Liver fibrosis assessment with semiquantitative indexes and image analysis quantification in sustained-responder and non-responder interferon-treated patients with chronic hepatitis C

Progression of fibrosis in advanced chronic hepatitis C

“…Mean collagen content of the liver biopsies decreased in the interferon-treated patients, but mean collagen increased by 26% in those treated with placebo for 24 weeks. Similarly, three other studies 20,23,33 found that collagen decreased after treatment with interferon alpha but included no placebo group. Finally, Kage et al 5 used morphometry to study 25 patients who progressed to cirrhosis caused by hepatitis C as well as 20 with hepatitis B.…”

“…Four published studies have used morphometry to study changes in hepatic fibrosis after alpha interferon therapy, 20,23,32,33 and one has used morphometry to study disease progression in untreated patients with chronic hepatitis C. 5 In an early interferon alpha-2b trial, Manabe et al 32 measured collagen content in 59 patients, 43 treated with interferon and 16 treated with placebo. Mean collagen content of the liver biopsies decreased in the interferon-treated patients, but mean collagen increased by 26% in those treated with placebo for 24 weeks.…”

“…All patients had been previously treated with interferon alpha, which three studies already cited reported to decrease fibrosis even in patients without a sustained virologic response. 20,23,33 Furthermore, 158 patients (65%) were treated with IFN-␥ 1b in the course of this study, but because there was no difference between these and placebo-treated patients (Tables 3 and 4), we combined the data from all 245 patients for the analyses. Even though our patients had been treated with potentially antifibrotic agents, the findings in this cohort are quite similar to those in the small groups of untreated patients reported by Manabe et al 32 and Kage et al 5 Extrapolating the reported data, Manabe et al 32 found an average increase in fibrosis of approximately 52% per year in 16 patients, Kage et al 5 found 55% per year in 25 patients, and we found 58% per year in 245 patients, despite the differences in patients and in the baseline levels of fibrosis.…”

“…Although the methodology is not standardized, a number of publications have described methods for quantifying hepatic fibrosis by image analysis, and all appear to yield similar results. 5,[18][19][20][21][22][23][24][25][26][27] The methods are time consuming compared with simple histologic scoring, and the necessary equipment and expertise are not widely available, but in a study to evaluate progression or regression of fibrosis, measuring the amount of fibrosis as precisely as possible seems appropriate.…”

Unsupervised Detection of Fibrosis in Microscopy Images Using Fractals and Fuzzy c-Means Clustering

“…In [14] a tool that classifies biological microscopic images of lung tissue sections with idiopathic pulmonary fibrosis was presented. Similar tools have also been proposed for the assessment of liver fibrosis [2,4,16,22], the study of micro vascular circulating leukocytes [9], the assessment of testicular interstitial fibrosis [19,20], or that of lung fibrosis [12]. The use of pattern recognition or classification methods like Support Vector Machines or Neural Networks has enabled the design of decision-making algorithms, appropriate to microscopic data.…”