Digital pathology and lipid droplet size as a key determinant of discrepancies between histology and MRI gradings in steatotic liver disease
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Le résumé fourni par la source
Abstract Background Hepatic steatosis grades derived from magnetic resonance imaging proton density fat fraction (MRI-PDFF) might disagree with those determined by histology. We investigated whether the size distribution of lipid droplets (LDs) assessed with digital image analysis (DIA) explains the discrepancies between histology and MRI-PDFF. Materials and methods Multicentric, prospective study of 355 patients with chronic liver disease, having paired biopsy and MRI. Using conventional microscopy, steatosis was graded by pathologists (S0-S3), based on the proportion of hepatocytes containing large LDs. MRI-PDFF graded steatosis using validated thresholds (PDFF-S1 ≥ 5.75%, PDFF-S2 ≥ 15.5%, PDFF-S3 ≥ 21.35%). DIA categorized LDs into tiny (< 1 μm 2 ), small (1–100 μm 2 ), and large (≥ 100 μm 2 ) subtypes. Multivariable modeling was performed to identify predictors of discordances. Results Histology- and PDFF-derived steatosis grades were discordant in 36%. Disagreement was associated with higher proportions of tiny and small LDs, and lower content of large LDs. Within histology-derived S0, disagreements were due to MRI overestimation having a higher content of tiny and small LDs. Within histology-derived S2-S3, disagreements were due to MRI underestimation, having a lower content of large and total LDs. Total LD proportionate area strongly correlated with MRI-PDFF ( r = 0.89). DIA showed that as steatosis accumulates, the size of LDs progressively increases. Conclusion Taking DIA as ground truth, the size distribution of LDs explains the discrepancies between histology and MRI-PDFF steatosis gradings. Compared to histology, MRI-PDFF overestimation is due to abundant tiny-small LDs, and underestimation is due to lower content of large LDs. These results indicate that MRI captures the whole spectrum of LD size, avoiding the conventional histology subjective assessment bias. Key Points Question Can the size distribution of hepatic lipid droplets (LDs), determined with digital pathology, provide insights into the discordances between histology and MRI-PDFF steatosis grading? Findings There is a 36% disagreement rate between histology and MRI-PDFF. Tiny and small LDs explain discordance, while large LDs favor concordance between both techniques . Clinical relevance MRI-PDFF captures the whole spectrum of LDs size beyond pathologists scoring system and strongly correlates with LDs total content avoiding conventional histology bias . Graphical Abstract
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Digital pathology and lipid droplet size as a key determinant of discrepancies between histology and MRI gradings in steatotic liver disease
- Date Crossref
- 08/08/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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INCLIVA Health Research Institute pays non établi dans la noticeÉtablissement de santé
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Universitat de València pays non établi dans la noticeUniversité ou école supérieure
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Leitat Technological Center pays non établi dans la noticeStructure de recherche
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Instituto de Investigación Sanitaria La Fe pays non établi dans la noticeOrganisation à but non lucratif
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Hospital Arnau de Vilanova Digestive Disease Department pays non établi dans la noticeÉtablissement de santé
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Hospital Universitari i Politècnic La Fe pays non établi dans la noticeÉtablissement de santé
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Instituto de Salud Carlos III Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas pays non établi dans la noticeOrganisme public
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Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas pays non établi dans la noticeStructure de recherche
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Universidad Cardenal Herrera CEU pays non établi dans la noticeUniversité ou école supérieure
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Center For Biomarker Research In Medicine pays non établi dans la noticeOrganisation à but non lucratif
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University of California San Diego Department of Radiology pays non établi dans la noticeUniversité ou école supérieure
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Clinic University Hospital Digestive Disease Department pays non établi dans la noticeUniversité ou école supérieure
INCLIVA Health Research Institute, Universitat de València et Leitat Technological Center, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.