Automated quantification and architectural pattern detection of hepatic fibrosis in NAFLD

• Published in: Annals of diagnostic pathology Vol. 47; p. 151518
• Main Authors: Gawrieh, Samer, Sethunath, Deepak, Cummings, Oscar W., Kleiner, David E., Vuppalanchi, Raj, Chalasani, Naga, Tuceryan, Mihran
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.2020
• Subjects: Artificial intelligence; Automation; Digital image analysis; NASH; Automation; NASH; Digital image analysis; Artificial intelligence
• ISSN: 1092-9134; 1532-8198
• DOI: 10.1016/j.anndiagpath.2020.151518

Accurate detection and quantification of hepatic fibrosis remain essential for assessing the severity of non-alcoholic fatty liver disease (NAFLD) and its response to therapy in clinical practice and research studies. Our aim was to develop an integrated artificial intelligence-based automated tool to detect and quantify hepatic fibrosis and assess its architectural pattern in NAFLD liver biopsies. Digital images of the trichrome-stained slides of liver biopsies from patients with NAFLD and different severity of fibrosis were used. Two expert liver pathologists semi-quantitatively assessed the severity of fibrosis in these biopsies and using a web applet provided a total of 987 annotations of different fibrosis types for developing, training and testing supervised machine learning models to detect fibrosis. The collagen proportionate area (CPA) was measured and correlated with each of the pathologists semi-quantitative fibrosis scores. Models were created and tested to detect each of six potential fibrosis patterns. There was good to excellent correlation between CPA and the pathologist score of fibrosis stage. The coefficient of determination (R2) of automated CPA with the pathologist stages ranged from 0.60 to 0.86. There was considerable overlap in the calculated CPA across different fibrosis stages. For identification of fibrosis patterns, the models areas under the receiver operator curve were 78.6% for detection of periportal fibrosis, 83.3% for pericellular fibrosis, 86.4% for portal fibrosis and >90% for detection of normal fibrosis, bridging fibrosis, and presence of nodule/cirrhosis. In conclusion, an integrated automated tool could accurately quantify hepatic fibrosis and determine its architectural patterns in NAFLD liver biopsies. •Accurate detection and quantification of fibrosis are essential for assessing NAFLD severity and its response to therapy.•Machine learning, an artificial intelligence method, was used for global automated assessment of hepatic fibrosis in NAFLD.•Continuous quantification of collagen proportionate area correlated well with expert liver pathologists’ fibrosis stages.•Accurate automated detection of different architectural patterns of fibrosis distribution in NAFLD liver biopsies is novel.•Global assessment is attained by combining automated quantification of fibrosis and detection of its distribution patterns.