This paper suggests a new technique for trabecular bone characterization using fractal analysis of X‐Ray and MRI texture images for osteoporosis diagnosis. Osteoporosis is a chronic disease characterized by a decrease in bone density that can lead to fracture and disability. In essence, the proposed fractal model makes use of the differential box‐counting method (DBCM) to estimate the fractal dimension (FD) after an appropriate image preprocessing stage that ensures a robust estimation process. In this study, we showed that within the frequency domain generated through discrete cosine transform (DCT), only a quarter of DCT coefficients are enough to characterize osteoporotic tissues. The algorithmic complexity of the developed approach is of the order of N8log2N8 where N stands for the size of the image, which, in turn, likely yields important gain in terms of medication cost. We report a successful separation of healthy and pathological cases in term of both P − value (using statistical Wilcoxon rank sum test) and margin difference. A comparative statistical analysis has been performed using a publicly available database that contains a set of MRI and X‐Ray texture images of both healthy and osteoporotic bone tissues. The statistical results demonstrated the feasibility and accepted performance level of our fractal model‐based diagnosis to discriminate healthy and unhealthy trabecular bone tissues. The developed approach has been implemented on a medical device prototype.
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