Assessing interstitial fibrosis and tubular atrophy in kidney biopsies - artificial intelligence versus humans

The degree to which computerized methods, such as artificial intelligence (AI), will aid in the assessment of kidney histopathology is undergoing intense study and application; and this is particularly true for interstitial fibrosis, which is often used as a surrogate measure of chronic kidney disease progression, since interobserver variability among human pathologists has been demonstrated in the assessment of interstitial fibrosis and other features.

Computerized assessment of interstitial fibrosis, including with AI, has been assessed alongside pathologists. Computerized methods such as AI have shown direct interstitial fibrosis measurement and indirect assessment through kidney compartment segmentation; however, some studies have shown lack of complete concordance among computerized methods and humans; and studies have still shown the persistent value of human assessment in many circumstances.

Computerized methods, including AI, are showing increased application in kidney pathology for a wide variety of clinical and histopathologic parameter assessment, including interstitial fibrosis; however, further studies are needed to characterize the performance of AI and handcrafted methods; and additional work is needed to fully integrate computerized methods into routine pathology practice. Ultimately, humans working with AI ("humans + AI") may provide enhanced analysis for more effective patient care.