{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:13:39Z","timestamp":1788779619142,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Research of Development Program of China","award":["2022YFA1303804"],"award-info":[{"award-number":["2022YFA1303804"]}]},{"name":"National Key Research of Development Program of China","award":["81870406"],"award-info":[{"award-number":["81870406"]}]},{"name":"National Key Research of Development Program of China","award":["7182174"],"award-info":[{"award-number":["7182174"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China (NSFC)","doi-asserted-by":"publisher","award":["2022YFA1303804"],"award-info":[{"award-number":["2022YFA1303804"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China (NSFC)","doi-asserted-by":"publisher","award":["81870406"],"award-info":[{"award-number":["81870406"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China (NSFC)","doi-asserted-by":"publisher","award":["7182174"],"award-info":[{"award-number":["7182174"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["2022YFA1303804"],"award-info":[{"award-number":["2022YFA1303804"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["81870406"],"award-info":[{"award-number":["81870406"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["7182174"],"award-info":[{"award-number":["7182174"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>This study aimed to understand the dynamic changes in fibrosis and its relationship with the evaluation of post-treatment viral hepatitis using qFibrosis. A total of 158 paired pre- and post-treatment liver samples from patients with chronic hepatitis B (CHB; n = 100) and C (CHC; n = 58) were examined. qFibrosis was employed with artificial intelligence (AI) to analyze the fibrosis dynamics in the portal tract (PT), periportal (PP), midzonal, pericentral, and central vein (CV) regions. All patients with CHB achieved a virological response after 78 weeks of treatment, whereas patients with CHC achieved a sustained viral response after 24 weeks. For patients initially staged as F5\/6 (Ishak system) at baseline, the post-treatment cases exhibited a significant reduction in the collagen proportionate area (CPA) (25\u201369%) and number of collagen strings (#string) (9\u201372%) across all regions. In contrast, those initially staged as F3\/4 at baseline showed a similar CPA and #string trend at 24 weeks. For regression patients, 27 parameters (25 in the CV region) in patients staged as F3\/4 and 15 parameters (three in the PT and 12 in the PP regions) in those staged as F5\/6 showed significant differences between the CHB and CHC groups at baseline. Following successful antiviral treatment, the pre- and post-treatment liver samples provided quantitative evidence of the heterogeneity of fibrotic features. qFibrosis has the potential to provide new insights into the characteristics of fibrosis regression in both patients with CHB and CHC as early as 24 weeks after antiviral therapy.<\/jats:p>","DOI":"10.3390\/diagnostics14161837","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T11:14:41Z","timestamp":1724325281000},"page":"1837","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["AI Digital Pathology Using qFibrosis Shows Heterogeneity of Fibrosis Regression in Patients with Chronic Hepatitis B and C with Viral Response"],"prefix":"10.3390","volume":"14","author":[{"given":"Feng","family":"Liu","sequence":"first","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People\u2019s Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yameng","family":"Sun","sequence":"additional","affiliation":[{"name":"Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6166-5618","authenticated-orcid":false,"given":"Dean","family":"Tai","sequence":"additional","affiliation":[{"name":"HistoIndex Pte. 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Ltd., Singapore 117674, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3107-7599","authenticated-orcid":false,"given":"Aileen","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Bedossa","sequence":"additional","affiliation":[{"name":"LiverPat SAS, F-75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5561-8746","authenticated-orcid":false,"given":"Rui","family":"Huang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People\u2019s Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People\u2019s Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai","family":"Wei","sequence":"additional","affiliation":[{"name":"Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"You","sequence":"additional","affiliation":[{"name":"Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Rao","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People\u2019s Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4093\/dmj.2023.0240","article-title":"Hepatic Fibrosis and Cancer: The Silent Threats of Metabolic Syndrome","volume":"48","author":"Friedman","year":"2024","journal-title":"Diabetes Metab. J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Caligiuri, A., Gentilini, A., Pastore, M., Gitto, S., and Marra, F. (2021). Cellular and Molecular Mechanisms Underlying Liver Fibrosis Regression. Cells, 10.","DOI":"10.3390\/cells10102759"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/s41575-023-00807-x","article-title":"Hepatic inflammatory responses in liver fibrosis","volume":"20","author":"Hammerich","year":"2023","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.coph.2019.09.006","article-title":"New and emerging anti-fibrotic therapeutics entering or already in clinical trials in chronic liver diseases","volume":"49","author":"Lemoinne","year":"2019","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Roehlen, N., Crouchet, E., and Baumert, T.F. (2020). Liver fibrosis: Mechanistic concepts and therapeutic perspectives. Cells, 9.","DOI":"10.3390\/cells9040875"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Akk\u0131z, H., Gieseler, R.K., and Canbay, A. (2024). Liver Fibrosis: From Basic Science towards Clinical Progress, Focusing on the Central Role of Hepatic Stellate Cells. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202405.1666.v1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1007\/s12072-015-9695-0","article-title":"Fibrosis assessment: Impact on current management of chronic liver disease and application of quantitative invasive tools","volume":"10","author":"Wang","year":"2016","journal-title":"Hepatol. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1038\/s41586-020-2938-9","article-title":"Fibrosis: From mechanisms to medicines","volume":"587","author":"Henderson","year":"2020","journal-title":"Nature"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1136\/gutjnl-2018-317593","article-title":"Advances in non-invasive assessment of hepatic fibrosis","volume":"69","author":"Loomba","year":"2020","journal-title":"Gut"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1016\/j.jhep.2022.03.026","article-title":"Impact of non-invasive biomarkers on hepatology practice: Past, present and future","volume":"76","author":"Anstee","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Oeda, S., Tanaka, K., Oshima, A., Matsumoto, Y., Sueoka, E., and Takahashi, H. (2020). Diagnostic Accuracy of FibroScan and Factors Affecting Measurements. Diagnostics, 10.","DOI":"10.3390\/diagnostics10110940"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/liv.13653","article-title":"Diagnosis of non-alcoholic fatty liver disease\/non-alcoholic steatohepatitis: Why liver biopsy is essential","volume":"38","author":"Bedossa","year":"2018","journal-title":"Liver Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s10238-022-00799-z","article-title":"Liver biopsy for assessment of chronic liver diseases: A synopsis","volume":"23","author":"Chowdhury","year":"2023","journal-title":"Clin. Exp. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.humpath.2019.08.023","article-title":"Pathology of liver disease: Advances in the last 50 years","volume":"95","author":"Torbenson","year":"2020","journal-title":"Hum. Pathol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1146\/annurev-virology-091919-062728","article-title":"Prospects for the global elimination of hepatitis B","volume":"8","author":"Block","year":"2021","journal-title":"Annu. Rev. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1053\/j.gastro.2020.09.065","article-title":"Fibrosis regression after eradication of hepatitis C virus: From bench to bedside","volume":"160","author":"Rockey","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_17","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."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1016\/j.jhep.2020.06.025","article-title":"Suboptimal reliability of liver biopsy evaluation has implications for randomized clinical trials","volume":"73","author":"Davison","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/cjp2.227","article-title":"Reliable computational quantification of liver fibrosis is compromised by inherent staining variation","volume":"7","author":"Astbury","year":"2021","journal-title":"J. Pathol. Clin. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Sun, Y., Zhou, J., Wu, X., Chen, Y., Piao, H., Lu, L., Ding, H., Nan, Y., Jiang, W., and Wang, T. (2018). Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak \u201cstable\u201d patients on anti-HBV therapy. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-21179-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jhep.2014.02.015","article-title":"qFibrosis: A fully-quantitative innovative method incorporating histological features to facilitate accurate fibrosis scoring in animal model and chronic hepatitis B patients","volume":"61","author":"Xu","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1002\/hep.30986","article-title":"qFIBS: An automated technique for quantitative evaluation of fibrosis, inflammation, ballooning, and steatosis in patients with nonalcoholic steatohepatitis","volume":"71","author":"Liu","year":"2020","journal-title":"Hepatology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/j.jhep.2022.06.018","article-title":"Digital pathology with artificial intelligence analyses provides greater insights into treatment-induced fibrosis regression in NASH","volume":"77","author":"Naoumov","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/s41575-023-00843-7","article-title":"Digital pathology for nonalcoholic steatohepatitis assessment","volume":"21","author":"Sanyal","year":"2024","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_25","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."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1109\/TSMC.1979.4310076","article-title":"A Threshold selection method from gray-level histograms","volume":"9","author":"Otsu","year":"1979","journal-title":"IEEE Trans. Syst. Man Cybern. B Cybern."},{"key":"ref_27","unstructured":"Lewis, R.J. (2000, January 22\u201325). An Introduction to Classification and Regression Tree. (CART) Analysis. Proceedings of the Annual Meeting of the Society for Academic Emergency Medicine, San Francisco, CA, USA."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2632010X231162317","DOI":"10.1177\/2632010X231162317","article-title":"Second-harmonic generated quantifiable fibrosis parameters provide signatures for disease progression and regression in nonalcoholic fatty liver disease","volume":"16","author":"Ng","year":"2023","journal-title":"Clin. Pathol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s12072-019-09955-2","article-title":"SHG\/TPEF-based image technology improves liver fibrosis assessment of minimally sized needle biopsies","volume":"13","author":"Wang","year":"2019","journal-title":"Hepatol. Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/hep.23785","article-title":"Long-term entecavir therapy results in the reversal of fibrosis\/cirrhosis and continued histological improvement in patients with chronic hepatitis B","volume":"52","author":"Chang","year":"2010","journal-title":"Hepatology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/S0140-6736(12)61425-1","article-title":"Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: A 5-year open-label follow-up study","volume":"381","author":"Marcellin","year":"2013","journal-title":"Lancet"},{"key":"ref_32","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":"ref_33","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1053\/gast.2002.33023","article-title":"Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C","volume":"122","author":"Poynard","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/liv.13193","article-title":"Impact of viral eradication with sofosbuvir-based therapy on the outcome of post-transplant hepatitis C with severe fibrosis","volume":"37","author":"Martini","year":"2017","journal-title":"Liver Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1002\/hep.29557","article-title":"Portal pressure and liver stiffness measurements in the prediction of fibrosis regression after sustained virological response in recurrent hepatitis C","volume":"67","author":"Mauro","year":"2018","journal-title":"Hepatology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1002\/hep.25606","article-title":"A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis","volume":"56","author":"Aghemo","year":"2012","journal-title":"Hepatology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3350\/cmh.2020.0181","article-title":"Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective","volume":"27","author":"Soon","year":"2021","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1136\/jcp.54.6.461","article-title":"Quantitative assessment of fibrosis and steatosis in liver biopsies from patients with chronic hepatitis C","volume":"54","author":"Zaitoun","year":"2001","journal-title":"J. Clin. Pathol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/16\/1837\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:41:39Z","timestamp":1760110899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/16\/1837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,22]]},"references-count":38,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["diagnostics14161837"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14161837","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,22]]}}}