# Quantification of Liver Fibrosis--A Comparative Study
## 4 Results and Discussion
### Results from Earlier Works Employing DIA and HAI Systems
[19], using the FibroQuant application, showed a significant reduction in porto-periportal and septal fibrosis areas among IFN responders (\(p<0.001\)) and non-responders (\(p<0.05\)). Finally, an increase in the fibrosis percentage in non-responders was observed (\(p<0.001\)). In [PERSON] et al. [20], the reduction of the biopsy length led to an increase of values in cases of mild fibrosis (\(p<0.001\)). Similarly, the number of complete and incomplete portal tracts decreased significantly when the specimen was shortened from the original \(\geq 3\) cm to 1 cm (\(p<0.001\)). The values in cases of severe fibrosis were also decreased among the shorter specimens. In terms of width,both fibrosis grade and stage were significantly underscored in the 1 mm samples, regardless of their length. In [PERSON] et al. [21], due to experimentation with different magnification factors, the coefficient of variation (CV) of the fibrosis index (FI) ranged from (a) 3.2% to 8.2% at the magnification of \(\times\)20, (b) 2.9% to 7.7% at \(\times\)40, and (c) 5.4% to 24.2% at \(\times\)100. It was concluded that FI at stoma closure or FIDR was significantly lower in living patients than in patients who eventually died or were subjected to liver transplantation. In [PERSON] et al. [22], at lower \(\times\)40 magnification, the peak proportion area change (PPAC) of fibrosis method was highly correlated with the modified HAI semi-quantitative fibrosis score (r = 0.621, \(p\) = 0.0002). During the comparison of semi-quantitative and DIA systems, both methods showed a good intra and inter-observer correlation: (a) DIA: r = 0.889, r = 0.837 and (b) modified HAI: r = 0.878, r = 0.776, respectively. [PERSON] et al. [23] found a significant Ishak correlation between the fibrosis ratio and an ordinal score change (r = 0.58, \(p\) < 0.001). However, a subset analysis showed that this correlation was restricted to biopsy specimens with high scores (r = 0.63, \(p\) < 0.001), and there was no correlation or difference between category means found among biopsy specimens with low scores (0-3: normal to early bridging fibrosis). Moreover, an agreement between the two estimates of fibrosis progression was found in only 11 (30%) of the 37 pairs compared. [PERSON] et al. [24] demonstrated that there were no significant differences relating to the risk of fibrosis progression, either using the Knodell or the Ishak scoring system. This was supported by the fact that there was a very strong correlation between the two staging systems (\(p\) = 0.0001). In [PERSON] et al. [25], the digital analysis of fibrosis percentage was highly correlated with the Ishak scores (\(p\) < 0.001). The area under receiver operating characteristic (AUROC) curves showed a reliable discriminative method capability when compared with semi-quantitative assessments of fibrosis and also an excellent inter-observer reliability (AUROC = 0.982-1.00). In [PERSON] et al. [26], patients with viral eradication presented a 7.2% \(\pm\) 1.5% fibrosis rate before therapy and 2.7% \(\pm\) 0.5% after therapy, showing a significant regression. Instead, in the conservative therapy group, the rate was 8.4% \(\pm\) 4.3% in the first biopsy and 15.9% \(\pm\) 7.7% in the second, respectively. Regression was overall confirmed to be a virologic response to IFN even in patients with liver cirrhosis. In [PERSON] et al. [27], the mean CPA value of the decompensated stage of CHB-related cirrhosis was 35.93% \(\pm\) 14.42%. The correlation coefficients of the CPA with a model for end-stage liver disease (MELD) score, serum total bilirubin (TBIL), and the international standard ratio (ISR) of prothrombin B were 0.553, 0.519 and 0.533, respectively (\(p\) < 0.001). In [PERSON] et al. [28], the multivariate analysis (MVA) showed that only CPA was associated with clinical liver decompensation (\(p\) = 0.010).