Hepatic steatosis estimated microscopically versus digital image analysis

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art_ALVES_Hepatic_steatosis_estimated_microscopically_versus_digital_image_analysis_2013.PDF (873.05 KB)
Citações na Scopus
41
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Autores
HALL, Andrew R.
DHILLON, Amar P.
GREEN, Anna C.
FERRELL, Linda
CRAWFORD, James M.
BALABAUD, Charles
BHATHAL, Prithi
BIOULAC-SAGE, Paulette
GUIDO, Maria
Citação
LIVER INTERNATIONAL, v.33, n.6, p.926-935, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background & 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.
Palavras-chave
alcoholic liver disease, digital image analysis, estimated fat proportionate area, fat proportionate area, fat quantification, measured fat proportionate area, non-alcoholic fatty liver disease, steatosis
URI
https://observatorio.fm.usp.br/handle/OPI/2183
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/14