Neutrophil Extracellular Traps (NETs): An unexplored territory in renal pathobiology, a pilot computational study

Briana A. Santo, Brahm H. Segal, John E. Tomaszewski, Imtiaz Mohammad, Amber M. Worral, Sanjay Jain, Michelle B. Visser, Pinaki Sarder

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

4 Scopus citations


In the age of modern medicine and artificial intelligence, image analysis and machine learning have revolutionized diagnostic pathology, facilitating the development of computer aided diagnostics (CADs) which circumvent prevalent diagnostic challenges. Although CADs will expedite and improve the precision of clinical workflow, their prognostic potential, when paired with clinical outcome data, remains indeterminate. In high impact renal diseases, such as diabetic nephropathy and lupus nephritis (LN), progression often occurs rapidly and without immediate detection, due to the subtlety of structural changes in transient disease states. In such states, exploration of quantifiable image biomarkers, such as Neutrophil Extracellular Traps (NETs), may reveal alternative progression measures which correlate with clinical data. NETs have been implicated in LN as immunogenic cellular structures, whose occurrence and dysregulation results in excessive tissue damage and lesion manifestation. We propose that renal biopsy NET distribution will function as a discriminate, predictive biomarker in LN, and will supplement existing classification schemes. We have developed a computational pipeline for segmenting NET-like structures in LN biopsies. NET-like structures segmented from our biopsies warrant further study as they appear pathologically distinct, and resemble non-lytic, vital NETs. Examination of corresponding H&E regions predominantly placed NET-like structures in glomeruli, including globally and segmentally sclerosed glomeruli, and tubule lumina. Our work continues to explore NET-like structures in LN biopsies by: 1.) revising detection and analytical methods based on evolving NETs definitions, and 2.) cataloguing NET morphology in order to implement supervised classification of NET-like structures in histopathology images.

Original languageEnglish
Title of host publicationMedical Imaging 2020
Subtitle of host publicationDigital Pathology
EditorsJohn E. Tomaszewski, Aaron D. Ward
ISBN (Electronic)9781510634077
StatePublished - 2020
EventMedical Imaging 2020: Digital Pathology - Houston, United States
Duration: Feb 19 2020Feb 20 2020

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2020: Digital Pathology
Country/TerritoryUnited States


  • Feature engineering
  • Lupus nephritis
  • Neutrophil extracellular traps
  • Segmentation
  • Systemic lupus erythematosus


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