Quantitative assessment of liver fibrosis by digital image analysis: Relationship to Ishak staging and elasticity by shear-wave elastography.

Abstract

OBJECTIVE:

To analyze the relationship between fibrosis staged by Ishak stage and quantified by digital image analysis (DIA), and to reveal the optimum performance of shear-wave elastography (SWE) using quantitative DIA measurements as a comparative histological standard.

METHODS:

The proportionate area (PA) of fibrosis was measured by DIA from images of the PA of trichrome-stain (TPA) of 168 chronic hepatitis patients. SWE was performed in 105 patients. The accuracy of SWE for predicting the fibrosis defined by quantitative PA thresholds (≥ 2.5%, ≥ 5%, ≥ 10% and ≥ 20%, respectively) and by Ishak stages was measured using the area under the receiver operating characteristic curve (AUROC).

RESULTS:

DIA was proven to be highly reproducible (interclass correlation coefficient  0.926). The TPA range corresponding to each Ishak stage was large, widened as stages progressed, and reached its greatest extent in cirrhosis. TPA magnified at ×50 ranges 11.9-56% for Ishak stage F5-6. A good correlation between TPA and elasticity was presented for more advanced fibrosis (TPA ≥10%, rs  = 0.732, P = 0.000) than milder fibrosis (TPA <10%, rs  = 0.308, P = 0.006). With the advance of fibrosis either by stages or PA thresholds the discriminative accuracy of SWE gradually increased, but was less satisfactory for milder fibrosis.

CONCLUSIONS:

DIA may serve as a reproducible and reliable quantitative standard for surrogate tests for liver fibrosis. The performance and correlation of SWE with the fibrotic extent were better for advanced fibrosis, but less satisfactory for milder fibrosis.

• Authors: Ender Gunes Yegin, Korkut Yegin, Emrah Karatay, Erdem Faruk Kombak, Davut Tuney, Cigdem Ataizi-Celikel, Osman Cavit Ozdogan
• Journal: Journal of digestive diseases (J Dig Dis) Vol. 16 Issue 4 Pg. 217-27 (Apr 2015) ISSN: 1751-2980 [Electronic] Australia
• PMID: 25620218 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Chemical References

• Azo Compounds
• trichrome stain
• Methyl Green
• Eosine Yellowish-(YS)

Topics

• Adolescent
• Adult
• Aged
• Azo Compounds
• Biopsy
• Elasticity
• Elasticity Imaging Techniques (methods)
• Eosine Yellowish-(YS)
• Female
• Hepatitis, Chronic (diagnostic imaging)
• Humans
• Liver (pathology)
• Liver Cirrhosis (diagnostic imaging, pathology)
• Male
• Methyl Green
• Middle Aged
• ROC Curve
• Reproducibility of Results
• Retrospective Studies
• Severity of Illness Index
• Young Adult