Imaging Sci Dent.  2012 Dec;42(4):231-235. 10.5624/isd.2012.42.4.231.

Prediction of age-related osteoporosis using fractal analysis on panoramic radiographs

• Koh KJ
• Park HN
• Kim KA

• KMID: 1806789
• DOI: http://doi.org/10.5624/isd.2012.42.4.231

Abstract

PURPOSE
This study was performed to evaluate the trabecular pattern on panoramic radiographs to predict age-related osteoporosis in postmenopausal women.
MATERIALS AND METHODS
Thirty-one postmenopausal osteoporotic women and 25 postmenopausal healthy women between the ages of 50 and 88 were enrolled in this study. The bone mineral density (BMD) of the lumbar vertebrae and femur were calculated using dual-energy X-ray absorptiometry (DXA), and panoramic radiographs were obtained. Fractal dimension (FD) was measured using the box counting method from 560 regions of interest (51x51 pixels) in 6 sites on the panoramic radiographs. The relationships between age and BMD and between FD and BMD were assessed, and the intraobserver agreement was determined.
RESULTS
There was a significant difference in the FD values between the osteoporotic and normal groups (p<0.05). There was a significant difference in the FD values at three sites in the jaws (p<0.05). Age was significantly correlated with the BMD measurements, with an odds ratio of 1.25. However, the FD values were not significantly correlated with the BMD measurements, with an odds ratio of 0.000. The intraobserver agreement showed relatively higher correlation coefficients at the upper premolar, lower premolar, and lower anterior regions than the other sites.
CONCLUSION
Age was an important risk factor for predicting the presence of osteoporosis in postmenopausal women. The lower premolar region was the most appropriate site for evaluating the FD value on panoramic radiographs. However, further investigation might be needed to predict osteoporosis using an FD value on panoramic radiographs.

Keyword

Osteoporosis, Age-Related; Fractals; Radiography, Panoramic

MeSH Terms

Absorptiometry, Photon
Bicuspid
Bone Density
Female
Femur
Fractals
Humans
Jaw
Lumbar Vertebrae
Odds Ratio
Osteoporosis
Radiography, Panoramic
Risk Factors

Figure

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  Fig. 1 Image processing procedures. A. The ROI (51×51 pixels) on a panoramic radiograph. B. The raw image before processing. C. A gaussian blurred image, D. A subtraction image. E. A binary image. F. An eroded image. G. A dilated image. H. A skeletonized image.

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