Development of a standardized histopathology scoring system using machine learning algorithms for intervertebral disc degeneration in the mouse model—An ORS spine section initiative
Itzel Paola Melgoza,
Srish S. Chenna,
Steven Tessier,
Yejia Zhang,
Simon Y. Tang,
Takashi Ohnishi,
Emanuel José Novais,
Geoffrey J. Kerr,
Sarthak Mohanty,
Vivian Tam,
Wilson C. W. Chan,
Chao‐Ming Zhou,
Ying Zhang,
Victor Y. Leung,
Angela K. Brice,
Cheryle A. Séguin,
Danny Chan,
Nam Vo,
Makarand V. Risbud,
Chitra L. Dahia
Affiliations
Itzel Paola Melgoza
Orthopedic Soft Tissue Research Program Hospital for Special Surgery New York City New York USA
Srish S. Chenna
Orthopedic Soft Tissue Research Program Hospital for Special Surgery New York City New York USA
Steven Tessier
Department of Orthopaedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia Pennsylvania USA
Yejia Zhang
University of Pennsylvania Philadelphia Pennsylvania USA
Simon Y. Tang
Department of Orthopaedic Surgery Washington University in St Louis Missouri USA
Takashi Ohnishi
Department of Orthopaedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia Pennsylvania USA
Emanuel José Novais
Department of Orthopaedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia Pennsylvania USA
Geoffrey J. Kerr
Department of Physiology & Pharmacology Bone & Joint Institute, University of Western Ontario London Ontario Canada
Sarthak Mohanty
University of Pennsylvania Philadelphia Pennsylvania USA
Vivian Tam
School of Biomedical Sciences The University of Hong Kong Pokfulam Hong Kong
Wilson C. W. Chan
School of Biomedical Sciences The University of Hong Kong Pokfulam Hong Kong
Chao‐Ming Zhou
Department of Orthopaedic Surgery University of Pittsburgh Pennsylvania USA
Ying Zhang
School of Biomedical Sciences The University of Hong Kong Pokfulam Hong Kong
Victor Y. Leung
Department of Orthopaedics and Traumatology The University of Hong Kong Pokfulam Hong Kong
Angela K. Brice
University of Pennsylvania Philadelphia Pennsylvania USA
Cheryle A. Séguin
Department of Physiology & Pharmacology Bone & Joint Institute, University of Western Ontario London Ontario Canada
Danny Chan
School of Biomedical Sciences The University of Hong Kong Pokfulam Hong Kong
Nam Vo
Department of Orthopaedic Surgery University of Pittsburgh Pennsylvania USA
Makarand V. Risbud
Department of Orthopaedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia Pennsylvania USA
Chitra L. Dahia
Orthopedic Soft Tissue Research Program Hospital for Special Surgery New York City New York USA
Abstract Mice have been increasingly used as preclinical model to elucidate mechanisms and test therapeutics for treating intervertebral disc degeneration (IDD). Several intervertebral disc (IVD) histological scoring systems have been proposed, but none exists that reliably quantitate mouse disc pathologies. Here, we report a new robust quantitative mouse IVD histopathological scoring system developed by building consensus from the spine community analyses of previous scoring systems and features noted on different mouse models of IDD. The new scoring system analyzes 14 key histopathological features from nucleus pulposus (NP), annulus fibrosus (AF), endplate (EP), and AF/NP/EP interface regions. Each feature is categorized and scored; hence, the weight for quantifying the disc histopathology is equally distributed and not driven by only a few features. We tested the new histopathological scoring criteria using images of lumbar and coccygeal discs from different IDD models of both sexes, including genetic, needle‐punctured, static compressive models, and natural aging mice spanning neonatal to old age stages. Moreover, disc sections from common histological preparation techniques and stains including H&E, SafraninO/Fast green, and FAST were analyzed to enable better cross‐study comparisons. Fleiss's multi‐rater agreement test shows significant agreement by both experienced and novice multiple raters for all 14 features on several mouse models and sections prepared using various histological techniques. The sensitivity and specificity of the new scoring system was validated using artificial intelligence and supervised and unsupervised machine learning algorithms, including artificial neural networks, k‐means clustering, and principal component analysis. Finally, we applied the new scoring system on established disc degeneration models and demonstrated high sensitivity and specificity of histopathological scoring changes. Overall, the new histopathological scoring system offers the ability to quantify histological changes in mouse models of disc degeneration and regeneration with high sensitivity and specificity.