Limited Correlation Between Conventional Pathologist and Automatic Computer-Assisted Quantification of Hepatic Steatosis due to Difference Between Event-Based and Surface-Based Analysis

Computer-assisted automatic quantification (CAQ) was developed as an alternative method for the diagnosis of hepatic steatosis in order to compensate for observer-dependent bias. Here, we aim to demonstrate that CAQ can provide an accurate and precise result in analysis of fatty content, but that it is inappropriate to validate CAQ by comparison with conventional pathologist estimation (PE). Male rats were fed with a methionine-choline-deficient plus high-fat diet for three days, one week, or two weeks to induce mild, moderate, or severe steatosis. Samples were collected from all liver lobes. Severity of hepatic steatosis was assessed by an experienced pathologist who estimated the percentage of hepatocytes containing lipid droplets. Fatty content was quantified by PE, CAQ, and biochemical analysis (BA). CAQ, PE, and BA can correctly reflect severe fatty change. However, in the case of mild and moderate steatosis, PE could not reflect the true fatty content ( r between PE and BA was <;0). The result of CAQ correlated well with that of BA among the various degrees of severity of hepatic steatosis. In conclusion, due to a difference between event-based and surface-based analysis, it is inappropriate to validate the CAQ of hepatic steatosis by comparison with PE.