Whole slide image with image analysis of atypical bile duct brushing: Quantitative features predictive of XXXX .

@entity5 @entity1157 @entity189
BACKGROUND: Whole slide images (WSIs) involve digitally capturing glass slides for microscopic computer-based viewing and these are amenable to quantitative image analysis. @entity1157 ( @entity1157 ) brushing can show morphologic features that are categorized as indeterminate for @entity5 . The study aims to evaluate quantitative morphologic features of atypical categories of @entity1157 brushing by WSI analysis for the identification of criteria predictive of @entity5 . MATERIALS AND METHODS: Over a 3-year period, @entity1157 brush specimens with indeterminate diagnostic categorization (atypical to suspicious) were subjected to WSI analysis. Ten well-visualized groups with morphologic atypical features were selected per case and had the quantitative analysis performed for group area, individual nuclear area, the number of nuclei per group, N: C ratio and nuclear size differential. RESULTS: There were 28 cases identified with 17 atypical and 11 suspicious. The average nuclear area was 63.7   m(2) for atypical and 80.1   m(2) for suspicious (+difference 16.4   m(2); P = 0.002). The nuclear size differential was 69.7   m(2) for atypical and 88.4   m(2) for suspicious (+difference 18.8   m(2); P = 0.009). An average nuclear area >70   m(2) had a 3.2 risk ratio for suspicious categorization. CONCLUSION: The quantitative criteria findings as measured by image analysis on WSI showed that cases categorized as suspicious had more nuclear size pleomorphism (+18.8   m(2)) and larger nuclei (+16.4   m(2)) than those categorized as atypical. WSI with morphologic image analysis can demonstrate quantitative statistically significant differences between atypical and suspicious @entity1157 brushings and provide objective criteria that support the diagnosis of @entity189 .
