Abstract：
OBJECTIVE: Guideline images of specific fat proportionate area (FPA) percentages have recently been published to aid the histological assessment of liver steatosis as subjective estimates of FPA are usually overestimated. To assess, (i) the effect of guideline images on accuracy and concordance of estimated FPA (eFPA), (ii) experience of steatosis grading systems on eFPA, (iii) the effect of magnification on assessment of FPA (iv) and produce a range of guideline images at x4 objective magnification (OM).
METHODS: Two circulations of sample images (C1 and C2) were circulated to UK liver external quality assessment histopathology scheme members who were asked to independently evaluate steatosis. Each circulation consisted of 15 images taken at both x20 and x4OM representing the full range of steatosis. C1 was distributed first, then C2 with guideline images of FPA 6 weeks later.
RESULTS: Participants overestimated FPA in C1. In C2, there was significant improvement in accuracy (P < 0.001) of eFPA for sample images with mFPA >5%. Concordance of x4OM eFPA was substantial in both circulations (C1 K = 0.878, C2 K = 0.724).
CONCLUSIONS: The tendency to overestimate eFPA has been corroborated and can be largely corrected with the use of guideline images (without needing digital image analysis). There is a need to redefine steatosis grades that are clinically significant and validated using an accurate quantification of steatosis.
METHODS: Two circulations of sample images (C1 and C2) were circulated to UK liver external quality assessment histopathology scheme members who were asked to independently evaluate steatosis. Each circulation consisted of 15 images taken at both x20 and x4OM representing the full range of steatosis. C1 was distributed first, then C2 with guideline images of FPA 6 weeks later.
RESULTS: Participants overestimated FPA in C1. In C2, there was significant improvement in accuracy (P < 0.001) of eFPA for sample images with mFPA >5%. Concordance of x4OM eFPA was substantial in both circulations (C1 K = 0.878, C2 K = 0.724).
CONCLUSIONS: The tendency to overestimate eFPA has been corroborated and can be largely corrected with the use of guideline images (without needing digital image analysis). There is a need to redefine steatosis grades that are clinically significant and validated using an accurate quantification of steatosis.
摘要：
目的：最近发表了特定脂肪比例面积（FPA）百分比的指南图像，以帮助肝脏脂肪变性的组织学评估，因为FPA的主观估计通常被高估。为了评估，（i）指南图像对估计的FPA（eFPA）的准确性和一致性的影响，(ii)eFPA脂肪变性分级系统的经验，（iii）放大倍数对FPA评估的影响（iv）并在x4物镜放大倍数（OM）下产生一系列指南图像。
方法：将两个循环的样本图像（C1和C2）传至英国肝脏外部质量评估组织病理学方案成员，他们被要求独立评估脂肪变性。每个循环由在x20和x4OM拍摄的15张图像组成，代表脂肪变性的全部范围。C1先分配,6周后，C2与FPA的指南图像。
结果：参与者高估了C1中的FPA。在C2中,对于mFPA>5%的样品图像,eFPA的准确度有显著提高(P<0.001)。在两个循环中，x4OMeFPA的一致性都很大（C1K=0.878，C2K=0.724）。
结论：高估eFPA的倾向已得到证实，并且可以通过使用指南图像（无需数字图像分析）在很大程度上得到纠正。需要重新定义具有临床意义并使用脂肪变性的准确定量来验证的脂肪变性等级。
方法：将两个循环的样本图像（C1和C2）传至英国肝脏外部质量评估组织病理学方案成员，他们被要求独立评估脂肪变性。每个循环由在x20和x4OM拍摄的15张图像组成，代表脂肪变性的全部范围。C1先分配,6周后，C2与FPA的指南图像。
结果：参与者高估了C1中的FPA。在C2中,对于mFPA>5%的样品图像,eFPA的准确度有显著提高(P<0.001)。在两个循环中，x4OMeFPA的一致性都很大（C1K=0.878，C2K=0.724）。
结论：高估eFPA的倾向已得到证实，并且可以通过使用指南图像（无需数字图像分析）在很大程度上得到纠正。需要重新定义具有临床意义并使用脂肪变性的准确定量来验证的脂肪变性等级。
