Ann Rheum Dis 1999;58:493-499 ( August )

Extended report

Quantitative analysis of synovial membrane inflammation: a comparison between automated and conventional microscopic measurements Gaye Cunnane^a, Lars Bjork^b, Ann-Kristin Ulfgren^c, Staffan Lindblad^c, Oliver FitzGerald^a, Barry Bresnihan^a, Ulf Andersson^c

^a Department of Rheumatology, St Vincents University Hospital, Dublin 4, Ireland, ^b Department of Biochemistry and Cell Biology, Pharmacia Upjohn, Stockholm, Sweden, ^c Rheumatology Research Laboratory, Karolinska Hospital, Stockholm, Sweden

Correspondence to: Dr B Bresnihan.

Accepted for publication 30 March 1999

OBJECTIVEThe objective of this study was to quantify selected features of chronic synovial tissue inflammation by computerised image analysis and to validate the results by comparison with conventional microscopic measurements.
METHODSSynovial biopsy samples were obtained from the knee joints of patients with chronic arthritis and prepared for immunohistochemical analysis using standard techniques. Following the development of special software, four parameters of chronic synovial inflammation were evaluated: intimal layer thickness, CD3+ cell infiltration, CD8+ cell infiltration and vascularity. Intimal layer thickness was expressed in microns. The intensity of CD3+ and CD8+ cell infiltration was expressed as the percentage area of the tissue section occupied by positively stained cells. Vascularity was expressed as the percentage area occupied by blood vessels. Conventional quantitative microscopic analysis was also undertaken and the results from both methods compared.
RESULTSSeventy eight tissue sections were selected for study. Measurements of intimal layer thickness by both techniques correlated strongly: r = 0.85, p = 0.0006. Measurements of CD8+ cell infiltration, usually widely dispersed, also correlated well: r = 0.64, p = 0.005. Measurements of CD3+ cell infiltration, often densely aggregated, correlated less well: r = 0.55, p = 0.02. Measurements of vascularity demonstrated no statistically significant correlation: r = 0.41, p = 0.07. Proficiency in the use of computerised image analysis was readily acquired.
CONCLUSIONComputerised image analysis was successfully applied to the measurement of some features of synovial tissue inflammation. Further software development is required to validate measurement of blood vessels of variable size.

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© 1999 by Annals of the Rheumatic Diseases
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