Stereological Analysis of Liver Biopsy Histology Sections as a Reference Standard for Validating Non-Invasive Liver Fat Fraction Measurements by MRI.
Stereological Analysis of Liver Biopsy Histology Sections as a Reference Standard for Validating Non-Invasive Liver Fat Fraction Measurements by MRI.
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DOI：
10.1371/journal.pone.0160789
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Adams LA
中科院分区：
文献类型：
--
作者：
St Pierre TG;House MJ;Bangma SJ;Pang W;Bathgate A;Gan EK;Ayonrinde OT;Bhathal PS;Clouston A;Olynyk JK;Adams LA
验证无创肝脂肪定量方法需要一个参考标准。然而，使用标准的肝活检组织病理学评估是有问题的，因为重复性差。我们的目的是评估在肝活检中测量体积肝脂肪分数（VLFF）的立体学方法，并使用该方法验证用于测量VLFF的磁共振成像方法。在59名受试者中测量vlff(1)由三名独立分析人员使用体视点计数技术结合Delesse原理对肝脏活检组织学切片进行测量，(2)由三名独立分析人员使用HepaFat-Scan®技术对肝脏磁共振图像进行测量。采用Bland Altman统计和类内相关性（IC）来评估每种方法的可重复性和肝脂肪分数测量方法之间的偏倚。体视学和HepaFat-Scan®方法的分析师间重复性系数分别为8.2 (95% CI 7.7-8.8)%和2.4 (95% CI 2.2-2.5)% VLFF。IC系数分别为0.86 （95% CI 0.69 ~ 0.93）和0.990 （95% CI 0.985 ~ 0.994）。使用立体分析的两对分析者之间观察到较小的偏差（≤3.4%），而使用HepaFat-Scan®的三对分析者之间没有观察到显著的偏差。在HepaFat-Scan®方法和立体学方法之间观察到1.4±0.5%的VLFF偏差。体视学方法的重复性优于先前报道的组织病理学家评估肝脂肪变性的表现，是验证无创测量VLFF方法的合适参考标准。
Validation of non-invasive methods of liver fat quantification requires a reference standard. However, using standard histopathology assessment of liver biopsies is problematical because of poor repeatability. We aimed to assess a stereological method of measuring volumetric liver fat fraction (VLFF) in liver biopsies and to use the method to validate a magnetic resonance imaging method for measurement of VLFF. VLFFs were measured in 59 subjects (1) by three independent analysts using a stereological point counting technique combined with the Delesse principle on liver biopsy histological sections and (2) by three independent analysts using the HepaFat-Scan® technique on magnetic resonance images of the liver. Bland Altman statistics and intraclass correlation (IC) were used to assess the repeatability of each method and the bias between the methods of liver fat fraction measurement. Inter-analyst repeatability coefficients for the stereology and HepaFat-Scan® methods were 8.2 (95% CI 7.7–8.8)% and 2.4 (95% CI 2.2–2.5)% VLFF respectively. IC coefficients were 0.86 (95% CI 0.69–0.93) and 0.990 (95% CI 0.985–0.994) respectively. Small biases (≤3.4%) were observable between two pairs of analysts using stereology while no significant biases were observable between any of the three pairs of analysts using HepaFat-Scan®. A bias of 1.4±0.5% VLFF was observed between the HepaFat-Scan® method and the stereological method. Repeatability of the stereological method is superior to the previously reported performance of assessment of hepatic steatosis by histopathologists and is a suitable reference standard for validating non-invasive methods of measurement of VLFF.