Paige.AI, Inc. stores petabytes of data on Microsoft Azure to help pathologists and thousands of patients with quicker cancer diagnoses

Hundreds of thousands of Americans receive a cancer diagnosis each year. Paige.AI, Inc. (Paige), a company dedicated to researching new technology to improve cancer diagnoses, has been developing unique software products to help pathologists make quicker, more confident diagnoses; increase the efficiency of cancer treatment; improve patient outcomes; enhance pathologists’ experiences; and help save lives. 

Paige decided to assist pathologists by creating easier ways to diagnose cancers on computers without the need for microscopes. It also wanted to create new AI applications that can pinpoint cancer in seconds to speed diagnoses and reduce errors. Paige needed a way to manage, store, and analyze its vast library of cancer images, which is approaching 10 petabytes in size, so that it could build AI solutions at scale.

To do this, Paige has been migrating its data to Microsoft Azure. With Azure, Paige can build diagnostic AI applications that help pathologists make more informed decisions and share diagnostic images among cancer experts worldwide.

Storing petabytes of image data in a globally accessible solution

No solid cancer, such as breast or prostate cancer, can be diagnosed without an anatomical pathologist, a specialist trained to study tissues and cells for diseases and cancers. Today, pathologists do this using a microscope and a glass slide with preparations of tissue biopsies. Relying on the human eye to interpret tissue changes is a task that is highly manual, cumbersome, and subject to error. 

Paige wanted to build future-proof cloud solutions for the pathology market rather than an on-premises solution. “A single glass slide in pathology generates an image between one and two gigabytes,” says Razik Yousfi, Senior Vice President for Technology at Paige. “Some large medical centers can generate up to 1.5 million glass slides a year. Doing the math, on-premises physical storage of these volumes of super-large images was neither cost-effective nor practical.” 

 Following US Food and Drug Administration (FDA) clearance, Paige released FullFocus®, a cloud-based image viewer. FullFocus facilitated digital image sharing between local pathologists or experts worldwide for more efficient and confident diagnoses for thousands of patients. It helped pathologists view large, multi-resolution images on a computer directly from the cloud, providing an experience comparable to using a physical microscope.

Using AI and Microsoft Azure to accelerate cancer diagnoses with data from millions of images

Next, Paige wanted to use the latest developments in AI infrastructure to develop AI solutions and assist doctors in making faster, more confident diagnoses. “By training deep-learning algorithms on millions of images and billions of pixels, systems can be developed to automatically detect cancer in tissue that may otherwise be missed by the human eye,” says Yousfi. 

Paige created an AI-driven cancer detection system for prostate cancer, Paige Prostate Detect, that assists pathologists in detecting suspicious foci (microscopic visualizations of tumor cells) that are easy to miss. Paige Prostate Detect was the first AI application in pathology to receive FDA approval. “We cleared Paige Prostate Detect through the FDA in 2021 as an AI application. It is now being used in laboratories worldwide to help diagnose and improve the lives of real patients. We continue to expand our AI portfolio in other cancer types,” says Yousfi.

Once deployed, AI applications require advanced computational power to analyze the billions of pixels in pathology images, identify cancerous areas, and grade the aggressiveness of the cancer. Hospitals generally don’t have this capability, so Paige sought a cloud-native solution in Azure. 

In 2023, Paige decided to migrate its data from Amazon Web Services to Azure and developed a three-phase plan to accomplish that migration without interfering with its service to customers.

Partnering with Microsoft on phased cloud migration and doubling adoption among pathologists

In the first phase of its migration, Paige transferred its high-performance computing and AI training resources to Azure so that it could provide that training in the cloud using GPU and CPU Azure Virtual Machines. In the second phase, Paige is migrating its data and that of its customers to Azure Blob Storage, which provides secure and massively scalable storage for unstructured data and similar objects. 

In the third phase, Paige plans to redeploy its entire platform on Azure. It will use Azure AI Infrastructure, an advanced and scalable infrastructure designed to meet the high-performance demands of new AI technology, to provide pathologists with easier, less expensive access to machine learning inference, data, and other offerings. “AI from Paige is transforming cancer diagnostics today and will continue to as we build a comprehensive portfolio of AI applications. This is set to become the norm that patients expect from hospitals,” says Andy Moye, CEO of Paige.

Paige joined the Microsoft co-selling initiative and worked closely with the Microsoft team to optimize its AI practices for the best possible outcomes. With its global reach, Microsoft is helping Paige market its innovative AI solutions to more hospitals and medical centers than ever, with a goal to double the number of pathologists using the platform every year.

“We didn’t see Microsoft as just Azure,” says Yousfi. “We looked at Microsoft as a comprehensive partner that helps us with adoption of the technology and migration to Azure as well as a partner through Microsoft Research and in AI development. Microsoft is the right partner for Paige across many strategic initiatives and projects.” 

Providing an all-in-one solution for digital pathology

By collaborating with Microsoft and other organizations, Paige hopes to provide a cost-effective, accessible solution to pathologists, facilitating faster and more informed cancer diagnoses and better care for patients. 

“We want to continue to offer best-in-class solutions, marrying the top players in this space to provide digital pathology and AI solutions that overcome challenges in cancer diagnosis and help more patients,” says Yousfi. “We’re partnering with Microsoft and others to make the adoption of these solutions as easy and transparent as possible.” 

Paige intends to continue its migration onto Azure and develop more AI-driven tools to help fight cancer.

“That’s why we come to work every day,” says Mark Fleishman, Vice President of Infrastructure and Operations at Paige. “We come to modernize healthcare through technology and are confident that we can make the lives of cancer patients better.” 

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