The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies

Avi Z. Rosenberg, Matthew Palmer, Lino Merlino, Jonathan P. Troost, Adil Gasim, Serena Bagnasco, Carmen Avila-Casado, Duncan Johnstone, Jeffrey B. Hodgin, Catherine Conway, Brenda W. Gillespie, Cynthia C. Nast, Laura Barisoni-Thomas, Stephen M. Hewitt

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numbere0156441
JournalPLoS One
Volume11
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Biopsy
Pathology
biopsy
kidneys
Kidney
nephrotic syndrome
Light
sclerosis
Nephrotic Syndrome
Sclerosis
prognosis
Optical microscopy
Glass
light microscopy
glass
Microscopy
image analysis
Tissue
Imaging techniques

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Rosenberg, A. Z., Palmer, M., Merlino, L., Troost, J. P., Gasim, A., Bagnasco, S., ... Hewitt, S. M. (2016). The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies. PLoS One, 11(6), [e0156441]. https://doi.org/10.1371/journal.pone.0156441

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-Thomas, Laura; Hewitt, Stephen M.

In: PLoS One, Vol. 11, No. 6, e0156441, 01.06.2016.

Research output: Contribution to journalArticle

Rosenberg, AZ, Palmer, M, Merlino, L, Troost, JP, Gasim, A, Bagnasco, S, Avila-Casado, C, Johnstone, D, Hodgin, JB, Conway, C, Gillespie, BW, Nast, CC, Barisoni-Thomas, L & Hewitt, SM 2016, 'The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies', PLoS One, vol. 11, no. 6, e0156441. https://doi.org/10.1371/journal.pone.0156441
Rosenberg AZ, Palmer M, Merlino L, Troost JP, Gasim A, Bagnasco S et al. The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies. PLoS One. 2016 Jun 1;11(6). e0156441. https://doi.org/10.1371/journal.pone.0156441
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-Thomas, Laura ; Hewitt, Stephen M. / The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies. In: PLoS One. 2016 ; Vol. 11, No. 6.
@article{d5db166a72d84d01b3540ec7b9696258,
title = "The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies",
abstract = "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.",
author = "Rosenberg, {Avi Z.} and Matthew Palmer and Lino Merlino and Troost, {Jonathan P.} and Adil Gasim and Serena Bagnasco and Carmen Avila-Casado and Duncan Johnstone and Hodgin, {Jeffrey B.} and Catherine Conway and Gillespie, {Brenda W.} and Nast, {Cynthia C.} and Laura Barisoni-Thomas and Hewitt, {Stephen M.}",
year = "2016",
month = "6",
day = "1",
doi = "10.1371/journal.pone.0156441",
language = "English (US)",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - The application of digital pathology to improve accuracy in glomerular enumeration in renal biopsies

AU - Rosenberg, Avi Z.

AU - Palmer, Matthew

AU - Merlino, Lino

AU - Troost, Jonathan P.

AU - Gasim, Adil

AU - Bagnasco, Serena

AU - Avila-Casado, Carmen

AU - Johnstone, Duncan

AU - Hodgin, Jeffrey B.

AU - Conway, Catherine

AU - Gillespie, Brenda W.

AU - Nast, Cynthia C.

AU - Barisoni-Thomas, Laura

AU - Hewitt, Stephen M.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84976448535&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976448535&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0156441

DO - 10.1371/journal.pone.0156441

M3 - Article

VL - 11

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 6

M1 - e0156441

ER -