{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T18:03:16Z","timestamp":1792260196911,"version":"4.4.0"},"reference-count":46,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Annals of Diagnostic Pathology"],"published-print":{"date-parts":[[2020,8]]},"DOI":"10.1016\/j.anndiagpath.2020.151518","type":"journal-article","created":{"date-parts":[[2020,4,12]],"date-time":"2020-04-12T10:20:56Z","timestamp":1586686856000},"page":"151518","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":68,"special_numbering":"C","title":["Automated quantification and architectural pattern detection of hepatic fibrosis in NAFLD"],"prefix":"10.1016","volume":"47","author":[{"given":"Samer","family":"Gawrieh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Sethunath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar W.","family":"Cummings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Kleiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Vuppalanchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naga","family":"Chalasani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihran","family":"Tuceryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.anndiagpath.2020.151518_bb0005","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1038\/nrgastro.2017.38","article-title":"Mechanisms of hepatic stellate cell activation","volume":"14","author":"Tsuchida","year":"2017","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0036-1597816","article-title":"Regression of liver fibrosis","volume":"37","author":"Campana","year":"2017","journal-title":"Semin Liver Dis"},{"issue":"1 Pt 1","key":"10.1016\/j.anndiagpath.2020.151518_bb0015","first-page":"15","volume":"20","year":"1994","journal-title":"Hepatology"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0020","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/0168-8278(95)80226-6","article-title":"Histological grading and staging of chronic hepatitis","volume":"22","author":"Ishak","year":"1995","journal-title":"J Hepatol"},{"issue":"9","key":"10.1016\/j.anndiagpath.2020.151518_bb0025","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1111\/j.1572-0241.1999.01377.x","article-title":"Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions","volume":"94","author":"Brunt","year":"1999","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0030","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/hep.20701","article-title":"Design and validation of a histological scoring system for nonalcoholic fatty liver disease","volume":"41","author":"Kleiner","year":"2005","journal-title":"Hepatology"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0035","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jhep.2008.10.014","article-title":"Liver biopsy: the best, not the gold standard","volume":"50","author":"Bedossa","year":"2009","journal-title":"J Hepatol"},{"issue":"5","key":"10.1016\/j.anndiagpath.2020.151518_bb0040","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.jhep.2012.11.021","article-title":"Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal","volume":"58","author":"Machado","year":"2013","journal-title":"J Hepatol"},{"issue":"3","key":"10.1016\/j.anndiagpath.2020.151518_bb0045","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0168-8278(00)80397-9","article-title":"Automatic quantification of liver fibrosis: design and validation of a new image analysis method: comparison with semi-quantitative indexes of fibrosis","volume":"32","author":"Masseroli","year":"2000","journal-title":"J Hepatol"},{"issue":"5","key":"10.1016\/j.anndiagpath.2020.151518_bb0050","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1309\/D7AU-EYW7-4B6C-K08Y","article-title":"An assessment of digital image analysis to measure fibrosis in liver biopsy specimens of patients with chronic hepatitis C","volume":"114","author":"O'Brien","year":"2000","journal-title":"Am J Clin Pathol"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0055","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/hep.21595","article-title":"Progression of fibrosis in advanced chronic hepatitis C: evaluation by morphometric image analysis","volume":"45","author":"Goodman","year":"2007","journal-title":"Hepatology"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0060","first-page":"560","article-title":"Nonalcoholic fatty liver disease: assessment of variability in pathologic interpretations","volume":"11","author":"Younossi","year":"1998","journal-title":"Mod Pathol Off J U S Can Acad Pathol, Inc"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0065","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.anndiagpath.2010.08.001","article-title":"Effects of interventions on intra- and interobserver agreement on interpretation of nonalcoholic fatty liver disease histology","volume":"15","author":"Gawrieh","year":"2011","journal-title":"Ann Diagn Pathol"},{"issue":"8","key":"10.1016\/j.anndiagpath.2020.151518_bb0070","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1111\/liv.12184","article-title":"Image analysis of liver collagen using sirius red is more accurate and correlates better with serum fibrosis markers than trichrome","volume":"33","author":"Huang","year":"2013","journal-title":"Liver Int"},{"issue":"5","key":"10.1016\/j.anndiagpath.2020.151518_bb0075","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/S0168-8278(01)00006-X","article-title":"Liver fibrosis assessment with semiquantitative indexes and image analysis quantification in sustained-responder and non-responder interferon-treated patients with chronic hepatitis C","volume":"34","author":"Caballero","year":"2001","journal-title":"J Hepatol"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0080","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1002\/hep.22745","article-title":"Computer-assisted image analysis of liver collagen: relationship to Ishak scoring and hepatic venous pressure gradient","volume":"49","author":"Calvaruso","year":"2009","journal-title":"Hepatology"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0085","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1111\/j.1478-3231.2005.01155.x","article-title":"Advances in digital quantification technique enhance discrimination between mild and advanced liver fibrosis in chronic hepatitis C","volume":"25","author":"Lazzarini","year":"2005","journal-title":"Liver Int"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0090","doi-asserted-by":"crossref","first-page":"881","DOI":"10.5604\/01.3001.0010.5278","article-title":"An inexpensive digital image analysis technique for liver fibrosis quantification in chronic hepatitis B patients","volume":"16","author":"Zhou","year":"2017","journal-title":"Ann Hepatol"},{"issue":"3","key":"10.1016\/j.anndiagpath.2020.151518_bb0095","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/jvh.12133","article-title":"An inexpensive and worldwide available digital image analysis technique for histological fibrosis quantification in chronic hepatitis C","volume":"21","author":"Campos","year":"2014","journal-title":"J Viral Hepat"},{"issue":"7","key":"10.1016\/j.anndiagpath.2020.151518_bb0100","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.dld.2018.12.005","article-title":"Comparison and correlation of fibrosis stage assessment by collagen proportionate area (CPA) and the ELF panel in patients with chronic liver disease","volume":"51","author":"Stasi","year":"2019","journal-title":"Dig Liver Dis"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0105","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/1751-2980.12231","article-title":"Quantitative assessment of liver fibrosis by digital image analysis: relationship to Ishak staging and elasticity by shear-wave elastography","volume":"16","author":"Yegin","year":"2015","journal-title":"J Dig Dis"},{"issue":"9","key":"10.1016\/j.anndiagpath.2020.151518_bb0110","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1111\/j.1478-3231.2006.01341.x","article-title":"Quantitative assessment of liver fibrosis: a novel automated image analysis method","volume":"26","author":"Matalka","year":"2006","journal-title":"Liver Int"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0115","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1093\/ajcp\/aqx011","article-title":"Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores","volume":"147","author":"Pavlides","year":"2017","journal-title":"Am J Clin Pathol"},{"issue":"12","key":"10.1016\/j.anndiagpath.2020.151518_bb0120","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/apm.12287","article-title":"Liver collagen in cirrhosis correlates with portal hypertension and liver dysfunction","volume":"122","author":"Nielsen","year":"2014","journal-title":"APMIS: Acta Pathol Microbiol Immunol Scand"},{"issue":"8","key":"10.1016\/j.anndiagpath.2020.151518_bb0125","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00535-012-0694-9","article-title":"The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis","volume":"48","author":"Isgro","year":"2013","journal-title":"J Gastroenterol"},{"key":"10.1016\/j.anndiagpath.2020.151518_bb0130","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/2153-3539.124009","article-title":"Color correction for automatic fibrosis quantification in liver biopsy specimens","volume":"4","author":"Murakami","year":"2013","journal-title":"J Pathol Inform"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0135","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1002\/hep.24805","article-title":"Quantitative histological-hemodynamic correlations in cirrhosis","volume":"55","author":"Sethasine","year":"2012","journal-title":"Hepatology"},{"issue":"2","key":"10.1016\/j.anndiagpath.2020.151518_bb0140","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/lt.22209","article-title":"Digital image analysis of liver collagen predicts clinical outcome of recurrent hepatitis C virus 1 year after liver transplantation","volume":"17","author":"Manousou","year":"2011","journal-title":"Liver Transpl"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0145","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.jhep.2014.02.031","article-title":"Image analysis of liver biopsy samples measures fibrosis and predicts clinical outcome","volume":"61","author":"Huang","year":"2014","journal-title":"J Hepatol"},{"issue":"5","key":"10.1016\/j.anndiagpath.2020.151518_bb0150","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.jhep.2013.12.023","article-title":"Collagen proportionate area is superior to other histological methods for sub-classifying cirrhosis and determining prognosis","volume":"60","author":"Tsochatzis","year":"2014","journal-title":"J Hepatol"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0155","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1002\/hep.30664","article-title":"The natural history of advanced fibrosis due to nonalcoholic steatohepatitis: data from the Simtuzumab trials","volume":"70","author":"Sanyal","year":"2019","journal-title":"Hepatology"},{"issue":"3","key":"10.1016\/j.anndiagpath.2020.151518_bb0160","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/hep.22099","article-title":"Relationship of serum fibrosis markers with liver fibrosis stage and collagen content in patients with advanced chronic hepatitis C","volume":"47","author":"Fontana","year":"2008","journal-title":"Hepatology"},{"issue":"3","key":"10.1016\/j.anndiagpath.2020.151518_bb0165","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/his.12010","article-title":"Sample size requirement for digital image analysis of collagen proportionate area in cirrhotic livers","volume":"62","author":"Hall","year":"2013","journal-title":"Histopathology"},{"issue":"3","key":"10.1016\/j.anndiagpath.2020.151518_bb0170","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.dld.2015.10.024","article-title":"Assessment of liver fibrosis in primary biliary cholangitis: comparison between indirect serum markers and fibrosis morphometry","volume":"48","author":"Stasi","year":"2016","journal-title":"Dig Liver Dis"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0175","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/hep4.1121","article-title":"Quantitative assessment of liver fibrosis reveals a nonlinear association with fibrosis stage in nonalcoholic fatty liver disease","volume":"2","author":"Masugi","year":"2018","journal-title":"Hepatol Commun"},{"issue":"9","key":"10.1016\/j.anndiagpath.2020.151518_bb0180","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/apt.15219","article-title":"Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease","volume":"49","author":"Buzzetti","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0185","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0190","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"issue":"2","key":"10.1016\/j.anndiagpath.2020.151518_bb0195","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1053\/j.gastro.2015.04.043","article-title":"Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease","volume":"149","author":"Angulo","year":"2015","journal-title":"Gastroenterology"},{"issue":"2","key":"10.1016\/j.anndiagpath.2020.151518_bb0200","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1053\/j.gastro.2018.04.034","article-title":"Fibrosis severity as a determinant of cause-specific mortality in patients with advanced nonalcoholic fatty liver disease","volume":"155","author":"Vilar-Gomez","year":"2018","journal-title":"Gastroenterology"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0205","first-page":"28","volume":"64","year":"2018","journal-title":"Minerva Gastroenterol Dietol"},{"issue":"1","key":"10.1016\/j.anndiagpath.2020.151518_bb0210","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.cld.2017.08.013","article-title":"Emerging treatments for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis","volume":"22","author":"Gawrieh","year":"2018","journal-title":"Clin Liver Dis"},{"issue":"6","key":"10.1016\/j.anndiagpath.2020.151518_bb0215","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1053\/j.gastro.2015.09.015","article-title":"Liver histology and clinical trials for nonalcoholic steatohepatitis-perspectives from 2 pathologists","volume":"149","author":"Kleiner","year":"2015","journal-title":"Gastroenterology"},{"issue":"4","key":"10.1016\/j.anndiagpath.2020.151518_bb0220","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.humpath.2013.11.011","article-title":"Automatic classification of white regions in liver biopsies by supervised machine learning","volume":"45","author":"Vanderbeck","year":"2014","journal-title":"Hum Pathol"},{"issue":"5","key":"10.1016\/j.anndiagpath.2020.151518_bb0225","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.humpath.2015.01.019","article-title":"Automatic quantification of lobular inflammation and hepatocyte ballooning in nonalcoholic fatty liver disease liver biopsies","volume":"46","author":"Vanderbeck","year":"2015","journal-title":"Hum Pathol"},{"issue":"2","key":"10.1016\/j.anndiagpath.2020.151518_bb0230","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.hepres.2005.09.018","article-title":"Interobserver variation in the histopathological assessment of nonalcoholic steatohepatitis","volume":"33","author":"Fukusato","year":"2005","journal-title":"Hepatol Res"}],"container-title":["Annals of Diagnostic Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1092913420300599?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1092913420300599?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T20:31:36Z","timestamp":1761078696000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1092913420300599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":46,"alternative-id":["S1092913420300599"],"URL":"https:\/\/doi.org\/10.1016\/j.anndiagpath.2020.151518","relation":{},"ISSN":["1092-9134"],"issn-type":[{"value":"1092-9134","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Automated quantification and architectural pattern detection of hepatic fibrosis in NAFLD","name":"articletitle","label":"Article Title"},{"value":"Annals of Diagnostic Pathology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.anndiagpath.2020.151518","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"151518"}}