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Digital camera image analysis of faeces in detection of cholestatic jaundice in infants
Parinya Parinyanut1, Tai Bandisak2, Piyawan Chiengkriwate1
1Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Insights
Digital stool analysis accurately detects infant cholestasis. Image analysis of stool colour using digital photographs shows higher predictive capability than traditional colour cards for identifying biliary tract obstruction in infants.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging Analysis
- Neonatal Jaundice Diagnostics
Background:
- Stool colour assessment is a critical screening method for detecting biliary tract obstruction in infants.
- Current methods rely on visual inspection and colour cards, which can be subjective.
- This study explores the potential of digital image analysis for objective stool colour assessment.
Purpose of the Study:
- To evaluate the efficacy of digital photograph image analysis of infant stool colour in detecting biliary tract obstruction.
- To compare the diagnostic accuracy of digital image analysis with traditional colour grading and stool bilirubin levels.
- To establish a proof of concept for a digital tool in diagnosing cholestasis.
Main Methods:
- Total bilirubin (TB) levels were measured in stool samples from 17 infants (<1 year), including 7 with confirmed cholestatic jaundice and 10 healthy controls.
- Stool colour was assessed using digital photography and compared to a standard stool colour card.
- Red, green, and blue (RGB) image analysis was employed, with artificial neural network (ANN) input, to predict stool TB levels.
Main Results:
- Infants with cholestasis presented with pale stools (Grade 1), while healthy infants had stools ranging from Grade 4 to 6.
- Average stool TB was significantly lower in pale stools (43.07 μg/g) compared to non-pale stools (101.78 μg/g).
- Digital RGB image analysis predicted stool TB with a high correlation (0.96), outperforming colour card grading (0.61).
Conclusions:
- Digital camera image analysis of infant stool colour demonstrates superior predictive capability for detecting cholestasis compared to standard stool colour cards.
- This technology offers a promising, objective tool for early identification of biliary tract issues in infants.
- Further development of digital photography-based diagnostics could improve infant jaundice screening.
Background:
Stool colour assessment is a screening method for biliary tract obstruction in infants. This study is aimed to be a proof of concept work of digital photograph image analysis of stool colour compared to colour grading by a colour card, and the stool bilirubin level test.
Materials And Methods:
The total bilirubin (TB) level contents in stool samples from 17 infants aged less than 1 year, seven with confirmed cholestatic jaundice and ten healthy subjects was measured, and outcome correlated with the physical colour of the stool.
Results:
The seven infants with cholestasis included 6 cases of biliary atresia and 1 case of pancreatic mass. All pre-operative stool samples in these cases were indicated as grade 1 on the stool card (stool colour in healthy infants ranges from 4 to 6). The average stool TB in the pale stool group was 43.07 μg/g compared to 101.78 μg/g in the non-pale stool group. Of the 3 colour channels assessed in the digital photographs, the blue and green light were best able to discriminate accurately between the pre-operative stool samples from infants with cholestasis and the samples from the healthy controls. With red, green, and blue (RGB) image analysis using wave level as the ANN input, the system predicts the stool TB with a relationship coefficient of 0.96, compared to 0.61 when stool colour card grading was used.
Conclusion:
Input from digital camera images of stool had a higher predictive capability compared to the standard stool colour card, indicating using digital photographs may be a useful tool for detection of cholestasis in infants.
