Viral Hepatitis
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 28, 2008; 14(48): 7335-7344
Published online Dec 28, 2008. doi: 10.3748/wjg.14.7335
Metrically measuring liver biopsy: A chronic hepatitis B and C computer-aided morphologic description
Nicola Dioguardi, Fabio Grizzi, Barbara Fiamengo, Carlo Russo
Nicola Dioguardi, Fabio Grizzi, Carlo Russo, Laboratories of Quantitative Medicine, Istituto Clinico Humanitas IRCCS, Rozzano 20089, Milan, Italy
Barbara Fiamengo, Department of Pathology, Istituto Clinico Humanitas IRCCS, Rozzano 20089, Milan, Italy
Author contributions: Dioguardi N designed and conducted the study, analyzed the data and prepared the manuscript; Grizzi F was responsible for the implementation of the fractal dimension software and for the metric and the immunology of inflammation; Fiamengo B did the anatomical interpretation of the liver biopsy sections; Russo C developed and implemented the computer metrical method.
Supported by Istituto Clinico Humanitas IRCCS, Rozzano, MI, and the “Michele Rodriguez” Foundation - Institute for Quantitative Measures in Medicine, Milan, Italy
Correspondence to: Nicola Dioguardi, MD, Scientific Superintendence, Istituto Clinico Humanitas IRCCS, Via Manzoni 56, Rozzano 20089, Milan, Italy.
Telephone: +39-2-82244501 Fax: +39-2-82244590
Received: July 9, 2008
Revised: August 16, 2008
Accepted: August 23, 2008
Published online: December 28, 2008

AIM: To describe a quantitative analysis method for liver biopsy sections with a machine that we have named “Dioguardi Histological Metriser” which automatically measures the residual hepatocyte mass (including hepatocytes vacuolization), inflammation, fibrosis and the loss of liver tissue tectonics.

METHODS: We analysed digitized images of liver biopsy sections taken from 398 patients. The analysis with Dioguardi Histological Metriser was validated by comparison with semi-quantitative scoring system.

RESULTS: The method provides: (1) the metrical extension in two-dimensions (the plane) of the residual hepatocellular set, including the area of vacuoles pertinent to abnormal lipid accumulation; (2) the geometric measure of the inflammation basin, which distinguishes intra-basin space and extra-basin dispersed parenchymal leukocytes; (3) the magnitude of collagen islets, (which were considered truncated fractals and classified into three degrees of magnitude); and (4) the tectonic index that quantifies alterations (disorders) in the organization of liver tissue. Dioguardi Histological Metriser machine allows to work at a speed of 0.1 mm2/s, scanning a whole section in 6-8 min.

CONCLUSION: The results are the first standardized metrical evaluation of the geometric properties of the parenchyma, inflammation, fibrosis, and alterations in liver tissue tectonics of the biopsy sections. The present study confirms that biopsies are still valuable, not only for diagnosing chronic hepatitis, but also for quantifying changes in the organization and order of liver tissue structure.

Keywords: Liver measurement, Image analysis, Liver lesion, Liver tectonics