Histomorphometric features predict 1-year outcome of patients with idiopathic dilated cardiomyopathy considered to be at low priority for cardiac transplantation

Pelliccia, Francesco; d’Amati, Giulia; Cianfrocca, Cinzia; Bernucci, Paola; Nigri, A; Marino, Benedetto; Gallo, Pietro

doi:10.1016/0002-8703(94)90485-5

Cited by 23 publications

(13 citation statements)

References 37 publications

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“…For these reasons, it is particularly important to understand cardiac fibrosis as the mechanistic basis of cardiac remodeling. It is well known, that fibrosis and certain histological changes in the myocardium impact heart function and even survival [3,4]. …”

Section: Introductionmentioning

confidence: 99%

Quantification of myocardial fibrosis by digital image analysis and interactive stereology

et al. 2014

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BackgroundCardiac fibrosis disrupts the normal myocardial structure and has a direct impact on heart function and survival. Despite already available digital methods, the pathologist’s visual score is still widely considered as ground truth and used as a primary method in histomorphometric evaluations. The aim of this study was to compare the accuracy of digital image analysis tools and the pathologist’s visual scoring for evaluating fibrosis in human myocardial biopsies, based on reference data obtained by point counting performed on the same images.MethodsEndomyocardial biopsy material from 38 patients diagnosed with inflammatory dilated cardiomyopathy was used. The extent of total cardiac fibrosis was assessed by image analysis on Masson’s trichrome-stained tissue specimens using automated Colocalization and Genie software, by Stereology grid count and manually by Pathologist’s visual score.ResultsA total of 116 slides were analyzed. The mean results obtained by the Colocalization software (13.72 ± 12.24%) were closest to the reference value of stereology (RVS), while the Genie software and Pathologist score gave a slight underestimation. RVS values correlated strongly with values obtained using the Colocalization and Genie (r > 0.9, p < 0.001) software as well as the pathologist visual score. Differences in fibrosis quantification by Colocalization and RVS were statistically insignificant. However, significant bias was found in the results obtained by using Genie versus RVS and pathologist score versus RVS with mean difference values of: -1.61% and 2.24%. Bland-Altman plots showed a bidirectional bias dependent on the magnitude of the measurement: Colocalization software overestimated the area fraction of fibrosis in the lower end, and underestimated in the higher end of the RVS values. Meanwhile, Genie software as well as the pathologist score showed more uniform results throughout the values, with a slight underestimation in the mid-range for both.ConclusionBoth applied digital image analysis methods revealed almost perfect correlation with the criterion standard obtained by stereology grid count and, in terms of accuracy, outperformed the pathologist’s visual score. Genie algorithm proved to be the method of choice with the only drawback of a slight underestimation bias, which is considered acceptable for both clinical and research evaluations.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9857909611227193

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Section: Introductionmentioning

confidence: 99%

Quantification of myocardial fibrosis by digital image analysis and interactive stereology

et al. 2014

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“…Cardiac arrhythmias, like atrial fibrillation, are known to originate from a disturbed intercellular signaling due to fibrosis [5, 12]. In many cardiac diseases, histological changes of the myocardium, including fibrosis, have been linked to cardiac function and even survival [29, 40]. …”

Section: Introductionmentioning

confidence: 99%

Rapid quantification of myocardial fibrosis: a new macro-based automated analysis

et al. 2011

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Background Fibrosis is associated with various cardiac pathologies and dysfunction. Current quantification methods are time-consuming and laborious. We describe a semiautomated quantification technique for myocardial fibrosis and validated this using traditional methods. Methods Pulmonary Hypertension (PH) was induced in adult Wistar rats by subcutaneous monocrotaline (MCT) injection(40 mg/kg). Cryosections of myocardial tissue (5 μm) of PH rats (n=9) and controls (n=9) were stained using Picrosirius red and scanned with a digital microscopic MIRAX slide scanner. From these sections 21 images were taken randomly of each heart. Using ImageJ software a macro for automated image analysis of the amount of fibrosis was developed. For comparison, fibrosis was quantified using traditional polarisation microscopy. Both methods were correlated and validated against stereology as the gold standard. Furthermore, the method was tested in paraffin-embedded human tissues. Results Automated analysis showed a significant increase of fibrosis in PH hearts vs. control. Automated analysis correlated with traditional polarisation and stereology analysis (r 2 =0.92 and r 2 =0.95 respectively). In human heart, lungs, kidney, and liver, a similar correlation with stereology (r 2 =0.91) was observed. Time required for automated analysis was 22% and 33% of the time needed for stereology and polarisation analysis respectively. Conclusion Automated quantification of fibrosis is feasible, objective, and time-efficient.

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“…Cardiac arrhythmias, like atrial fibrillation, are known to originate from a disturbed in-tercellular signaling due to fibrosis [5,12]. In many cardiac diseases, histological changes of the myocardium, including fibrosis, have been linked to cardiac function and even survival [29,40].…”

Section: Introductionmentioning

confidence: 99%

Rapid Quantification of Myocardial Fibrosis: A New Macro-Based Automated Analysis

Hadi

Mouchaers

Schalij

et al. 2010

Analytical Cellular Pathology

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Abstract.Background: Fibrosis is associated with various cardiac pathologies and dysfunction. Current quantification methods are time-consuming and laborious. We describe a semi-automated quantification technique for myocardial fibrosis and validated this using traditional methods.Methods: Pulmonary Hypertension (PH) was induced in adult Wistar rats by subcutaneous monocrotaline (MCT) injection (40 mg/kg). Cryosections of myocardial tissue (5 µm) of PH rats (n = 9) and controls (n = 9) were stained using Picrosirius red and scanned with a digital microscopic Mirax slide scanner. From these sections 21 images were taken randomly of each heart. Using ImageJ software a macro for automated image analysis of the amount of fibrosis was developed. For comparison, fibrosis was quantified using traditional polarisation microscopy. Both methods were correlated and validated against stereology as the gold standard. Furthermore, the method was tested in paraffin-embedded human tissues.Results: Automated analysis showed a significant increase of fibrosis in PH hearts vs. control. Automated analysis correlated with traditional polarisation and stereology analysis (r 2 = 0.92 and r 2 = 0.95, respectively). In human heart, lungs, kidney and liver, a similar correlation with stereology (r 2 = 0.91) was observed. Time required for automated analysis was 22 and 33% of the time needed for stereology and polarisation analysis, respectively.Conclusion: Automated quantification of fibrosis is feasible, objective and time-efficient.

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Histomorphometric features predict 1-year outcome of patients with idiopathic dilated cardiomyopathy considered to be at low priority for cardiac transplantation

Cited by 23 publications

References 37 publications

Quantification of myocardial fibrosis by digital image analysis and interactive stereology

Quantification of myocardial fibrosis by digital image analysis and interactive stereology

Rapid quantification of myocardial fibrosis: a new macro-based automated analysis

Rapid Quantification of Myocardial Fibrosis: A New Macro-Based Automated Analysis

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