Hepatic steatosis estimated microscopically versus digital image analysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorHALL, Andrew R.
dc.contributor.authorDHILLON, Amar P.
dc.contributor.authorGREEN, Anna C.
dc.contributor.authorFERRELL, Linda
dc.contributor.authorCRAWFORD, James M.
dc.contributor.authorALVES, Venancio
dc.contributor.authorBALABAUD, Charles
dc.contributor.authorBHATHAL, Prithi
dc.contributor.authorBIOULAC-SAGE, Paulette
dc.contributor.authorGUIDO, Maria
dc.contributor.authorHYTIROGLOU, Prodromos
dc.contributor.authorNAKANUMA, Yasuni
dc.contributor.authorPARADIS, Valerie
dc.contributor.authorQUAGLIA, Alberto
dc.contributor.authorSNOVER, Dale
dc.contributor.authorTHEISE, Neil
dc.contributor.authorTHUNG, Swan
dc.contributor.authorTSUI, Wilson
dc.contributor.authorLEEUWEN, Dirk J. van
dc.date.accessioned2013-09-23T16:44:32Z
dc.date.available2013-09-23T16:44:32Z
dc.date.issued2013
dc.description.abstractBackground & Aims Evaluate in liver biopsies: (i) interobserver agreement of estimates of fat proportionate area (eFPA) and steatosis grading, (ii) the relationship between steatosis grades and measured fat proportionate area (mFPA, digital image analysis), (iii) the accuracy of eFPA, (iv) to present images to aid standardization and accuracy of eFPA. Methods Twenty-one liver biopsies were selected from the Royal Free Hospital (RFH) histopathology archive to represent the full range of histopathological steatosis severity. As many non-overlapping fields of parenchyma as possible were photographed at x20 objective magnification from the biopsies (n=651). A total of 15 sample images were selected to represent the range of steatosis seen. Twelve hepatopathologists from 11 sites worldwide independently evaluated the sample images for steatosis grade [normal (none)/mild/moderate/severe], and eFPA (% area of liver parenchyma occupied by fat). Results The hepatopathologists had good linear correlation between eFPA and mFPA for sample images (r=0.924, P<.001) and excellent concordance (kappa=0.91, P<0.001). Interobserver concordance of steatosis grade showed substantial agreement' (kappa=0.64). There was significant difference between eFPA and mFPA in the sample images for mild, moderate and severe steatosis (P=0.024, P<0.001, P<0.001 respectively): the observers consistently over-estimated the eFPA. Conclusion Hepatopathologists showed excellent' interobserver agreement in eFPA and substantial' agreement in assigning steatosis grade (precision was high). However, compared with mFPA, eFPA was inaccurate. eFPA systematically exceeds mFPA; generally the overestimation increases with severity of steatosis. Considering that non-invasive technologies for estimating liver fat utilize histopathology as reference, such assessments would benefit from quantitative validation of visually estimated microscopic liver fat percentages.
dc.description.indexMEDLINE
dc.identifier.citationLIVER INTERNATIONAL, v.33, n.6, p.926-935, 2013
dc.identifier.doi10.1111/liv.12162
dc.identifier.issn1478-3223
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/2183
dc.language.isoeng
dc.publisherWILEY-BLACKWELL
dc.relation.ispartofLiver International
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY-BLACKWELL
dc.subjectalcoholic liver disease
dc.subjectdigital image analysis
dc.subjectestimated fat proportionate area
dc.subjectfat proportionate area
dc.subjectfat quantification
dc.subjectmeasured fat proportionate area
dc.subjectnon-alcoholic fatty liver disease
dc.subjectsteatosis
dc.subject.otherfatty liver-disease
dc.subject.othernoninvasive assessment
dc.subject.othermr spectroscopy
dc.subject.otherrisk-factor
dc.subject.othertransplantation
dc.subject.otherbiopsies
dc.subject.otherresection
dc.subject.othersoftware
dc.subject.wosGastroenterology & Hepatology
dc.titleHepatic steatosis estimated microscopically versus digital image analysis
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryAustrália
hcfmusp.affiliation.countryChina
hcfmusp.affiliation.countryJapão
hcfmusp.affiliation.countryGrécia
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryInglaterra
hcfmusp.affiliation.countryFrança
hcfmusp.affiliation.countryisogb
hcfmusp.affiliation.countryisous
hcfmusp.affiliation.countryisofr
hcfmusp.affiliation.countryisoau
hcfmusp.affiliation.countryisoit
hcfmusp.affiliation.countryisogr
hcfmusp.affiliation.countryisojp
hcfmusp.affiliation.countryisocn
hcfmusp.author.externalHALL, Andrew R.:Royal Free London NHS Fdn Trust, Dept Cellular Pathol, London NW3 2QG, England
hcfmusp.author.externalDHILLON, Amar P.:UCL Med Sch, Dept Cellular Pathol, London, England
hcfmusp.author.externalGREEN, Anna C.:Royal Free London NHS Fdn Trust, Dept Cellular Pathol, London NW3 2QG, England
hcfmusp.author.externalFERRELL, Linda:Univ Calif San Francisco, Dept Anat Pathol, San Francisco, CA 94143 USA
hcfmusp.author.externalCRAWFORD, James M.:Hofstra North Shore LIJ Sch Med, Dept Pathol & Lab Med, Manhasset, NY USA
hcfmusp.author.externalBALABAUD, Charles:Univ Bordeaux 2, INSERM, U1053, F-33076 Bordeaux, France
hcfmusp.author.externalBHATHAL, Prithi:Univ Melbourne, Dept Pathol, Melbourne, Vic, Australia
hcfmusp.author.externalBIOULAC-SAGE, Paulette:Univ Bordeaux 2, INSERM, U1053, F-33076 Bordeaux, France; Hop Pellegrin, Dept Pathol, F-33076 Bordeaux, France
hcfmusp.author.externalGUIDO, Maria:Univ Padua, Dept Med DIMED, Sect Anat Pathol, Padua, Italy
hcfmusp.author.externalHYTIROGLOU, Prodromos:Aristotle Univ Thessaloniki, Sch Med, Dept Pathol, GR-54006 Thessaloniki, Greece
hcfmusp.author.externalNAKANUMA, Yasuni:Kanazawa Univ, Grad Sch Med, Dept Human Pathol, Kanazawa, Ishikawa, Japan
hcfmusp.author.externalPARADIS, Valerie:Hop Beaujon, Anat Pathol Lab, Clichy, France
hcfmusp.author.externalQUAGLIA, Alberto:Kings Coll Hosp London, Inst Liver Studies, London, England
hcfmusp.author.externalSNOVER, Dale:Fairview Southdale Hosp, Dept Pathol, Edina, MN USA
hcfmusp.author.externalTHEISE, Neil:Beth Israel Deaconess Med Ctr, Div Digest Dis, New York, NY 10003 USA
hcfmusp.author.externalTHUNG, Swan:Mt Sinai Sch Med, Dept Pathol, New York, NY USA
hcfmusp.author.externalTSUI, Wilson:Caritas Med Ctr, Dept Pathol, Hong Kong, Hong Kong, Peoples R China
hcfmusp.author.externalLEEUWEN, Dirk J. van:Onze Lieve Vrouw Hosp, Amsterdam, Netherlands; Geisel Sch Med Dartmouth, Dept Gastroenterol & Hepatol, Hanover, NH USA
hcfmusp.citation.scopus41
hcfmusp.contributor.author-fmusphcVENANCIO AVANCINI FERREIRA ALVES
hcfmusp.description.beginpage926
hcfmusp.description.endpage935
hcfmusp.description.issue6
hcfmusp.description.volume33
hcfmusp.origemWOS
hcfmusp.origem.pubmed23560780
hcfmusp.origem.scopus2-s2.0-84878897156
hcfmusp.origem.wosWOS:000320139000015
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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