A more accurate way to diagnose liver diseases

Imaging system removes need for manual assessment and has been licensed for use here

An image taken by Laennec of liver tissue with non-alcoholic steatohepatitis. The imaging technology highlights fine collagen fibres, which cannot be observed using conventional staining techniques.
An image taken by Laennec of liver tissue with non-alcoholic steatohepatitis. The imaging technology highlights fine collagen fibres, which cannot be observed using conventional staining techniques. PHOTO: HISTOINDEX

A new imaging system that can automatically scan liver tissue samples to check for diseases - obviating the need for pathologists to do so manually - has been licensed for use in Singapore.

Called Laennec, it is the first such system to be approved for clinical use.

Its developer, local medtech company HistoIndex, is in discussions with three of Singapore's largest hospitals to introduce it.

HistoIndex chief executive Gideon Ho hopes it will be used to diagnose liver diseases in the second half of this year.

These include non-alcoholic fatty liver disease (NAFLD), the leading cause of chronic liver disease, estimated to afflict 20 to 30 per cent of the adult population in Asia.

Typically, tissue samples obtained from a liver biopsy are stained by a pathologist to manually visualise the disease and judge how serious it is.

The approach, however, is often time-consuming and may produce different results among different pathologists.

"In conventional microscopy, when staining is applied on the slide, it is like slapping an artefact on the tissue.

"If you take an image of the sample, it is an artefact that you are looking at and not the tissue in its truest form. This leads to inconsistent observations and discrepancies in diagnosis," said Dr Ho.

As the Laennec system does not require staining, anatomical details are clearly visible and fibrotic changes in the tissue can be distinguished easily, he added.

Dr Ho, 44, said his interest in developing a system that could aid in diagnosing liver diseases started 14 yearsago when he was a scientist at the Agency for Science, Technology and Research (A*Star).

He was then investigating techniques for the early and accurate detection of liver fibrosis (the accumulation of scars left by damaged cells) to improve treatment regimes.

"Detecting the severity and treatment of the disease has long been a health challenge globally, and from interactions with clinicians and researchers, we found there was no proper solution for the accurate assessment of liver fibrosis, which occurs in most types of chronic liver disease," he said.

He hopes his company's system will help clinicians by providing them with a more accurate staging of fibrosis in patients. This will also allow them to track the progression of the disease and its treatment efficacy.

The technology has already been used in clinical studies.

Professor Stephen Harrison, medical director of Pinnacle Clinical Research in Texas, used it to study biopsy samples from 101 patients with NAFLD and non-alcoholic steatohepatitis - a severe form of NAFLD.

Prof Harrison, who is also chairman of HistoIndex's scientific advisory board, said the system's novel way of measuring collagen is fully quantitative, compared with the current standard of care approach which is semi-quantitative.

"This difference allows for a much more accurate assessment of total fibrosis load," he added.

Join ST's WhatsApp Channel and get the latest news and must-reads.

A version of this article appeared in the print edition of The Straits Times on January 11, 2018, with the headline A more accurate way to diagnose liver diseases. Subscribe