Liver steatosis assessment

Correlations among pathology, radiology, clinical data and automated image analysis software

Michael J. Lee, Pelin Bagci, Jun Kong, Miriam B. Vos, Puneet Sharma, Bobby T Kalb, Joel H. Saltz, Diego R Martin, N. Volkan Adsay, Alton B. Farris

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Quantitating hepatic steatosis is important in many liver diseases and liver transplantation. Since steatosis estimation by pathologists has inherent intra- and inter-observer variability, we compared and contrasted computerized techniques with magnetic resonance imaging measurements, pathologist visual scoring, and clinical parameters. Computerized methods applied to whole slide images included a commercial positive pixel count algorithm and a custom algorithm programmed at our institution. For all liver samples (n=59), including pediatric, adult, frozen section, and permanent specimens, statistically significant correlations were observed between pathology, radiology, and each image analysis modality (r=0.75-0.97, p<0.0001), with the strongest correlations in the pediatric cohort. Statistically significant relationships were observed between each method and with body mass index (r=0.37-0.56, p from <0.0001 to <0.05) and with albumin (r=0.55-0.64, p<0.05) but not with alanine aminotransferase or aspartate aminotransferase. Although pathologist assessments correlated (r=0.64-0.86, 0.92-0.97, and 0.78-0.91 for microvesicular, macrovesicular, and overall steatosis, respectively), the absolute values of hepatic steatosis visual assessment were susceptible to intra- and inter-observer variability, particularly for microvesicular steatosis. Image analysis, pathologist assessments, radiology measurements, and several clinical parameters all showed correlations in this study, providing evidence for the utility of each method in different clinical and research settings.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalPathology Research and Practice
Volume209
Issue number6
DOIs
StatePublished - Jun 2013

Fingerprint

Clinical Pathology
Fatty Liver
Radiology
Software
Observer Variation
Liver
Pediatrics
Frozen Sections
Aspartate Aminotransferases
Alanine Transaminase
Liver Transplantation
Liver Diseases
Albumins
Body Mass Index
Magnetic Resonance Imaging
Pathology
Pathologists
Research

Keywords

  • Image analysis
  • Liver
  • Magnetic resonance imaging (MRI)
  • Morphometry
  • Steatosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology

Cite this

Liver steatosis assessment : Correlations among pathology, radiology, clinical data and automated image analysis software. / Lee, Michael J.; Bagci, Pelin; Kong, Jun; Vos, Miriam B.; Sharma, Puneet; Kalb, Bobby T; Saltz, Joel H.; Martin, Diego R; Adsay, N. Volkan; Farris, Alton B.

In: Pathology Research and Practice, Vol. 209, No. 6, 06.2013, p. 371-379.

Research output: Contribution to journalArticle

Lee, Michael J. ; Bagci, Pelin ; Kong, Jun ; Vos, Miriam B. ; Sharma, Puneet ; Kalb, Bobby T ; Saltz, Joel H. ; Martin, Diego R ; Adsay, N. Volkan ; Farris, Alton B. / Liver steatosis assessment : Correlations among pathology, radiology, clinical data and automated image analysis software. In: Pathology Research and Practice. 2013 ; Vol. 209, No. 6. pp. 371-379.
@article{d31220b86cdf408f9b7127b4e54dd1d8,
title = "Liver steatosis assessment: Correlations among pathology, radiology, clinical data and automated image analysis software",
abstract = "Quantitating hepatic steatosis is important in many liver diseases and liver transplantation. Since steatosis estimation by pathologists has inherent intra- and inter-observer variability, we compared and contrasted computerized techniques with magnetic resonance imaging measurements, pathologist visual scoring, and clinical parameters. Computerized methods applied to whole slide images included a commercial positive pixel count algorithm and a custom algorithm programmed at our institution. For all liver samples (n=59), including pediatric, adult, frozen section, and permanent specimens, statistically significant correlations were observed between pathology, radiology, and each image analysis modality (r=0.75-0.97, p<0.0001), with the strongest correlations in the pediatric cohort. Statistically significant relationships were observed between each method and with body mass index (r=0.37-0.56, p from <0.0001 to <0.05) and with albumin (r=0.55-0.64, p<0.05) but not with alanine aminotransferase or aspartate aminotransferase. Although pathologist assessments correlated (r=0.64-0.86, 0.92-0.97, and 0.78-0.91 for microvesicular, macrovesicular, and overall steatosis, respectively), the absolute values of hepatic steatosis visual assessment were susceptible to intra- and inter-observer variability, particularly for microvesicular steatosis. Image analysis, pathologist assessments, radiology measurements, and several clinical parameters all showed correlations in this study, providing evidence for the utility of each method in different clinical and research settings.",
keywords = "Image analysis, Liver, Magnetic resonance imaging (MRI), Morphometry, Steatosis",
author = "Lee, {Michael J.} and Pelin Bagci and Jun Kong and Vos, {Miriam B.} and Puneet Sharma and Kalb, {Bobby T} and Saltz, {Joel H.} and Martin, {Diego R} and Adsay, {N. Volkan} and Farris, {Alton B.}",
year = "2013",
month = "6",
doi = "10.1016/j.prp.2013.04.001",
language = "English (US)",
volume = "209",
pages = "371--379",
journal = "Pathology Research and Practice",
issn = "0344-0338",
publisher = "Urban und Fischer Verlag GmbH und Co. KG",
number = "6",

}

TY - JOUR

T1 - Liver steatosis assessment

T2 - Correlations among pathology, radiology, clinical data and automated image analysis software

AU - Lee, Michael J.

AU - Bagci, Pelin

AU - Kong, Jun

AU - Vos, Miriam B.

AU - Sharma, Puneet

AU - Kalb, Bobby T

AU - Saltz, Joel H.

AU - Martin, Diego R

AU - Adsay, N. Volkan

AU - Farris, Alton B.

PY - 2013/6

Y1 - 2013/6

N2 - Quantitating hepatic steatosis is important in many liver diseases and liver transplantation. Since steatosis estimation by pathologists has inherent intra- and inter-observer variability, we compared and contrasted computerized techniques with magnetic resonance imaging measurements, pathologist visual scoring, and clinical parameters. Computerized methods applied to whole slide images included a commercial positive pixel count algorithm and a custom algorithm programmed at our institution. For all liver samples (n=59), including pediatric, adult, frozen section, and permanent specimens, statistically significant correlations were observed between pathology, radiology, and each image analysis modality (r=0.75-0.97, p<0.0001), with the strongest correlations in the pediatric cohort. Statistically significant relationships were observed between each method and with body mass index (r=0.37-0.56, p from <0.0001 to <0.05) and with albumin (r=0.55-0.64, p<0.05) but not with alanine aminotransferase or aspartate aminotransferase. Although pathologist assessments correlated (r=0.64-0.86, 0.92-0.97, and 0.78-0.91 for microvesicular, macrovesicular, and overall steatosis, respectively), the absolute values of hepatic steatosis visual assessment were susceptible to intra- and inter-observer variability, particularly for microvesicular steatosis. Image analysis, pathologist assessments, radiology measurements, and several clinical parameters all showed correlations in this study, providing evidence for the utility of each method in different clinical and research settings.

AB - Quantitating hepatic steatosis is important in many liver diseases and liver transplantation. Since steatosis estimation by pathologists has inherent intra- and inter-observer variability, we compared and contrasted computerized techniques with magnetic resonance imaging measurements, pathologist visual scoring, and clinical parameters. Computerized methods applied to whole slide images included a commercial positive pixel count algorithm and a custom algorithm programmed at our institution. For all liver samples (n=59), including pediatric, adult, frozen section, and permanent specimens, statistically significant correlations were observed between pathology, radiology, and each image analysis modality (r=0.75-0.97, p<0.0001), with the strongest correlations in the pediatric cohort. Statistically significant relationships were observed between each method and with body mass index (r=0.37-0.56, p from <0.0001 to <0.05) and with albumin (r=0.55-0.64, p<0.05) but not with alanine aminotransferase or aspartate aminotransferase. Although pathologist assessments correlated (r=0.64-0.86, 0.92-0.97, and 0.78-0.91 for microvesicular, macrovesicular, and overall steatosis, respectively), the absolute values of hepatic steatosis visual assessment were susceptible to intra- and inter-observer variability, particularly for microvesicular steatosis. Image analysis, pathologist assessments, radiology measurements, and several clinical parameters all showed correlations in this study, providing evidence for the utility of each method in different clinical and research settings.

KW - Image analysis

KW - Liver

KW - Magnetic resonance imaging (MRI)

KW - Morphometry

KW - Steatosis

UR - http://www.scopus.com/inward/record.url?scp=84878390629&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878390629&partnerID=8YFLogxK

U2 - 10.1016/j.prp.2013.04.001

DO - 10.1016/j.prp.2013.04.001

M3 - Article

VL - 209

SP - 371

EP - 379

JO - Pathology Research and Practice

JF - Pathology Research and Practice

SN - 0344-0338

IS - 6

ER -