Comparative study of automated morphometric and semiquantitative estimations of alcoholic liver steatosis

Needle biopsy of the liver is of great value in appreciating the intensity, type and topography of the steatosis commonly observed during chronic alcoholic diseases. The usual semiquantitative optical analysis is very inaccurate and depends on the subjectivity and training of the pathologist. We therefore performed an automated analysis of liver steatosis using a QTM 720 image analyzer connected to a PDP 11/34 minicomputer. Visual control of the results of the automated analysis showed it to give good results: 94% of the droplets were detected and only 10% of the patterns automatically selected were not droplets. Eight normal biopsies and 37 biopsies showing alcoholic liver steatosis were analyzed. The automated morphometric analysis calculated the mean density (percentage) of steatosis and the size distribution of the droplets. Statistical comparison of these results with those of the semiquantitative optical analysis performed independently by two pathologists showed a significant correlation between their calculations of the density/degree of steatosis but significant differences for their evaluation of the type of steatosis. The pathologists constantly overestimated the ratio of macrodroplets to microdroplets.