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PathoScribe: Transforming Pathology Data into a Living Library with a Unified LLM-Driven Framework for Semantic Retrieval and Clinical Integration

arXiv cs.AI / 3/11/2026

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Key Points

  • PathoScribe is a unified large language model (LLM) framework designed to transform static pathology archives into an interactive, searchable, and reasoning-enabled living library.
  • The system supports natural language case exploration, automated cohort construction, clinical question answering, immunohistochemistry panel recommendations, and report transformation within a single architecture.
  • Evaluated on 70,000 multi-institutional surgical pathology reports, PathoScribe achieved perfect Recall@10 for case retrieval and demonstrated strong retrieval-grounded reasoning quality with high reviewer scores.
  • PathoScribe significantly reduces cohort construction time and cost by automating cohort assembly from free-text eligibility criteria, achieving over 91% agreement with human reviewers and excluding no eligible cases.
  • This framework establishes a scalable foundation for converting digital pathology archives from passive repositories into active clinical intelligence platforms that can meaningfully inform patient care.

Computer Science > Computer Vision and Pattern Recognition

arXiv:2603.08935 (cs)
[Submitted on 9 Mar 2026]

Title:PathoScribe: Transforming Pathology Data into a Living Library with a Unified LLM-Driven Framework for Semantic Retrieval and Clinical Integration

View a PDF of the paper titled PathoScribe: Transforming Pathology Data into a Living Library with a Unified LLM-Driven Framework for Semantic Retrieval and Clinical Integration, by Abdul Rehman Akbar and 7 other authors
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Abstract:Pathology underpins modern diagnosis and cancer care, yet its most valuable asset, the accumulated experience encoded in millions of narrative reports, remains largely inaccessible. Although institutions are rapidly digitizing pathology workflows, storing data without effective mechanisms for retrieval and reasoning risks transforming archives into a passive data repository, where institutional knowledge exists but cannot meaningfully inform patient care. True progress requires not only digitization, but the ability for pathologists to interrogate prior similar cases in real time while evaluating a new diagnostic dilemma. We present PathoScribe, a unified retrieval-augmented large language model (LLM) framework designed to transform static pathology archives into a searchable, reasoning-enabled living library. PathoScribe enables natural language case exploration, automated cohort construction, clinical question answering, immunohistochemistry (IHC) panel recommendation, and prompt-controlled report transformation within a single architecture. Evaluated on 70,000 multi-institutional surgical pathology reports, PathoScribe achieved perfect Recall@10 for natural language case retrieval and demonstrated high-quality retrieval-grounded reasoning (mean reviewer score 4.56/5). Critically, the system operationalized automated cohort construction from free-text eligibility criteria, assembling research-ready cohorts in minutes (mean 9.2 minutes) with 91.3% agreement to human reviewers and no eligible cases incorrectly excluded, representing orders-of-magnitude reductions in time and cost compared to traditional manual chart review. This work establishes a scalable foundation for converting digital pathology archives from passive storage systems into active clinical intelligence platforms.
Subjects: Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI); Computation and Language (cs.CL); Digital Libraries (cs.DL); Information Retrieval (cs.IR)
Cite as: arXiv:2603.08935 [cs.CV]
  (or arXiv:2603.08935v1 [cs.CV] for this version)
  https://doi.org/10.48550/arXiv.2603.08935
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arXiv-issued DOI via DataCite

Submission history

From: Abdul Akbar [view email]
[v1] Mon, 9 Mar 2026 21:09:24 UTC (1,577 KB)
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