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Quantitative assessment of the degree of villous atrophy in patients with coeliac disease
  1. E J Ciaccio1,2,
  2. G Bhagat3,
  3. A J Naiyer4,
  4. L Hernandez4,
  5. P H R Green4
  1. 1Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, USA
  2. 2Department of Biomedical Engineering, Columbia University College of Physicians and Surgeons, New York, USA
  3. 3Department of Pathology, Columbia University College of Physicians and Surgeons, New York, USA
  4. 4Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA
  1. Dr E J Ciaccio, Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, New York, NY 10032, USA; ciaccio{at}columbia.edu

Abstract

Background: Endoscopy and biopsy are used to diagnose coeliac disease. There are, however, observer-dependent interpretations of the degree of villous atrophy in biopsies. A pilot study using quantitative image-processing procedures was performed to quantify the degree of villous atrophy in patients with coeliac disease.

Method: The degree of villous atrophy in duodenal biopsy images was quantified by calculating the ratio of villous edge-to-piecewise arc length (E/P ratio), and this value was compared with the blinded assessment of Marsh score for degree of villous atrophy.

Results: Mean E/P ratios for n = 31 biopsy images, 2.76 (SD 0.44) (Marsh IIIa), 1.91 (0.50) (Marsh IIIb) and 1.18 (0.22) (Marsh IIIc), were significantly different (p = 0.006). Based on non-parametric testing, the E/P ratios were inversely correlated with Marsh scores (Spearman coefficient ρ = −0.798, Kendall τ = −0.681; p<0.0001).

Conclusions: Biopsy images quantified by image analysis correlated exceedingly well with the histopathological grade of villous atrophy. Since quantified measurements are real-numbered values and lack observer bias, measurement of villous atrophy based on image analysis lends itself to standardisation of histological grading.

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Footnotes

  • Competing interests: None.

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