Image analysis assessment of fibrosis from liver biopsy of chronic hepatitis patients

ABSTRACT

Liver fibrosis results from chronic inflammation of the hepatic parenchyma. Progressive accumulation of fibrous tissue eventually leads to cirrhosis and its complications. The severity of liver fibrosis defines the stage of chronic hepatitis and carries with it important clinical implications. Histological scoring systems such as Ishak provide descriptive evaluation of the liver tissue mainly in terms of architectural changes without measuring the amount of fibrosis. This study aimed to assess the theoretical advantage of image analysis morphometry for providing truly quantitative data with respect to the amount of fibrous tissue. A Lieca Qwin 500 image analyzer with a damaged area morphometry software was used applying the interactive method to measure the fibrous tissue area on the basis of different colors of hepatocytes and fibers following staining with Masson's trichrome stain. Forty-three patients [38 men and five women] were recruited into the study with a mean age of 45.5 years [range 15-58 years]. Of them, 40 had chronic viral hepatitis and three had chronic nonviral hepatitis. Morphometric measurements of fibrosis obtained with the image analyzer were highly correlated with results obtained using the Ishak method. The correlation was found to be statistically significant using the chi2-test [P<0.0001]. Quantitative image analysis for estimation of the percentage area of liver fibrosis is a simple and accurate method for evaluating fibrous tissue in patients with chronic hepatitis, aiding therapeutic approaches