Adaptive compression framework for giga-pixel whole slide images

Digital pathology generates gigapixel whole-slide images that require extensive storage, limiting scalability and increasing costs. Traditional compression methods apply uniform ratios, disregarding variations in diagnostic importance across regions. Here we show Adaptive compression for gigapixel whole-slide images (AdaSlide), a framework that balances compression efficiency and diagnostic integrity. AdaSlide integrates a reinforcement learning-based Compression Decision Agent (CDA) that determines the optimal compression ratio per region, and a Foundational Image Enhancer (FIE) that restores visual fidelity after compression. In evaluations, pathologists achieved near-chance accuracy (55%) in distinguishing original from restored images, confirming high perceptual fidelity. Across 13 downstream tasks, AdaSlide maintained diagnostic performance in most tasks while reducing storage to 10-35% of the original size. By aligning compression strategies with clinical relevance, AdaSlide enables efficient, scalable, and reliable storage for digital pathology and future AI development. Lee and colleagues present AdaSlide, an AI-driven adaptive compression system for gigapixel pathology slides that preserves diagnostic quality while reducing storage by up to 90%, enabling scalable and cost-efficient digital pathology archiving.