Publications by authors named "Alastair D Burt"

Article Synopsis
  • - Clinical trials for metabolic dysfunction-associated steatohepatitis (MASH) need accurate histologic scoring to assess participants and outcomes, but varying interpretations have affected results.
  • - The AI-based tool AIM-MASH showed strong consistency and agreement with expert pathologists in scoring MASH histology, achieving accuracy comparable to that of average pathologists.
  • - AIM-MASH demonstrated a strong ability to predict patient outcomes, correlating well with pathologist scores and noninvasive biomarkers, indicating it could enhance the efficiency and reliability of clinical trials for MASH.
View Article and Find Full Text PDF

Histological subtyping of hepatocellular carcinoma (HCC) is challenging in the presence of histological heterogeneity, where distinctly different morphological patterns are present within the same tumor. Current approaches rely on percent cut-offs. We hypothesized that morphologic intratumor heterogeneity is a non-random biological feature and that incorporating recurrent patterns would improve histological subtyping of HCC.

View Article and Find Full Text PDF
Article Synopsis
  • Liver biopsies have been crucial in understanding the causes and development of acute liver diseases, although their role has evolved with new diagnostic methods.
  • While they are not mandatory in clinical guidelines for acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), many medical centers continue to perform them because they are relatively safe and provide important prognostic information.
  • The increasing use of liver biopsies for diagnosing less severe acute liver injuries has led to a shift in the types of specimens analyzed, emphasizing the need for histopathologists to be prepared for these complex cases.
View Article and Find Full Text PDF

Conventional histopathology involves expensive and labor-intensive processes that often consume tissue samples, rendering them unavailable for other analyses. We present a novel end-to-end workflow for pathology powered by hyperspectral microscopy and deep learning. First, we developed a custom hyperspectral microscope to nondestructively image the autofluorescence of unstained tissue sections.

View Article and Find Full Text PDF
Article Synopsis
  • Clinical trials for nonalcoholic steatohepatitis (NASH) rely on consistent histologic scoring, but variability in these interpretations has affected trial results.* -
  • An AI tool called AIM-NASH was developed to provide standardized scoring for NASH histology, showing strong correlation with expert consensus scores and improving predictive accuracy for patient outcomes.* -
  • In a retrospective analysis, AIM-NASH helped meet previously unmet pathological endpoints in the ATLAS trial, suggesting it could reduce variability in scoring and enhance the assessment of treatment responses in clinical trials.*
View Article and Find Full Text PDF

Introduction: Heparin sulphate proteoglycans in the liver tumour microenvironment (TME) are key regulators of cell signalling, modulated by sulfatase-2 (SULF2). SULF2 overexpression occurs in hepatocellular carcinoma (HCC). Our aims were to define the nature and impact of SULF2 in the HCC TME.

View Article and Find Full Text PDF

Background & Aims: Cancer-associated fibroblasts (CAFs) play an important role in colorectal cancer (CRC) progression and predict poor prognosis in CRC patients. However, the cellular origins of CAFs remain unknown, making it challenging to therapeutically target these cells. Here, we aimed to identify the origins and contribution of colorectal CAFs associated with poor prognosis.

View Article and Find Full Text PDF

A 39-year-old female presented with a one-week history of jaundice and nausea after taking an over-the-counter herbal supplement containing ashwagandha root extract. Initial investigations revealed a hepatocellular pattern of liver enzyme abnormality with jaundice. Investigations, including viral serology, liver specific autoantibodies and an ultrasound scan of the abdomen, were unremarkable.

View Article and Find Full Text PDF

Hepatic metastasis of colorectal cancer (CRC) is a leading cause of cancer-related death. Cancer-associated fibroblasts (CAFs), a major component of the tumor microenvironment, play a crucial role in metastatic CRC progression and predict poor patient prognosis. However, there is a lack of satisfactory mouse models to study the crosstalk between metastatic cancer cells and CAFs.

View Article and Find Full Text PDF

Obesity and non-alcoholic fatty liver disease (NAFLD) are contributing to the global rise in deaths from hepatocellular carcinoma (HCC). The pathogenesis of NAFLD-HCC is not well understood. The severity of hepatic steatosis, steatohepatitis and fibrosis are key pathogenic mechanisms, but animal studies suggest altered immune responses are also involved.

View Article and Find Full Text PDF

Background & Aims: Cancer-associated fibroblasts (CAFs), key constituents of the tumor microenvironment, either promote or restrain tumor growth. Attempts to therapeutically target CAFs have been hampered by our incomplete understanding of these functionally heterogeneous cells. Key growth factors in the intestinal epithelial niche, bone morphogenetic proteins (BMPs), also play a critical role in colorectal cancer (CRC) progression.

View Article and Find Full Text PDF

Background And Aim: Commonly used classifications for colorectal lesions (CLs) include the Narrow Band Imaging (NBI) International Colorectal Endoscopic (NICE) and Japan NBI Expert Team (JNET) classifications. However, both lack a sessile serrated adenoma/polyp (SSA/P) category. This has been addressed by the modified Sano's (MS) and Workgroup serrAted polypS and Polyposis (WASP) classifications.

View Article and Find Full Text PDF

Introduction: Quality measures for colonoscopy such as adenoma detection rate (ADR) have been proposed to be surveilled for ensuring minimum standards. However, its direct measurement is time consuming and often neglected. Extrapolating ADR and other quality measures from polyp detection rate (PDR) can be a pragmatic alternative.

View Article and Find Full Text PDF

Background And Aim: Endoscopic submucosal dissection (ESD) is a challenging procedure. A dissection speed of ≥9 cm/h has been acknowledged as a mark for expertise, alongside a complication rate of ≤5% and en bloc resection rate of ≥90%. However, there is lack of objective information on whether the three measures correlate with each other.

View Article and Find Full Text PDF

Professional societies play a major role in medicine and science. The societies tend to be large with well-developed administrative structures. An additional model, however, is based on small groups of experts who meet regularly in an egalitarian model in order to discuss disease-specific scientific and medical problems.

View Article and Find Full Text PDF

Current data shows there are differences in factors associated with colorectal neoplasia based on geographical location and cultural settings. There are no studies focusing on the association between environmental factors and colorectal polyps in Australia. The aim of this study was to prospectively evaluate the association of various factors with different colorectal neoplasia histology.

View Article and Find Full Text PDF

Background & Aims: Genetic factors associated with non-alcoholic fatty liver disease (NAFLD) remain incompletely understood. To date, most genome-wide association studies (GWASs) have adopted radiologically assessed hepatic triglyceride content as the reference phenotype and so cannot address steatohepatitis or fibrosis. We describe a GWAS encompassing the full spectrum of histologically characterised NAFLD.

View Article and Find Full Text PDF

Background And Aims: Endoscopy guidelines recommend adhering to policies such as resect and discard only if the optical biopsy is accurate. However, accuracy in predicting histology can vary greatly. Computer-aided diagnosis (CAD) for characterization of colorectal lesions may help with this issue.

View Article and Find Full Text PDF

Background And Aim: Microbiota have been associated with several diseases including colorectal cancer (CRC). This study aimed to evaluate the microbiota in early/invasive CRC utilizing stool and cytological brushes to determine differences in relative abundance (RA).

Methods: Colonoscopy patients referred for endoscopic submucosal dissection or previous to CRC surgery were prospectively enrolled.

View Article and Find Full Text PDF

Background And Aims: Surveillance post-endoscopic resection (ER) currently warrants biopsy samples from the resection site scar in most cases, although clinical practice is variable. A classification with standard criteria for scars has not yet been established. We aimed to create and validate a novel classification for post-ER scars by using specific criteria based on advanced imaging.

View Article and Find Full Text PDF