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Deployment of an Artificial Intelligence Histology Tool to Aid Qualitative Assessment of Histopathology Using the Nancy Histopathology Index in Ulcerative Colitis

Rubin, David T; Kubassova, Olga; Weber, Christopher R; Adsul, Shashi; Freire, Marcelo; Biedermann, Luc; Koelzer, Viktor H; Bressler, Brian; Xiong, Wei; Niess, Jan H; Matter, Matthias S; Kopylov, Uri; Barshack, Iris; Mayer, Chen; Magro, Fernando; Carneiro, Fatima; Maharshak, Nitsan; Greenberg, Ariel; Hart, Simon; Dehmeshki, Jamshid; Peyrin-Biroulet, Laurent (2025). Deployment of an Artificial Intelligence Histology Tool to Aid Qualitative Assessment of Histopathology Using the Nancy Histopathology Index in Ulcerative Colitis. Inflammatory Bowel Diseases, 31(6):1630-1636.

Abstract

BACKGROUND

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by increased stool frequency, rectal bleeding, and urgency. To streamline the quantitative assessment of histopathology using the Nancy Index in UC patients, we developed a novel artificial intelligence (AI) tool based on deep learning and tested it in a proof-of-concept trial. In this study, we report the performance of a modified version of the AI tool.

METHODS

Nine sites from 6 countries were included. Patients were aged ≥18 years and had UC. Slides were prepared with hematoxylin and eosin staining. A total of 791 images were divided into 2 groups: 630 for training the tool and 161 for testing vs expert histopathologist assessment. The refined AI histology tool utilized a 4-neural network structure to characterize images into a series of cell and tissue type combinations and locations, and then 1 classifier module assigned a Nancy Index score.

RESULTS

In comparison with the proof-of-concept tool, each feature demonstrated an improvement in accuracy. Confusion matrix analysis demonstrated an 80% correlation between predicted and true labels for Nancy scores of 0 or 4; a 96% correlation for a true score of 0 being predicted as 0 or 1; and a 100% correlation for a true score of 2 being predicted as 2 or 3. The Nancy metric (which evaluated Nancy Index prediction) was 74.9% compared with 72.3% for the proof-of-concept model.

CONCLUSIONS

We have developed a modified AI histology tool in UC that correlates highly with histopathologists' assessments and suggests promising potential for its clinical application.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:13 June 2025
Deposited On:10 Feb 2025 15:01
Last Modified:08 Jul 2025 14:42
Publisher:Oxford University Press
ISSN:1078-0998
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/ibd/izae204
PubMed ID:39284932
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  • Language: English
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)

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