Cargando…
The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies
BACKGROUND: In renal biopsy reporting, quantitative measurements, such as glomerular number and percentage of globally sclerotic glomeruli, is central to diagnostic accuracy and prognosis. The aim of this study is to determine the number of glomeruli and percent globally sclerotic in renal biopsies...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911144/ https://www.ncbi.nlm.nih.gov/pubmed/27310011 http://dx.doi.org/10.1371/journal.pone.0156441 |
_version_ | 1782438093838614528 |
---|---|
author | Rosenberg, Avi Z. Palmer, Matthew Merlino, Lino Troost, Jonathan P. Gasim, Adil Bagnasco, Serena Avila-Casado, Carmen Johnstone, Duncan Hodgin, Jeffrey B. Conway, Catherine Gillespie, Brenda W. Nast, Cynthia C. Barisoni, Laura Hewitt, Stephen M. |
author_facet | Rosenberg, Avi Z. Palmer, Matthew Merlino, Lino Troost, Jonathan P. Gasim, Adil Bagnasco, Serena Avila-Casado, Carmen Johnstone, Duncan Hodgin, Jeffrey B. Conway, Catherine Gillespie, Brenda W. Nast, Cynthia C. Barisoni, Laura Hewitt, Stephen M. |
author_sort | Rosenberg, Avi Z. |
collection | PubMed |
description | BACKGROUND: In renal biopsy reporting, quantitative measurements, such as glomerular number and percentage of globally sclerotic glomeruli, is central to diagnostic accuracy and prognosis. The aim of this study is to determine the number of glomeruli and percent globally sclerotic in renal biopsies by means of registration of serial tissue sections and manual enumeration, compared to the numbers in pathology reports from routine light microscopic assessment. DESIGN: We reviewed 277 biopsies from the Nephrotic Syndrome Study Network (NEPTUNE) digital pathology repository, enumerating 9,379 glomeruli by means of whole slide imaging. Glomerular number and the percentage of globally sclerotic glomeruli are values routinely recorded in the official renal biopsy pathology report from the 25 participating centers. Two general trends in reporting were noted: total number per biopsy or average number per level/section. Both of these approaches were assessed for their accuracy in comparison to the analogous numbers of annotated glomeruli on WSI. RESULTS: The number of glomeruli annotated was consistently higher than those reported (p<0.001); this difference was proportional to the number of glomeruli. In contrast, percent globally sclerotic were similar when calculated on total glomeruli, but greater in FSGS when calculated on average number of glomeruli (p<0.01). The difference in percent globally sclerotic between annotated and those recorded in pathology reports was significant when global sclerosis is greater than 40%. CONCLUSIONS: Although glass slides were not available for direct comparison to whole slide image annotation, this study indicates that routine manual light microscopy assessment of number of glomeruli is inaccurate, and the magnitude of this error is proportional to the total number of glomeruli. |
format | Online Article Text |
id | pubmed-4911144 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-49111442016-07-06 The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies Rosenberg, Avi Z. Palmer, Matthew Merlino, Lino Troost, Jonathan P. Gasim, Adil Bagnasco, Serena Avila-Casado, Carmen Johnstone, Duncan Hodgin, Jeffrey B. Conway, Catherine Gillespie, Brenda W. Nast, Cynthia C. Barisoni, Laura Hewitt, Stephen M. PLoS One Research Article BACKGROUND: In renal biopsy reporting, quantitative measurements, such as glomerular number and percentage of globally sclerotic glomeruli, is central to diagnostic accuracy and prognosis. The aim of this study is to determine the number of glomeruli and percent globally sclerotic in renal biopsies by means of registration of serial tissue sections and manual enumeration, compared to the numbers in pathology reports from routine light microscopic assessment. DESIGN: We reviewed 277 biopsies from the Nephrotic Syndrome Study Network (NEPTUNE) digital pathology repository, enumerating 9,379 glomeruli by means of whole slide imaging. Glomerular number and the percentage of globally sclerotic glomeruli are values routinely recorded in the official renal biopsy pathology report from the 25 participating centers. Two general trends in reporting were noted: total number per biopsy or average number per level/section. Both of these approaches were assessed for their accuracy in comparison to the analogous numbers of annotated glomeruli on WSI. RESULTS: The number of glomeruli annotated was consistently higher than those reported (p<0.001); this difference was proportional to the number of glomeruli. In contrast, percent globally sclerotic were similar when calculated on total glomeruli, but greater in FSGS when calculated on average number of glomeruli (p<0.01). The difference in percent globally sclerotic between annotated and those recorded in pathology reports was significant when global sclerosis is greater than 40%. CONCLUSIONS: Although glass slides were not available for direct comparison to whole slide image annotation, this study indicates that routine manual light microscopy assessment of number of glomeruli is inaccurate, and the magnitude of this error is proportional to the total number of glomeruli. Public Library of Science 2016-06-16 /pmc/articles/PMC4911144/ /pubmed/27310011 http://dx.doi.org/10.1371/journal.pone.0156441 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Rosenberg, Avi Z. Palmer, Matthew Merlino, Lino Troost, Jonathan P. Gasim, Adil Bagnasco, Serena Avila-Casado, Carmen Johnstone, Duncan Hodgin, Jeffrey B. Conway, Catherine Gillespie, Brenda W. Nast, Cynthia C. Barisoni, Laura Hewitt, Stephen M. The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title | The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title_full | The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title_fullStr | The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title_full_unstemmed | The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title_short | The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies |
title_sort | application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911144/ https://www.ncbi.nlm.nih.gov/pubmed/27310011 http://dx.doi.org/10.1371/journal.pone.0156441 |
work_keys_str_mv | AT rosenbergaviz theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT palmermatthew theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT merlinolino theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT troostjonathanp theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT gasimadil theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT bagnascoserena theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT avilacasadocarmen theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT johnstoneduncan theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT hodginjeffreyb theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT conwaycatherine theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT gillespiebrendaw theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT nastcynthiac theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT barisonilaura theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT hewittstephenm theapplicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT rosenbergaviz applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT palmermatthew applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT merlinolino applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT troostjonathanp applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT gasimadil applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT bagnascoserena applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT avilacasadocarmen applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT johnstoneduncan applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT hodginjeffreyb applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT conwaycatherine applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT gillespiebrendaw applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT nastcynthiac applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT barisonilaura applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies AT hewittstephenm applicationofdigitalpathologytoimproveaccuracyinglomerularenumerationinrenalbiopsies |