A rigorous method for liver biopsy

Liver biopsy is still considered the gold standard for grading, staging and "stad-ging" the chronic liver disease.

In addition, it remains a primary source for acquiring new knowledge on the liver pathology. Demand for precise evaluations of the fibrosis and inflammatory tissue detectable in liver biopsy samples has been fuelled by the need to understand the closest-to-real effects of new antiviral molecules on the lesions characterising the histological patterns of chronic viral, toxic, metabolic and autoimmune diseases. The current scoring systems do not quantify these lesions, but only describe subjective classes of severity labelled with ordinal numbers, and the available automated methods based on observer-computer interactions do not abolish observer subjectivity or use an inadequate measurement unit, and also take too long to analyse entire histological sections.

A research article to be published on December 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Nicola Dioguardi from Italy described a quantitative analysis method of liver biopsy sections with a machine called "Metriser" which, at a speed of 0.1 mm2/s, automatically measures the residual hepatocyte mass (including hepatocytes vacuolisation), inflammation, fibrosis and the loss of liver tissue tectonics.

In the absence of any other means of obtaining correct reproducible information concerning the status of liver tissue, the authors explored the possibility of constructing the first totally computer-aided and strictly objective method of rigorously, rapidly and easily obtaining metrical measurements of liver lesions directly from bioptic specimens. The method provides: (1) the metrical extension in two-dimensions of the residual hepatocellular set including the area of vacuoles pertinent to abnormal lipid accumulation; (2) the geometric measure of the inflammation basin, distinguishing intra-basin space and extra-basin dispersed parenchymal leukocytes; (3) he magnitude of collagen islets, which were considered truncated fractals and classified into three classes of magnitude; and (4) the Tectonic Index that quantifies alterations (disorders) in the organization of liver tissue.

This study not only introduced a new kind of liver biopsy measurement but also described a histological picture in verbal and repeatable terms.