1. Digital Pathology Enables Automated and Quantitative Assessment of Inflammatory Activity in Patients with Chronic Liver Disease
- Author
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David Marti-Aguado, Matías Fernández-Patón, Clara Alfaro-Cervello, Claudia Mestre-Alagarda, Mónica Bauza, Ana Gallen-Peris, Víctor Merino, Salvador Benlloch, Judith Pérez-Rojas, Antonio Ferrández, Víctor Puglia, Marta Gimeno-Torres, Victoria Aguilera, Cristina Monton, Desamparados Escudero-García, Ángel Alberich-Bayarri, Miguel A. Serra, and Luis Marti-Bonmati
- Subjects
digital pathology ,inflammation ,nonalcoholic fatty liver disease ,chronic hepatitis ,Microbiology ,QR1-502 - Abstract
Traditional histological evaluation for grading liver disease severity is based on subjective and semi-quantitative scores. We examined the relationship between digital pathology analysis and corresponding scoring systems for the assessment of hepatic necroinflammatory activity. A prospective, multicenter study including 156 patients with chronic liver disease (74% nonalcoholic fatty liver disease-NAFLD, 26% chronic hepatitis-CH etiologies) was performed. Inflammation was graded according to the Nonalcoholic Steatohepatitis (NASH) Clinical Research Network system and METAVIR score. Whole-slide digital image analysis based on quantitative (I-score: inflammation ratio) and morphometric (C-score: proportionate area of staining intensities clusters) measurements were independently performed. Our data show that I-scores and C-scores increase with inflammation grades (p < 0.001). High correlation was seen for CH (ρ = 0.85–0.88), but only moderate for NAFLD (ρ = 0.5–0.53). I-score (p = 0.008) and C-score (p = 0.002) were higher for CH than NAFLD. Our MATLAB algorithm performed better than QuPath software for the diagnosis of low-moderate inflammation (p < 0.05). C-score AUC for classifying NASH was 0.75 (95%CI, 0.65–0.84) and for moderate/severe CH was 0.99 (95%CI, 0.97–1.00). Digital pathology measurements increased with fibrosis stages (p < 0.001). In conclusion, quantitative and morphometric metrics of inflammatory burden obtained by digital pathology correlate well with pathologists’ scores, showing a higher accuracy for the evaluation of CH than NAFLD.
- Published
- 2021
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