Computer Aided Quantification of Pathological Features for Flexor Tendon Pulleys on Microscopic Images

Abstract

Quantifying the pathological features of flexor tendon pulleys is essential for grading the trigger finger since it provides clinicians with objective evidence derived from microscopic images. Although manual grading is time consuming and dependent on the observer experience, there is a lack of image processing methods for automatically extracting pulley pathological features. In this paper, we design and develop a color-based image segmentation system to extract the color and shape features from pulley microscopic images. Two parameters which are the size ratio of abnormal tissue regions and the number ratio of abnormal nuclei are estimated as the pathological progression indices. The automatic quantification results show clear discrimination among different levels of diseased pulley specimens which are prone to misjudgments for human visual inspection. The proposed system provides a reliable and automatic way to obtain pathological parameters instead of manual evaluation which is with intra- and interoperator variability. Experiments with 290 microscopic images from 29 pulley specimens show good correspondence with pathologist expectations. Hence, the proposed system has great potential for assisting clinical experts in routine histopathological examinations.

Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

“…Furthermore, nuclei of cartilage-like cells had become rounded in shape [23]. All the specimens used in the study were examined by three pathologists and sorted into 3 grades [16] according to a modified version of the description proposed by Sbernardori and Bandiera in 2007 [23] and classification proposed by Drossos et al in 2009 [10]. The low grade (L) included those with a slightly basophilic myxoid matrix between collagen bundles.…”

“…The middle grade (M) showed irregular distribution of a chondromyxoid matrix and some sporadic round cartilaginous cells. The high grade (H) revealed patches of a chondromyxoid matrix and an increase of clustered round cartilaginous cells called chondroid metaplasia [16]. …”

“…In clinical severity classification, there were 8 in grade II, 6 in grade III and 7 in grade IV according to Froimson’s classification system [6]. In pathological grading, there were 5 in grade L, 8 in grade M, and 8 in grade H [16]. …”

“…Digital analysis provides the most direct information, not only from gross texture, but also from tissue or cells at the microscopic or biomolecular level, which may have morphological or feature changes [12-21]. In this study, we employed an automatic quantitative image analysis system developed by Liu et al in 2013 [16] in order to create a quantitative, accurate and reproducible assessment method. With this system, we attempted to address three correlations through a quantitative experimental study.…”

Tendinosis in Trigger Finger

“…There are systems for computer-aided quantification of pulley histopathology 167 . They can be used for histopathological grading, but are perhaps of little use in clinical practice because of the lack of a correlation between the histopathological and triggering grades.…”