Fractal analysis of subchondral bone changes of the hand in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disorder. Conventional radiography, a widely available and cost-effective examination method, remains the standard of reference for the detection and quantification of joint involvement in RA. Fractal dimension (FD) of the trabecular bone structure has been proven to correlate with the bone's physical properties. The present study was designed to use fractal analysis to validate radiograph changes in the hand of RA patients.This study retrospectively evaluated the hand radiographs of 108 subjects. Fifty-four patients were suffering from RA, of which 18 were men and 36 were women. Their ages ranged from 25 to 90 years. The hand radiographs of 54 healthy patients, 18 men and 36 women (age range 23–88 years), were used as the control group. Bone structure value (BSV) is a critical parameter for the assessment and analysis of bone microarchitecture. The BSVs were calculated over the fractal dimension using the Brownian motion.The BSV calculated for ROI showed a significant difference in ROI5 (0.210 ± 0.045), ROI6 (0.186 ± 0.066), and ROI11 (0.201 ± 0.056) in patients with RA, in comparison to the CG (P < 0.05). A significant correlation was observed between anti-CCP and ROI4, ROI5, ROI6, ROI9, and ROI12 in seropositive RA patients (post hoc test (Bonferroni) P <0.001).This study demonstrates that the bone textural image analysis technique can be used to quantify the radiographic changes in RA hands, based on comparisons of FDs.

Study of the Efficacy of Artificial Intelligence Algorithm-Based Analysis of the Functional and Anatomical Improvement in Polynucleotide Treatment in Knee Osteoarthritis Patients: A Prospective Case Series

“…Among the parameters, we used the bone structure value (BSV) to analyze changes in the microstructure of the tibial subchondral bone after PN-filler treatment. According to previous studies on radiocarpal and knee joints, BSV is considered as a maximum-likelihood estimator of OA [ 30 , 31 , 32 ]. The BSV algorithm analyzes the self-similarity (uniformity) in the fractal dimension of the bone support structures based on the gray values of an X-ray image.…”

Assessment of correlation between hand-wrist maturation and cervical vertebral maturation: a fractal analysis study

“…Information about the 3D structure of the bone can be obtained through two-dimensional images, and fractal analysis enables detection of details that may be missed on radiographs [ 4 , 13 , 20 ]. Changes in the trabecular bone pattern have been demonstrated in several studies using fractal analysis [ 21 – 23 ].…”

Assessing the effects of long-term osteoporosis treatment by using conventional spine radiographs: results from a pilot study in a sub-cohort of a large randomized controlled trial

“…Clinically, fractal-based analysis applied to trabecular bone of calcaneus radiographs has been shown to discriminate between patients with prevalent vertebral fractures from such without, and that the discriminative power of fractal analysis may even be superior to that provided by BMD measurement [ 11 , 12 ]. In addition, it has been demonstrated that if applied to conventional radiographs of subchondral bone of the proximal tibia in patients with osteoarthritis, fractal-based analysis may provide reliable information on osteoarthritis progress, facilitating quantification of the severity and classification of this disease [ 13 , 14 ]; and finally, it has been demonstrated recently that fractal-based image analysis, similar to the one used in the prevailing study, can be used to quantify the radiographic changes of subchondral bone in rheumatoid arthritis hands [ 15 ].…”