Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2006; 12(47): 7660-7665
Published online Dec 21, 2006. doi: 10.3748/wjg.v12.i47.7660
Sampling variability of computer-aided fractal-corrected measures of liver fibrosis in needle biopsy specimens
Fabio Grizzi, Carlo Russo, Barbara Franceschini, Mariagrazia Di Rocco, Valter Torri, Emanuela Morenghi, Luigi Rainiero Fassati, Nicola Dioguardi
Fabio Grizzi, Carlo Russo, Barbara Franceschini, Nicola Dioguardi, Laboratori di Medicina Quantitativa, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy
Mariagrazia Di Rocco, Department of Pathology, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy
Valter Torri, Laboratory of Clinical Research in Oncology, Mario Negri Institute of Pharmacological Research, Milan, Italy
Emanuela Morenghi, Clinical Research Office, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy
Luigi Rainiero Fassati, Department of General Surgery and Transplantation, Ospedale Maggiore IRCCS, Milan, Italy
Author contributions: All authors contributed equally to the work.
Supported by “Michele Rodriguez” Foundation, Institute for Quantitative Measures in Medicine, Milan, Italy
Correspondence to: Nicola Dioguardi, MD, Laboratori di Medicina Quantitativa, Istituto Clinico Humanitas IRCCS, Via Manzoni 56, Rozzano MI 20089, Italy.
Telephone: +39-2-82244501 Fax: +39-2-82244590
Received: May 31, 2006
Revised: November 1, 2006
Accepted: November 6, 2006
Published online: December 21, 2006

AIM: To assess the sampling variability of computer-aided, fractal-corrected measures of fibrosis in liver biopsies.

METHODS: Samples were derived from six to eight different parts of livers removed from 12 patients with clinically and histologically proven cirrhosis undergoing orthotopic liver transplantation. Sirius red-stained sections with a thickness of 2 μm were digitized using a computer-aided image analysis system that automatically measures the surface of fibrosis, as well as its outline perimeter, fractal surface and outline dimensions, wrinkledness, and Hurst coefficient.

RESULTS: We found a high degree of inter-sample variability in the measurements of the surface [coefficient of variation (CV) = 43% ± 13%] and wrinkledness (CV = 28% ± 9%) of fibrosis, but the inter-sample variability of Hurst’s exponent was low (CV = 14% ± 2%).

CONCLUSION: This study suggests that Hurst’s exponent might be used in clinical practice as the best histological estimate of fibrosis in the whole organ, and evidences the fact that biopsy sections, which are fundamental for the qualitative diagnosis of chronic hepatitis, play a key role in the quantitative estimate of architectural changes in liver tissue.

Keywords: Cirrhosis, Hepatitis C virus, Inter-sample variability, Extra-cellular matrix, Image analysis