{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:35:06Z","timestamp":1788593706719,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T00:00:00Z","timestamp":1374624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Hepatic fibrosis staging is based on semiquantitative scores. Digital imaging analysis (<jats:styled-content style=\"fixed-case\">DIA<\/jats:styled-content>) appears more accurate because fibrosis is quantified in a continuous scale. However, high cost, lack of standardization and worldwide unavailability restrict its use in clinical practice. We developed an inexpensive and widely available <jats:styled-content style=\"fixed-case\">DIA<\/jats:styled-content> technique for fibrosis quantification in hepatitis C, and here, we evaluate its reproducibility and correlation with semiquantitative scores, and determine the fibrosis percentage associated with septal fibrosis and cirrhosis. 282 needle biopsies staged by Ishak and <jats:styled-content style=\"fixed-case\">METAVIR<\/jats:styled-content> scores were included. Images of trichrome\u2010stained sections were captured and processed using Adobe<jats:sup>\u00ae<\/jats:sup> Photoshop<jats:sup>\u00ae<\/jats:sup> <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>3 and Adobe<jats:sup>\u00ae<\/jats:sup> Bridge<jats:sup>\u00ae<\/jats:sup> softwares. The percentage of fibrosis (fibrosis index) was determined by the ratio between the fibrosis area and the total sample area, expressed in pixels calculated in an automated way. An excellent correlation between <jats:styled-content style=\"fixed-case\">DIA<\/jats:styled-content> fibrosis index and Ishak and <jats:styled-content style=\"fixed-case\">METAVIR<\/jats:styled-content> scores was observed (Spearman's <jats:italic>r<\/jats:italic>\u00a0=\u00a00.95 and 0.92; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, respectively). Excellent intra\u2010observer reproducibility was observed in a randomly chosen subset of 39 biopsies with an intraclass correlation index of 0.99 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.95\u20130.99). The best cut\u2010offs associated with septal fibrosis and cirrhosis were 6% (<jats:styled-content style=\"fixed-case\">AUROC<\/jats:styled-content> 0.97, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.95\u20130.99) and 27% (<jats:styled-content style=\"fixed-case\">AUROC<\/jats:styled-content> 1.0, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.99\u20131), respectively. This new <jats:styled-content style=\"fixed-case\">DIA<\/jats:styled-content> technique had high correlation with semiquantitative scores in hepatitis C. This method is reproducible, inexpensive and available worldwide allowing its use in clinical practice. The incorporation of <jats:styled-content style=\"fixed-case\">DIA<\/jats:styled-content> technique provides a more complete evaluation of fibrosis adding the quantification to architectural patterns.<\/jats:p>","DOI":"10.1111\/jvh.12133","type":"journal-article","created":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T19:32:42Z","timestamp":1374694362000},"page":"216-222","source":"Crossref","is-referenced-by-count":21,"title":["An inexpensive and worldwide available digital image analysis technique for histological fibrosis quantification in chronic hepatitis C"],"prefix":"10.1111","volume":"21","author":[{"given":"C. F. F.","family":"Campos","sequence":"first","affiliation":[{"name":"Pathology Department University of the State of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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