Seems very similar to how maps work on the web these days, in particular protomap files [0]. I wonder if you could view the medical images in leaflet or another frontend map library with the addition of a shim layer? Cool work!

0: https://protomaps.com/

Thanks! Indeed, digital pathology, satellite imaging and geospatial data share a lot of computational problems: efficient storage, fast spatial retrieval/indexing. I think this could be doable.

As for digital pathology, the field is very much tied to scanner-vendor proprietary formats (SVS, NDPI, MRXS, etc).