Recommendations to quantify villous atrophy in video capsule endoscopy images of celiac disease patients

Abstract

AIMTo quantify the presence of villous atrophy in endoscopic images for improved automation.METHODSThere are two main categories of quantitative descriptors helpful to detect villous atrophy: (1) Statistical and (2) Syntactic. Statistical descriptors measure the small intestinal substrate in endoscope-acquired images based on mathematical methods. Texture is the most commonly used statistical descriptor to quantify villous atrophy. Syntactic descriptors comprise a syntax, or set of rules, for analyzing and parsing the substrate into a set of objects with boundaries. The syntax is designed to identify and distinguish three-dimensional structures based on their shape.RESULTSThe variance texture statistical descriptor is useful to describe the average variability in image gray level representing villous atrophy, but does not determine the range in variability and the spatial relationships between regions. Improved textural descriptors will incorporate these factors, so that areas with variability gradients and regions that are orientation dependent can be distinguished. The protrusion syntactic descriptor is useful to detect three-dimensional architectural components, but is limited to identifying objects of a certain shape. Improvement in this descriptor will require incorporating flexibility to the prototypical template, so that protrusions of any shape can be detected, measured, and distinguished.CONCLUSIONImproved quantitative descriptors of villous atrophy are being developed, which will be useful in detecting subtle, varying patterns of villous atrophy in the small intestinal mucosa of suspected and known celiac disease patients.

Impact of gastrointestinal disease states on oral drug absorption – implications for formulation design – a PEARRL review

“…Normally, the villous atrophy occurs in patches and is localised at the duodenal bulb and in the descending duodenum, but more distal GI segments can also be affected. The villous atrophy results in decreased availability of absorptive surface area leading to impaired drug and nutrient absorption …”

Use of shape-from-shading to characterize mucosal topography in celiac disease videocapsule images

“…The resulting images provide depth information, although the process would be slow to complete for all areas where villous atrophy is suspected, due to the need to direct the probe across small areas at a time. An advantage of syntactic and textural-based methods for videocapsule analysis is the speed of computation, which would be useful for real-time analysis[ 20 , 21 ]. These methods, like the calculation done in this study to generate Figure 5 , are entirely automated, thus eliminating observer bias.…”

Current Evidence on Computer-Aided Diagnosis of Celiac Disease: Systematic Review

“…Among spatio-temporal features one can mention the pixel brightness, dynamic estimate of wall motility (Bassotti et al, 1994;Tursi, 2004) (standard deviation), periodicity in brightness, histogram mean level, shape-from-shading, pooling protocol, and statistical and syntactical measurements. Ciaccio et al proposed some quantitative measurement (statistical and syntactical measurement, motility estimation) in video capsule endoscopy images in order to detect and measure the presence of VA in CD patients (Ciaccio et al, 2016a;Ciaccio et al, 2016b). Also in (Ciaccio et al, 2017b), Ciaccio et al described and discussed methods used for quantitative detection and analysis of VA in the small intestinal mucosa of CD patients using video capsule endoscopy images but these remain to be further validated in larger samples (Ciaccio et al, 2017b).…”