The digital pathology market continues to make inroads with the clinical laboratory industry, but a frequent roadblock to market growth persists: low adoption. Imogen Fitt, principal analyst at Signify Research, notes that digital pathology vendors must convince labs that the costs and complexity of their solutions will bring eventual return on investment. Fitt co-wrote Signify’s 2025 Digital Pathology World Report, which predicted that the digital pathology market will grow to nearly $2.1 billion from 2024 through 2029.
In this Q&A, Fitt discusses what was surprising about her latest research, explains digital pathology software integration challenges, and offers thoughts on cost barriers.
Was there anything that surprised you in the latest version of your Digital Pathology World Report?
Imogen Fitt: The digital pathology market continued to grow, and there is genuine momentum behind it. Labs are scanning more and more slides every year, and general adoption continues to broaden. However, there was a clear distinction between vendors that grew in line with the market and those that did not. That was my big surprise.
The competitive environment is relatively consolidated, but it is beginning to fragment. Leica Biosystems holds a majority share in the market. However, in the mid-sized business segment, there were many players throughout 2024 and 2025 that didn't perform so well and some that did. In 2023, some of those vendors, which I will not name here, had been gaining market share quite aggressively. For me, that is the key takeaway.
Imogen Fitt
Signify Research
This is not a market where vendors can rely on past success or assume momentum will carry them forward. Digital pathology is evolving quickly, whether in technology, commercial models, or customer expectations. Execution matters, and the competitive landscape can shift faster than many expect.
Given those observations, what should clinical laboratories keep an eye on?
IF: Adopting digital pathology can feel like a minefield for many laboratories. There are numerous vendors, multiple software considerations, and a growing number of AI tools. It’s hard to compare different options meaningfully. This is one reason the first step towards digitization can be so difficult. You're going from one analogue method of diagnosis to a completely different one with another instrument and workflow. It's not like radiology, where the transition to digital was a lot more economically compelling.
If you're using digital pathology for clinical and primary diagnosis, you want to pay attention to the vendor that you select for your software. That vendor’s IMS [image management system] is likely going to have to integrate with multiple third-party AI applications. It's also going to have to integrate with your LIS, possibly your EHR, and lots of other software that you have in place. That can really make or break high-volume use because it's the difference between having a pop-up window and having something seamlessly embedded in a workflow. So, laboratories need to pay close attention to their software choices. IT considerations are often overlooked because so much focus goes on the scanner initially.
Back in summer 2024, Labcorp surveyed laboratory professionals, and one of the findings was that digital pathology’s biggest obstacle for adoption remained the cost. Have you seen any data more recently that indicates that's still the case, or has there been a shift?
IF: Vendors have not fully addressed the questions that determine whether a lab buys a scanner now or later. Those questions include: Does this solution make me money? Is it a necessity, or is it just added cost? And if it is added cost, can I put it off for a while because I'm going to have to prioritize another initiative?
Cost remains one of the most significant barriers to adoption. It impacts how quickly a lab can digitize and become digitally mature as well. You have to separately pay for integrations, the AI, and the IMS, particularly for more sophisticated deployments. You can buy end-to-end solutions with a scanner, IMS, and AI, but those are relatively new in the market.
There are vendors experimenting with operational expenditure models. For example, One Dorset Pathology in the UK recently announced a managed service agreement with Fujifilm Healthcare UK. Under the model, the contract is extended over a number of years, making the investment more manageable. Instead of liaising with multiple vendors when something goes wrong, One Dorset Pathology has Fujifilm as a single point of contact. The arrangement also extends beyond Fujifilm’s own digital pathology software to include other laboratory products. For example, A. Menarini Diagnostics also has products within that ecosystem. Those types of partnerships are becoming more frequent, but it's still a slow transition.
So, costs remain high in the digital pathology market?
IF: Some of these scanners—the ones with the high-end robotics—are still around $500,000. Adopting digital pathology is largely an additive cost for laboratories. When radiology went digital, they saved costs on the consumables. But labs still have to make the slide in digital pathology, so they’re not saving anything immediately. Labs therefore have to justify an uncertain return based on scan volumes, workflow improvements, and projected efficiency gains.
Vendors are trying to address that problem more proactively. There are multiple ROI calculators available, and some are launching new initiatives to drive ROI sooner. One example is Proscia Aperture. Part of that solution identifies patients within a population who may be eligible for clinical trials, after which the lab gets a referral fee. There's also PathPresenter’s ConsultConnect, which allows labs to take referrals and third-party consulting, and that is obviously something that generates revenue from day one. However, many digital pathology vendors position their solutions as more efficient and cost effective, but they cannot quantify when those savings will materialize or even answer in a compelling way why labs need to invest today, not tomorrow.
Part of the problem also lies with how early an IT department is brought into the conversation, if there are wider plans for a larger IT overhaul, or if IT would rather the lab go with another vendor based on perceived advantages.
Are there other areas to discuss based on your research?
IF: There are also several interesting fringe technologies that are being developed by some of the vendors. There's direct-to-digital pathology, which eliminates the need for glass slide prep. It is interesting and worth watching, but it remains far from clinical validation.
There's also virtual staining, which uses AI to eliminate physical staining. That's an interesting case. If labs have virtual staining, then suddenly it becomes more analogous to radiology, because labs then don't have to purchase some of the consumables any more. That's worth keeping an eye on. But again, you need to validate it carefully, and the economics need to make sense.
Editor's note: Today's Clinical Lab will host its free 2026 Digital Pathology Digital Forum on June 26.
