Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2015; 6(2): 221-235
Published online Mar 18, 2015. doi: 10.5312/wjo.v6.i2.221
Fractal lacunarity of trabecular bone and magnetic resonance imaging: New perspectives for osteoporotic fracture risk assessment
Annamaria Zaia
Annamaria Zaia, Gerontologic and Geriatric Research Department, Italian National Research Center on Aging, I-60121 Ancona, Italy
Author contributions: Zaia A designed and performed the study, analyzed data, designed and wrote the paper.
Conflict-of-interest: The author has no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Annamaria Zaia, PhD, Gerontologic and Geriatric Research Department, Italian National Research Center on Aging, Via Birarelli 8, I-60121 Ancona, Italy. a.zaia@inrca.it
Telephone: +39-071-8004204 Fax: +39-071-206791
Received: June 18, 2014
Peer-review started: June 19, 2014
First decision: July 10, 2014
Revised: November 5, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: March 18, 2015
Core Tip

Core tip: High-resolution magnetic resonance imaging emerges as a useful tool for in vivo characterization of trabecular bone architecture (TBA). However, texture analysis is not frequently used as the large number of calculated parameters makes difficult their interpretation. Dealing with complexity and fractal properties of living beings, it is possible to quantify morpho-functional changes in aging and pathology with a limited number of parameters. In this context, fractal lacunarity appears the most suitable approach to TBA texture analysis as it describes discontinuity of bone network and sizes of bone marrow spaces, changes of which are an index of increased fracture risk.