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Background <p>Digital pathology (DP) and whole-slide imaging (WSI) are increasingly utilized in clinical pathology; however, their role in forensic medicine remains less defined, as evidentiary standards demand robust validation, auditability, and a chain of custody.</p> Methods <p>We conducted a systematic review of PubMed, Scopus, and Web of Science for studies that applied DP and WSI to forensic, autopsy, or postmortem contexts, with eligibility requiring peer-reviewed human studies that reported methods and outcomes. Data were charted for study design, tissue, devices/software, and outcomes (diagnostic agreement, quantitative metrics, validation/quality assurance (QA)).</p> Results <p>The search retrieved 361 records; after screening and full-text assessment, 21 studies were selected for inclusion. Fifteen studies primarily advanced diagnostic knowledge using postmortem material (e.g., quantitative neuropathology and organ-specific morphometry), while five had direct forensic aims (casework validation or core forensic tests).</p> Conclusions <p>The review highlights that DP is technically ready for medico-legal workflows; however, its use remains low compared to other clinical settings. Adoption in forensics should centre on CAP-style, use–case–specific validation, traceable/auditable pipelines (including hashing, logs, and tile-linked overlays), stain/colour governance, and external robustness testing. Under these conditions, DP can deliver reproducible, transparent, and court-defensible evidence across forensic practice.</p>

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Digital pathology in forensic science: a systematic review of the literature

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月13日

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  • Laura Ambrosi,
  • Federica Amirante,
  • Simona Nicolì,
  • Andrea Marzullo,
  • Giuseppe Ingravallo,
  • Davide Ferorelli,
  • Biagio Solarino,
  • Gianmarco Argentiero

摘要

Background

Digital pathology (DP) and whole-slide imaging (WSI) are increasingly utilized in clinical pathology; however, their role in forensic medicine remains less defined, as evidentiary standards demand robust validation, auditability, and a chain of custody.

Methods

We conducted a systematic review of PubMed, Scopus, and Web of Science for studies that applied DP and WSI to forensic, autopsy, or postmortem contexts, with eligibility requiring peer-reviewed human studies that reported methods and outcomes. Data were charted for study design, tissue, devices/software, and outcomes (diagnostic agreement, quantitative metrics, validation/quality assurance (QA)).

Results

The search retrieved 361 records; after screening and full-text assessment, 21 studies were selected for inclusion. Fifteen studies primarily advanced diagnostic knowledge using postmortem material (e.g., quantitative neuropathology and organ-specific morphometry), while five had direct forensic aims (casework validation or core forensic tests).

Conclusions

The review highlights that DP is technically ready for medico-legal workflows; however, its use remains low compared to other clinical settings. Adoption in forensics should centre on CAP-style, use–case–specific validation, traceable/auditable pipelines (including hashing, logs, and tile-linked overlays), stain/colour governance, and external robustness testing. Under these conditions, DP can deliver reproducible, transparent, and court-defensible evidence across forensic practice.