Automated image analysis of keratin 7 staining can predict disease outcome in primary sclerosing cholangitis

Abstract

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that can lead to liver cirrhosis or cholangiocarcinoma. Here, we developed a K7-AI model 2.0 to analyze K7-stained liver specimens of patients with PSC. We found that the K7-AI model 2.0 can serve as a prognostic tool for clinical endpoints, since it was able to provide significant information on disease outcomes based on different histological features.

Deep learning quantification reveals a fundamental prognostic role for ductular reaction in biliary atresia

“… 34 , 35 Other studies have reported DR to be associated with higher MELD scores in alcoholic hepatitis and high alkaline phosphatase levels in primary biliary cholangitis. 32 , 36 DR also predicted the development of cholangiocarcinoma and liver-related death in primary sclerosing cholangitis 22 as well as overall survival in patients with hepatitis C cirrhosis and alcoholic hepatitis. 34 , 37 …”

“… 18 – 20 A recently published image-processing neural network of K7-stained liver sections developed for primary sclerosing cholangitis showed improved performance in identifying various DR components with accuracy beyond the reach of manual scoring and enhanced prognostic value. 21 , 22 …”

Tumour stage and overall survival in patients with intrahepatic cholangiocarcinoma and primary sclerosing cholangitis – a retrospective cohort study

“…Consistently with the aforementioned study, all patients in our cohort with data on prior imaging had advanced CCA. Altogether, these results argue against the efficacy of imaging-based screening for iCCA in patients with PSC and, consequently, emphasise the need for new screening modalities, e. g., anti-glycoprotein (GP) 2-IgA, bile and urine proteome analysis, next-generation sequencing, or protein biomarkers containing serum extracellular vesicles [4,14,15,16]. Whereas liver transplantation in carefully selected patients with pCCA, e. g., patients with unresectable tumours or tumours in PSC, with a diameter < 3 cm, after neoadjuvant therapy, and in the absence of intrahepatic or extrahepatic metastasis may be considered a therapeutic option, iCCA is widely considered a contraindication for liver transplantation because of high recurrence rates and reduced long-term survival [17,18].…”

Tumour stage and overall survival in patients with intrahepatic cholangiocarcinoma and primary sclerosing cholangitis – a retrospective cohort study

“…Consistently with the aforementioned study, all patients in our cohort with data on prior imaging had advanced CCA. Altogether, these results argue against the efficacy of imaging-based screening for iCCA in patients with PSC and, consequently, emphasise the need for new screening modalities, e. g., anti-glycoprotein (GP) 2-IgA, bile and urine proteome analysis, next-generation sequencing, or protein biomarkers containing serum extracellular vesicles [4,14,15,16].…”