RT Journal Article
SR Electronic
T1 Quantitative assessment of the degree of villous atrophy in patients with coeliac disease
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 1089
OP 1093
DO 10.1136/jcp.2008.058669
VO 61
IS 10
A1 E J Ciaccio
A1 G Bhagat
A1 A J Naiyer
A1 L Hernandez
A1 P H R Green
YR 2008
UL http://jcp.bmj.com/content/61/10/1089.abstract
AB 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.