Recommendations to quantify villous atrophy in video capsule endoscopy images of celiac disease patients.
OBJECTIVE
To quantify the presence of villous atrophy in endoscopic images for improved automation.


METHODS
There 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.


RESULTS
The 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.


CONCLUSIONS
Improved 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.
Edward J Ciaccio, Govind Bhagat, Suzanne K Lewis, Peter H Green, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States.
Edward J
EJ
Ciaccio
Edward J Ciaccio, Govind Bhagat, Suzanne K Lewis, Peter H Green, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States.
Govind
G
Bhagat
Edward J Ciaccio, Govind Bhagat, Suzanne K Lewis, Peter H Green, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States.
Suzanne K
SK
Lewis
Edward J Ciaccio, Govind Bhagat, Suzanne K Lewis, Peter H Green, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States.
Peter H
PH
Green
Celiac disease; Endoscopy; Small intestine; Video capsule; Villous atrophy