TY - JOUR T1 - Quantitative assessment of the degree of villous atrophy in patients with coeliac disease JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 1089 LP - 1093 DO - 10.1136/jcp.2008.058669 VL - 61 IS - 10 AU - E J Ciaccio AU - G Bhagat AU - A J Naiyer AU - L Hernandez AU - P H R Green Y1 - 2008/10/01 UR - http://jcp.bmj.com/content/61/10/1089.abstract N2 - 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. ER -