PIRO: A web-based search platform for pathology reports, leveraging large language models to generate discrete searchable insights

Abstract

Pathologists rely on access to historical diagnostic case texts for research, education, and peer learning. However, many laboratory information systems (LIS), including Epic Beaker, lack optimized search tools tailored to pathology-specific text queries. To address this need, we developed PIRO (Pathology Information Retrieval Optimizer), a web-based platform enabling efficient text searches of diagnostic archives. Built using FastAPI, Angular, and Apache Solr, PIRO supports both basic and advanced search functionalities, faceted filtering, and data extraction, while ensuring compliance with institutional privacy protocols. PIRO's capabilities extend to case cohort building, search result export, and secure access control within the institutional network. In an 8-month study, we observed significantly higher PIRO adoption rates (67 %) among pathologists compared to Epic Beaker's SlicerDicer (9 %), underscoring PIRO's usability and relevance. Additionally, we implemented a large language model (LLM) to annotate reports with a “Malignancy Risk” label, enhancing search precision and enabling future expansion of automated annotations. Ongoing work focuses on integrating PIRO with our digital pathology platform, enabling direct access to digital slides from case results. PIRO's adaptable design makes it applicable across institutions, advancing search and retrieval efficiency in pathology archives and enhancing support for pathology research and education.