title: Evaluation of Quantitative Digital Pathology in the Assessment of Barrett Esophagus-Associated Dysplasia.
abstract: OBJECTIVE
  Barrett esophagus (BE) is a precursor lesion that confers an increased risk of esophageal adenocarcinoma. Two issues confront the diagnosis of patients with BE: (1) sampling error at the time of endoscopy and (2) variability among pathologists in grading dysplasia. The purpose of our study was to evaluate quantitative digital pathology (QDP) as a marker of dysplasia and stratification from low-grade to high-grade dysplasia to intramucosal adenocarcinoma in BE.
  
  
  METHODS
  Sixty-one esophageal biopsy specimens with BE were selected and divided into six groups according to the dysplasia grade. QDP image analysis was carried out by an in-house automated quantitative system on sections. The values of 110 nuclear features that analyze the morphology and chromatin texture were generated for each nucleus.
  
  
  RESULTS
  A progressive correlation was found between nuclear morphometric features and chromatin features with BE dysplasia. The chromatin texture was the best discriminator of the class diagnosis. There was a significant difference between the chromatin features of isolated low-grade dysplasia vs low-grade dysplasia that was associated with higher grade lesions in other biopsy tissue fragments.
  
  
  CONCLUSIONS
  QDP is a promising tool in the new era of digital pathology. Pending clinical validation studies, analysis of chromatin texture could contribute to the differential diagnosis of BE class and the detection of concomitant high-grade lesions if not sampled.
authors.affiliation: From the Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada, and.
authors.forename: Soufiane
authors.initials: S
authors.lastname: El Hallani
authors.affiliation: Integrative Oncology-Cancer Imaging Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada.
authors.forename: Martial
authors.initials: M
authors.lastname: Guillaud
authors.affiliation: Integrative Oncology-Cancer Imaging Unit, British Columbia Cancer Research Centre, Vancouver, BC, Canada.
authors.forename: Jakoda
authors.initials: J
authors.lastname: Korbelik
authors.affiliation: From the Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada, and cmarginean@toh.on.ca.
authors.forename: Esmeralda Celia
authors.initials: EC
authors.lastname: Marginean
mesh_terms: D001471:Barrett Esophagus / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D011230:Precancerous Conditions / Q000473:pathology*
keywords: Barrett esophagus; Dysplasia; Quantitative pathology