Abstract
AIM: To assess the sampling variability of computer-aided, fractal-corrected measures of fibrosis in liver biopsies. METHODS: Samples were derived from six to eight different parts of livers removed from 12 patients with clinically and histologically proven cirrhosis undergoing orthotopic liver transplantation. Sirius red-stained sections with a thickness of 2 mum were digitized using a computer-aided image analysis system that automatically measures the surface of fibrosis, as well as its outline perimeter, fractal surface and outline dimensions, wrinkledness, and Hurst coefficient. RESULTS: We found a high degree of inter-sample variability in the measurements of the surface [coefficient of variation (CV) = 43% +/- 13%] and wrinkledness (CV = 28% +/- 9%) of fibrosis, but the inter-sample variability of Hurst's exponent was low (CV = 14% +/- 2%). CONCLUSION: This study suggests that Hurst's exponent might be used in clinical practice as the best histological estimate of fibrosis in the whole organ, and evidences the fact that biopsy sections, which are fundamental for the qualitative diagnosis of chronic hepatitis, play a key role in the quantitative estimate of architectural changes in liver tissue.