Background: The chronic liver disease is one of the most deadly diseases
in Egypt and around the world; perfect diagnosis methods are urgently needed.
The proper assessment of liver fibrosis offers acute information for both
perfect diagnosis and accurate therapeutic decision-making. Although digital
image analysis (DIA) is a promising method for quantitative assessment of liver
fibrosis, it has not been fully evaluated in practice yet. The present study
was designed to explore the possibilities of using open access image analysis
software (ImageJ) for accurate quantitative assessment of liver fibrosis.
Methods: This study investigated the use of digital images analysis by software
ImageJ of liver sections stained by sirius red (SR). Reproducibility of this
technique was tested in comparison with the a semi-quantitative score of liver
fibrosis as well as other markers of fibrosis including physiological markers
of liver functions such as alanine transaminase (ALT), aspartate
aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase
(GGT). In addition, it was tested compared to serum marker collagen IV (Col IV)
and hepatic hydroxyproline. Results: From physiological point of view; hepatic
hydroxyproline, serum Col IV and ALT showed higher accuracy, sensitivity and
specificity than other physiological markers with area under curve (AUC) of
0.935, 0.955 and 0.902 respectively. On the other hand, DIA of SR by ImageJ
software had shown the best accuracy with AUC of 1.0. In conclusions: our novel
data prove that the use of ImageJ with semiautomatic color segmentation is a
reliable and practical way of measuring collagen proportionate area. - See moreat
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