## 4 Discussion  
Korean pathologists showed high positive expectations for implementing a DPS, but the main reasons for implementing a DPS differed according to the types of medical institutions where they worked and their careers. Pathologists placed high significance on digital pathology to be able to view pathologic images in a digitized form without finding an individual patient's glass slides in a warehouse. Pathologists had low expectations regarding the use of CAD to lead to reduced work hours or workload. However, the group that responded positively regarding DPS implementation had relatively high expectations for reduced work hours and workload. Pathologists working at medical institutions using digital pathology showed higher satisfaction with DPSs than pathologists working at institutions that did not use them. Although many pathologists were positive about DPSs, pathologists thought that the most considerable obstacle to the introduction of these systems was the high introduction cost. In particular, in Korea, DPS implementation is entirely borne by the medical institution that introduces the program; thus, each medical institution has a considerable burden for system introduction. A reduction in the high initial investment can be accomplished through the provision of incentives for hospitals by creating pathological 'big data' and academic alliances of companies and/or academia, establishing a nationwide DPS infrastructure, and, in the long run, improving market participation of more scanner manufacturers and DPS developers. In this survey, some pathologists were concerned that the implementation of digital pathology could increase pathologists' workload. In particular, the group who had negative perceptions of implementing digital pathology had low expectations for a reduced workload and working hours, while their expectations for the use of DPSs in consultation and education tended to be high. Therefore, to increase positive perceptions of digital pathology among more pathologists, demonstrating and practically promoting that the introduction of digital pathology can actually reduce pathologists' workload and working hours is important. It may also be necessary to provide a national or global interface of DPSs for consultation and education. When implementing a DPS, conducting systematic and repetitive education for pathologists considering their IT proficiency is necessary. In addition, considerable effort is needed to customized programs that can be interfaced with each hospital's own medical record system. To date, data on the merits of digital pathology from commercial companies that provide digital pathology have suggested the overall efficiency of pathologic diagnosis. However, there has been not much evidence of a reduced pathologist workload or the convenience of using CAD software considering the medical system of each country [14; 15; 16]. This may be because few hospitals have introduced and implemented DPSs in the overall workflow of their pathology departments and because CAD software other than morphometric software is also rarely used. To date, CAD software has been developed with a focus on naming or grading malignancies; however, pathologists had many demands that various prognosis- and treatment-related characteristics be present on pathology diagnostic reports. Considering this, future CAD software will need to be developed based on these unmet needs for various convenient functions to help pathologists in the process of preparing diagnostic reports. Since the incidence of prostate cancer is high, most cases are adenocarcinoma, and the histological grading and reporting guidelines are well established, and many studies using digital pathology have been conducted from the early days of the introduction of AI in the pathology field [17]. Most studies on prostate cancer have been aimed at accurate cancer segmentation and Gleason grade/grade group suggestion [5; 8; 9; 10; 11].