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Pathology & Second Opinions

Digital Pathology and — Remote Slide Review

Your pathology slides do not need to travel to reach a specialist. Digital scanning turns glass slides into high-resolution files that any pathologist can review from anywhere in the world — without the original glass ever leaving the laboratory.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • No courier risk — Fragile glass slides are not shipped. The digital file is shared securely, leaving the original tissue intact at the first laboratory.
  • Accessible internationally — A specialist in another city or country can review your slides and issue a formal report without a physical visit.
  • Tissue remains available — Because the glass is not transported, your original sample stays safe for any further testing that may be needed.
  • The process is straightforward — You request your slides, they are scanned, and the file is shared. Most of the steps happen between laboratories, not between you and a clinic.
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Yes, your glass slides can be digitally scanned at high resolution and shared with any pathologist worldwide without couriering the glass. The College of American Pathologists and the Royal College of Pathologists recognise digital review as diagnostically equivalent to glass-slide review, when properly validated. Digital pathology is available in India.

How does digital pathology slide review work?

  1. Request your slides or tissue block

    Contact the pathology department of the hospital where your biopsy was done — not the general helpline. Quote your pathology report number and the biopsy date. You are entitled to your own tissue samples. Ask whether the laboratory can provide glass slides directly or whether the paraffin block needs to go to a scanning centre.

  2. The laboratory scans the slides

    A whole-slide imaging scanner photographs the entire surface of each glass slide at high magnification, producing a large digital image file. The process does not damage or consume any tissue. The original slide remains available for further testing after scanning.

  3. The digital file is shared securely

    The scanned image is uploaded to a secure digital pathology platform and made accessible to the reviewing pathologist. Relevant clinical information — your cancer type, stage, and any prior treatment — is shared alongside the images so the review has the full picture.

  4. The reviewing pathologist examines the slide

    Using specialised viewing software, the pathologist can zoom into any area of the tissue at the same magnification they would use at a conventional microscope. They compare what they see against the original report and clinical context before drawing their conclusions.

  5. A formal written report is issued

    The reviewing pathologist produces a written second-opinion report. Your oncologist uses this alongside the original report to confirm, refine, or reconsider the diagnosis before finalising your treatment plan.

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What do you need before requesting a digital second opinion?

  • Find out which hospital or laboratory holds your biopsy material and get the pathology department's direct contact number.
  • Locate your pathology report — the report number lets the laboratory find your sample quickly.
  • Confirm your biopsy tissue is stored in a paraffin block (FFPE format), which is standard and can be scanned.
  • Tell your oncologist you are seeking a second opinion so they can share clinical notes with the reviewing pathologist.
  • Ask whether any tissue was sent to an external laboratory at the time of biopsy — you may need to request it from a different site.
  • Keep a copy of your original pathology report to share with the reviewing team.

Did you know?

A single scanned whole-slide image of tumour tissue is typically a file several gigabytes in size — many times larger than a high-definition film.

That file can be reviewed by a pathologist in another country within minutes of being uploaded, with no glass slide ever shipped and no risk of it being lost or broken in transit.

Source: College of American Pathologists, Guideline on Validating Whole-Slide Imaging for Diagnostic Purposes

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Common questions

Frequently asked questions

Is digital slide review as accurate as looking at the original glass slide?

The College of American Pathologists and the Royal College of Pathologists both recognise digital pathology as diagnostically equivalent to conventional microscopy, provided the scanning equipment and workflow have been formally validated. The key condition is validation: not every scanner or software platform meets this standard, so it matters where the scanning is done. When arranging a digital second opinion, ask whether the centre uses a validated whole-slide imaging system.

Can any pathology laboratory scan slides?

No. Whole-slide imaging requires specific scanning hardware, validated software, and a tested workflow. Not every laboratory has this equipment. If your original laboratory cannot scan your slides, the glass slides or your paraffin tissue block can usually be transferred to a centre that can. The block is the priority — slides can be cut fresh from it if needed, so protecting the block matters more than protecting any individual stained slide.

How do I get my slides released from my current hospital?

Contact the pathology department directly with your pathology report number and biopsy date. You are entitled to your own tissue samples. Some hospitals release slides to you directly; others require a written request from a doctor. Start the process early, as it can take several days. In most cases a duplicate set of stained slides is prepared for release while the original paraffin block stays at the first laboratory, keeping both sites' interests intact.

Does CION coordinate digital pathology second opinions?

Yes. CION can help coordinate the scanning of your slides and a remote second opinion through our pathology network. Bring your existing pathology report and your tissue block or slides to any CION centre. The team will explain what steps are needed for your specific case and which specialist is most appropriate for your cancer type.

What happens if the second opinion disagrees with the first?

Disagreement between two pathologists happens, and it is more common in complex or rare tumour types. When reports differ, your oncologist will consider both opinions and may request a tumour board review or a third opinion. Additional tests — such as immunohistochemistry or molecular profiling — are sometimes used to resolve the question. A difference in pathology opinion is not a crisis; it is the reason second opinions exist. Treatment decisions are only as reliable as the diagnosis they rest on.

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