I am curious what digital pathology libraries you are referring to (by any chance, is one of them https://www.openmicroscopy.org/bio-formats/ ?)

Also, I am sure you are aware the DICOM folks have been trying to get digital pathology pulled into the standard. I am not sure how much success they have had, but David Clunie (the current editor of the standard and a very friendly and open-minded person) had a funny set of power point slides about this topic. I recommend taking a look just for the humor:

https://www.dclunie.com/papers/HIMA_2017_DICOMWSI_Clunie.pdf