Nuclear fractal dimension: A new objective approach for discriminating normal mucosa, dysplasia and carcinoma

Abstract

Background:Various clinical and histological factors have helped in predicting the survival of patients with oral squamous cell carcinoma (OSCC). However, there has been a need for more specialized diagnostic and prognostic factors to avoid subjective variation among opinion. Thus, fractal dimension (FD) can be used as an index of the morphological changes that the epithelial cells undergo during their transformation into neoplastic cell. In oral cancer study, nuclear FD (NFD) can be used as a quantitative index to discriminate between normal, dysplastic and neoplastic oral mucosa.Aim:To use nuclear fractal geometry to compare the morphometric complexity in the normal, epithelial dysplasia and OSCC cases and to verify the difference among the various histological grades of dysplasia and OSCC. It was fulfilled by estimating the FDs of the nuclear surface.Materials and Methods:Histopathologically diagnosed cases of epithelial dysplasia and OSCC were taken from the archives. Photomicrographs were captured with the help of Lawrence and Mayo research microscope. The images were then subjected to image analysis using the Image J software with FracLac plugin java 1.6 to obtain FDs. FD of ten selected nuclei was calculated using the box-counting algorithm.Statistical Analysis:was done using descriptive analysis, ANOVA and Tukey's honest significant difference post hoc tests with STATAIC-13 software.Results and Conclusion:NFD can provide valuable information to discriminate between normal mucosa, dysplasia and carcinoma objectively without subjective discrimination.

Surgical margins in head and neck squamous cell carcinoma: a narrative review

“…Fractal dimension (FD), which quantifies a pattern’s complexity by comparing how detail changes with the scale at which it is measured, presents a promising method to objectively distinguish dysplasia and carcinoma from normal mucosa 206 . FD, a quantitative result of fractal analysis applied to radiological perfusion imaging, represents chaos in the perfusion pattern and can be related to the structure of the underlying vascular tree 207 – 209 .…”

Fractal Analysis Applied to the Diagnosis of Oral Cancer and Oral Potentially Malignant Disorders: A Comprehensive Review

“…The 27 eligible studies were published over 30 years (1993-2022) from different countries of origin. Forty-four percent of them were published by Indian research groups [20][21][22][23][24][25][26][27][28][29][30][31], followed by, per number, four works from Greece [32][33][34][35], three from Italy [36][37][38], and the remaining papers from different countries, such as the UK [39], Romania [40], Germany [41], Canada [42], Taiwan [43], China [44], Poland [45], and Spain [46]. All the main characteristics of the studies are reported in Table 1.…”

“…nFD seemed a reliable diagnostic tool that need standardization to be validated, but the data collected suggest the possible use of FD also as a prognostic factor. 17 Phulari, (2016), India [24] To compare the morphometric complexity using nFD in normal, epithelial dysplasia, and OC cases and to verify the differences among the various histological grades of dysplasia and OC Histological specimens for assessment for distinguishing OC and various degrees of dysplasia…”

“…Discriminative multifractal signatures for healthy and pathological tissues FA was useful to distinguish alterations in the singularity spectrum width across healthy, pre-cancerous, and cancerous tissues. 24 Sharma, (2021), India [28] To understand the crystallization patterns in saliva and their relation to oral potentially malignant disorders in male patients Salivary specimens for assessment of crystallization pattern in OSF, OL, and OC Not specified Dried salivary films from patients with OSF, OL, and OC were examined under a stereo-zoom microscope to select ROIs for fern structure analysis.…”

“…Fractal analysis was predominantly applied to the analysis of the nuclear fractal dimension [23,24,31,32,39,43], in some cases supported by adjunct methods such as fluorescent or immunohistochemical staining [37,38,41,42], while other authors considered the fractal analysis to detect mitotic cells [25]. In some works, the vascular fractal dimension [33] or the geometry of the lymphatic vessels [40] was considered instead.…”