Digital Pathology Enables Automated and Quantitative Assessment of Inflammatory Activity in Patients with Chronic Liver Disease.

Fecha de publicación: 02/12/2021 Fecha Ahead of Print: 02/12/2021

Autores de IIS La Fe

• David Martí Aguado

  Autor

• Matías Fernández Patón

  Autor

• Mónica Elizabeth Bauza D'auria

  Autor

• Judith Pérez Rojas

  Autor

• Victoria Aguilera Sancho-Tello

  Autor

• Ángel Alberich Bayarri

  Autor

• 

  Luis Martí Bonmatí

  Autor

Participantes ajenos a IIS La Fe

• Alfaro-Cervello, Clara
• Mestre-Alagarda, Claudia
• Gallen-Peris, Ana
• Merino, Victor
• Benlloch, Salvador
• Ferrandez, Antonio
• Puglia, Victor
• Gimeno-Torres, Marta
• Monton, Cristina
• Escudero-Garcia, Desamparados
• Serra, Miguel A.

Grupos

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

  

  Leader

  Marina Berenguer Haym

• Investigacion Biomédica en Imagen (GIBI 2-30)

  Investigador Principal

  Leonor Cerdá Alberich

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 (? = 0.85-0.88), but only moderate for NAFLD (? = 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.

Keywords

• *chronic hepatitis; *digital pathology; *inflammation; *nonalcoholic fatty liver disease