Dear Trillium readers,

In an era where precision medicine is reshaping the landscape of healthcare, the role of pathology has never been more pivotal. As the cornerstone of diagnosis and treatment, pathologists are at the forefront of integrating cutting-edge technology and deepening our understanding of disease mechanisms. This year’s edition of Trillium Pathology delves into the latest advancements in diagnostic techniques, the impact of artificial intelligence on pathology, and the current trends in research that may soon find their way into the diagnostic routine. Join us as we explore these transformative changes and their implications for the future of patient care.

We deliberately chose to name this journal Trillium Pathology as we want to deliver a complementary bouquet of both medical and technological topics in the field. On the medical side, this issue features a must-read summary on hereditary and predictive aspects of molecular pathology for prostate cancer.

Two further articles should be interesting reads for all pathologists considering “to go digital” at some point. Founders of a start-up that specializes in consulting and assisting labs in the transition to Digital Pathology disclose their approach and best practices here. The scanner overview should prove as an additional invaluable source that lists important considerations when selecting a slide scanner and compares some current models.

Working digitally also opens the door to a more seamless workflow when viewing multiple stains from serial sections. Experts from Fraunhofer MEVIS share how their award-winning slide alignment technology works and how it can best be utilized in the diagnostic or research workflow. 

Clearly, digital and computational pathology are not just a hype – they have come to stay. In a growing number of labs and practices, pathologists can today enjoy home office, remote-diagnose in between talks at a conference, ask for a second opinion from an expert in another city, remote-review frozen sections at a satellite site, or virtually merge serial sections with different IHC stains. The number of commercial and non-commercial AIs in pathology has grown exponentially. The pace might increase further as vendors speed up developments by utilizing foundation models that are pre-trained on gigantic amounts of histopathology slides. 

Experts from Helmholtz Munich have discovered that these foundation models retain irrelevant information that stem from site-specific variations in wet lab or digitization protocols. They explain what these batch effects entail and how to deal with them. 

Finally, researchers from the Max Delbrück Center in Berlin and Fraunhofer IIS in Erlangen explain the potential of spatial proteomics, a method that was recently named the Nature Method of the Year 2024. While today it helps life science researchers reverse-engineer complicated biological processes, in the near future this technology might find its way into the clinical routine, e.g. to better predict if a patient will benefit from a particular therapy or to squeeze as much information as possible from a small and hard-to-obtain biopsy to select potential targeted therapies such as antibody drug conjugates. 

We hope you will enjoy this broad spectrum of articles that shed light on our interesting field of pathology from wildly different perspectives.