ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Is fractal dimension a reliable imaging biomarker for the quantitative classification of an intervertebral disk?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Fractal analysis of tumor subregions differentiates benign from malignant breast lesions.Polish journal of radiology · 2026Article
- Novel Methods to Measure Height and Volume in Healthy and Degenerated Lumbar Discs in MRIs: A Reliability Assessment Study.Diagnostics (Basel, Switzerland) · 2022Article
- Deep learning-based high-accuracy quantitation for lumbar intervertebral disc degeneration from MRI.Nature communications · 2022Article
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6 authors.
Funding
Abstract
purposeThis study aimed to explore the feasibility of the fractal method used in decoding disk heterogeneity, hoping to find a reliable imaging biomarker for the quantitative and continuous grading of intervertebral disks (IVDs).
methodsTotally, 180 IVDs in 65 low back pain patients (29 males, 36 female, 28-69 years) were examined with MRI. Each IVD was manually segmented on axial slice (at the mid-height layer of the disk). All disks were visually evaluated regarding degeneration grade, using Pfirrmann classification, by two experienced radiologists. Fractal dimension (FD) of the IVD was calculated from the defined regions of interest and correlated with Pfirrmann grade.
resultsFractal dimension differed significantly between any two groups (P < 0.01). The mean FDs for the four grades were as follows: Pfirrmann 1: 1.13 ± 0.02; Pfirrmann 2: 1.30 ± 0.05; Pfirrmann 3: 1.50 ± 0.05; and Pfirrmann 4: 1.65 ± 0.02. The well-hydrated IVDs displayed low fractal dimension. Degenerated IVDs displayed increased fractal dimension caused by disk heterogeneity, where the fractal dimension was shown to correlate strongly with Pfirrmann grade.
conclusionsFractal dimension associated well with IVD degeneration, determined with Pfirrmann grading, suggesting that the IVD fractal analysis was a suitable detection tool for the objective and continuous classification of IVD degeneration. These slides can be retrieved under Electronic Supplementary Material.
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