Simplified method of hepatic fibrosis quantification: design of a new morphometric analysis application.

INTRODUCTION: Semiquantitative evaluation of liver specimens is considered the standard method for measuring fibrosis; however, these systems lack the precision of a quantitative technique. METHODS: We developed an image analysis application (FibroXact) that automates and simplifies color segmentation. Trichrome slides were scanned and the program was used to evaluate each pixel based upon hue, lightness, and saturation values. Percent fibrosis was automatically calculated after thresholding. RESULTS: Linear regression demonstrated a strong relationship between the FibroXact result and the semiquantitative result (P<0.001). CONCLUSION: We have developed an image analysis application to quantify liver fibrosis. Correlation between our results and a standard semiquantitative system was demonstrated.

Abdominal computed tomography prolongs length of stay and is frequently unnecessary in the evaluation of acute pancreatitis.

BACKGROUND: Computed tomography (CT) can play a vital role in the diagnosis and staging of patients with acute pancreatitis. However, according to current guidelines, a CT examination should not be performed in all patients. We assessed the use of CT scanning in the evaluation of patients with acute pancreatitis at an urban teaching hospital. METHODS: Retrospective review of patients admitted with the diagnosis of acute pancreatitis from October 1999 to October 2001. We recorded demographics, laboratory values, severity of illness, length of stay, indication for CT, ordering physician, and outcome. RESULTS: Overall, 108 patients met our inclusion criteria. Of these, 58 (54%) underwent CT examination. There was no difference (all P > 0.60) in markers of severity of illness in patients undergoing CT versus no CT. The only significant difference was length of stay (P = 0.003). Patients not undergoing CT were discharged a mean of 3 days sooner. Most appropriate CTs were ordered by the gastroenterology consultants as opposed to the emergency room and medical groups; however, this group's length of stay was longest (P = 0.035). CONCLUSIONS: In 1 teaching institution, physicians ordering CT for the evaluation of acute pancreatitis frequently do so without regard to the severity of patient illness. These examinations may prolong the length of hospitalization. Continued refinement and dissemination of guidelines for the diagnostic evaluation of acute pancreatitis is needed.