These educational innovations also support collaborative learning. Digital platforms may allow students to discuss findings in real-time or asynchronously, often in global, cross-institutional settings. Students can work together on complex cases, consult with experts remotely, and receive feedback on their diagnostic approaches. In this sense, digital forensic histopathology may contribute to a more dynamic, connected learning environment [18, 19].