tokens: A confirmatory diagnosis requires detection of histological changes associated with the disease , which are classified according to guidelines from either Marsh [ 12 ] , Marsh modified ( Oberhuber ) [ 13 ] , or Corazza [ 14]. Endoscopic findings that indicate CD include scalloped folds with or without mosaic pattern mucosa , reduction in the number of folds , and nodular mucosa [ 15]. The spectrum of histologic changes in CD ranges from only increasing intraepithelial lymphocytes with preserved villous architecture to mild villous blunting to complete villous atrophy [ 16]. Studies have shown that the histological diagnosis of biopsies are subject to a significant degree of inter - observer variability [ 17 - 20]. One potential method for improving the accuracy of CD detection on duodenal biopsies is to apply automated image analysis to aid pathologists .