title: Digital camera image analysis of faeces in detection of cholestatic jaundice in infants.
abstract: BACKGROUND
  Stool colour assessment is a screening method for biliary tract obstruction in infants. This study is aimed to be a proof of concept work of digital photograph image analysis of stool colour compared to colour grading by a colour card, and the stool bilirubin level test.
  
  
  METHODS
  The total bilirubin (TB) level contents in stool samples from 17 infants aged less than 1 year, seven with confirmed cholestatic jaundice and ten healthy subjects was measured, and outcome correlated with the physical colour of the stool.
  
  
  RESULTS
  The seven infants with cholestasis included 6 cases of biliary atresia and 1 case of pancreatic mass. All pre-operative stool samples in these cases were indicated as grade 1 on the stool card (stool colour in healthy infants ranges from 4 to 6). The average stool TB in the pale stool group was 43.07 μg/g compared to 101.78 μg/g in the non-pale stool group. Of the 3 colour channels assessed in the digital photographs, the blue and green light were best able to discriminate accurately between the pre-operative stool samples from infants with cholestasis and the samples from the healthy controls. With red, green, and blue (RGB) image analysis using wave level as the ANN input, the system predicts the stool TB with a relationship coefficient of 0.96, compared to 0.61 when stool colour card grading was used.
  
  
  CONCLUSIONS
  Input from digital camera images of stool had a higher predictive capability compared to the standard stool colour card, indicating using digital photographs may be a useful tool for detection of cholestasis in infants.
authors: Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Parinya
authors: P
authors: Parinyanut
authors: Department of Electrical Engineering, Faculty of Engineering, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Tai
authors: T
authors: Bandisak
authors: Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Piyawan
authors: P
authors: Chiengkriwate
authors: Department of Electrical Engineering, Faculty of Engineering, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Sawit
authors: S
authors: Tanthanuch
authors: Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Surasak
authors: S
authors: Sangkhathat
mesh_terms: D016022:Case-Control Studies; D002779:Cholestasis / Q000000981:diagnostic imaging*; D005243:Feces; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D041781:Jaundice, Obstructive / Q000000981:diagnostic imaging*; D008297:Male; D010781:Photography; D012372:ROC Curve