Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Binder, L.
Morphometric analysis of hepatic steatosis and fibrosis in patients with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2015. pp. 59
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Lackner Karoline
- Stauber Rudolf
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- Abstract:
- BACKGROUND & AIMS: NAFLD (non-alcoholic fatty liver disease) has the potential to progress to non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis which paves the way for the development of hepatocellular carcinoma. Over the last decades the prevalence of NAFLD has reached an epidemic dimension and therefore is to be considered a major problem of public health. Several formal scoring systems have been developed for the semiquantitative evaluation of the histological activity (grade) and degree of fibrosis (stage), however, as has been shown by a number of studies these scoring systems are prone to inter- as well as intra-observer bias, which might be improved by the use of computer assisted digital image analysis. METHODS: Liver samples from biopsies of 41 patients with non-cirrhotic NASH (recruited from the University of Virginia liver clinic) were analysed using Definiens™ Tissue Studio V3.51to assess their levels of hepatic fibrosis and hepatocellular steatosis. Results were compared with semiquantitative histological scoring systems as well as magnetic resonance imaging (MRI). RESULTS: In hepatocellular steatosis detection, digital image analysis showed better correlation (r = 0,794 ; p < 0,001) with the gold standard method (Dixon modificated MRI measurement), than semiquantitative histological scoring (¿ = 0,704 ; p = 0,001). The detection of hepatic fibrosis (which was much harder to perform), only showed significant correlation to the semiquantitative histological scoring results of one of the two observers (¿ = 0,517 ; p = 0,01). CONCLUSIONS: Digital image analysis is a useful tool to assess hepatocellular steatosis as well as hepatic fibrosis in liver specimen. It is able to detect minimal changes in histologic features very precisely. Still, this method is currently still unable to provide important information like the diseases‘ activity, which clearly suggests that digital image analysis can only assist, but never replace the well-trained eye of a histopathologist.