A computer-assisted morphometric quantitative analysis of iron overload in liver biopsies. A comparison with histological and biochemical methods

The aim of this study was to evaluate a new method of image analysis used to quantify the iron load in routinely processed liver biopsies. Sixty-four liver biopsies from the same number of patients were studied. Both biochemical determination of iron concentration and histopathological semiquantification and quantification were performed. The latter was performed on Perls-stained liver sections by a semiautomatic system of image analysis that yields the percentage of stained liver tissue. In 43 samples with an hepatic iron content higher than 2000 μg/mg of dry tissue, this morphometric index was compared to the liver iron load measured biochemically, showing a significant correlation (Spearman's test) between both variables (ρ=0.686, p<0.001). Moreover, there is a better correlation when the semiquantitative Deugnier's histological index is compared with the biochemical method (ρ=0.425, p<0.004). Thus, we conclude that image analysis may be a valid method to assess hepatic iron storage in patients with liver diseases and that it may be more accurate than semiquantitative grading systems, such as the one described by Deugnier, since the morphometric method shows a closer correlation with the hepatic iron concentration determined biochemically.