Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 6995-7000
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.6995
Computer-aided morphometry of liver inflammation in needle biopsies
N Dioguardi, B Franceschini, C Russo, F Grizzi
N Dioguardi, B Franceschini, C Russo, F Grizzi, Scientific Direction, Istituto Clinico Humanitas, Rozzano, Milan, Italy and “Michele Rodriguez” Foundation, Institute for Quantitative Measures in Medicine, Milan, Italy
Author contributions: All authors contributed equally to the work.
Supported by the “Michele Rodriguez” Foundation, Institute for Quantitative Measures in Medicine, Milan, Italy
Correspondence to: Nicola Dioguardi, MD, Scientific Direction, Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano MI, Italy.
Telephone: +39-02-82244501 Fax: +39-02-82244590
Received: March 24, 2005
Revised: April 15, 2005
Accepted: April 18, 2005
Published online: November 28, 2005

AIM: To introduce a computer-aided morphometric method for quantifying the necro-inflammatory phase in liver biopsy specimens using fractal geometry and Delaunay’s triangulation.

METHODS: Two-micrometer thick biopsy sections taken from 78 chronic hepatitis C virus-infected patients were immunohistochemically treated to identify the inflammatory cells. An automatic computer-aided image analysis system was used to define the inflammatory cell network defined on the basis of Delaunay’s triangulation, and the inflammatory cells were geometrically classified as forming a cluster (an aggregation of a minimum of three cells) or as being irregularly distributed within the tissue. The phase of inflammatory activity was estimated using Hurst’s exponent.

RESULTS: The proposed automatic method was rapid and objective. It could not only provide rigorous results expressed by scalar numbers, but also allow the state of the whole organ to be represented by Hurst’s exponent with an error of no more than 12%.

CONCLUSION: The availability of rigorous metrical measures and the reasonable representativeness of the status of the organ as a whole raise the question as to whether the indication for hepatic biopsy should be revised by establishing clear rules concerning the contraindications suggested by its invasiveness and subjective interpretation.

Keywords: Biopsy, Grading, Image analysis, Fractal geometry, Topography, Delaunay