title: Fractal analysis in radiological and nuclear medicine perfusion imaging: a systematic review.
abstract: OBJECTIVE
  To provide an overview of recent research in fractal analysis of tissue perfusion imaging, using standard radiological and nuclear medicine imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and to discuss implications for different fields of application.
  
  
  METHODS
  A systematic review of fractal analysis for tissue perfusion imaging was performed by searching the databases MEDLINE (via PubMed), EMBASE (via Ovid) and ISI Web of Science.
  
  
  RESULTS
  Thirty-seven eligible studies were identified. Fractal analysis was performed on perfusion imaging of tumours, lung, myocardium, kidney, skeletal muscle and cerebral diseases. Clinically, different aspects of tumour perfusion and cerebral diseases were successfully evaluated including detection and classification. In physiological settings, it was shown that perfusion under different conditions and in various organs can be properly described using fractal analysis.
  
  
  CONCLUSIONS
  Fractal analysis is a suitable method for quantifying heterogeneity from radiological and nuclear medicine perfusion images under a variety of conditions and in different organs. Further research is required to exploit physiologically proven fractal behaviour in the clinical setting.
  
  
  CONCLUSIONS
  • Fractal analysis of perfusion images can be successfully performed. • Tumour, pulmonary, myocardial, renal, skeletal muscle and cerebral perfusion have already been examined. • Clinical applications of fractal analysis include tumour and brain perfusion assessment. • Fractal analysis is a suitable method for quantifying perfusion heterogeneity. • Fractal analysis requires further research concerning the development of clinical applications.
authors: Charité - Universitätsmedizin Berlin, Medical School, Department of Radiology, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.
authors: Florian
authors: F
authors: Michallek
authors: Marc
authors: M
authors: Dewey
mesh_terms: D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D017709:Fractals; D006801:Humans; D009683:Nuclear Medicine / Q000379:methods*; D055420:Perfusion Imaging / Q000379:methods*
references: Nucl Med Commun. 2006 Feb;27(2):157-64
references: 16404229
references: IEEE Trans Biomed Eng. 2001 Apr;48(4):462-73
references: 11322534
references: Ultrasonics. 2012 Apr;52(4):508-20
references: 22154208
references: J Appl Physiol (1985). 2000 Apr;88(4):1365-73
references: 10749831
references: Med Image Anal. 2009 Aug;13(4):634-49
references: 19535282
references: J Neurol. 2003 Feb;250(2):194-200
references: 12574950
references: Circ Res. 1989 Sep;65(3):578-90
references: 2766485
references: J Nucl Med. 2003 Feb;44(2):316; author reply 317
references: 12571223
references: Eur J Nucl Med Mol Imaging. 2004 Feb;31(2):162-8
references: 15129697
references: Nuklearmedizin. 2000;39(2):37-42
references: 10768168
references: Eur J Nucl Med. 2001 Apr;28(4):450-6
references: 11357494
references: J Physiol. 2003 Jan 15;546(Pt 2):529-35
references: 12527739
references: J Nucl Med. 2002 Dec;43(12):1727-8; author reply 1728
references: 12468525
references: J Nucl Med. 2003 Nov;44(11):1874
references: 14602874
references: MAGMA. 2012 Oct;25(5):335-44
references: 22446877
references: Phys Med Biol. 2011 Mar 21;56(6):1601-16
references: 21335648
references: PLoS Med. 2009 Jul 21;6(7):e1000100
references: 19621070
references: J Nucl Med. 2003 Apr;44(4):505-11
references: 12679392
references: J Vis Exp. 2011 May 30;(51):
references: 21673635
references: J Appl Physiol (1985). 2009 Apr;106(4):1057-64
references: 19057006
references: Eur J Nucl Med Mol Imaging. 2010 Aug;37 Suppl 1:S52-64
references: 20461372
references: Eur Radiol. 2009 Jun;19(6):1358-65
references: 19190914
references: J Appl Physiol (1985). 2007 May;102(5):2064-70
references: 17303711
references: Invest Radiol. 1994 Jan;29(1):16-23
references: 8144332
references: Phys Med. 2008 Jun;24(2):87-91
references: 18294894
references: J Nucl Med. 2001 Oct;42(10):1446-50
references: 11585855
references: Ann Biomed Eng. 1998 Jul-Aug;26(4):519-25
references: 9662144
references: IEEE Trans Biomed Eng. 2008 Jul;55(7):1822-30
references: 18595800
references: Neurosci Res. 2006 Jul;55(3):285-91
references: 16644047
references: Nat Methods. 2012 Jun 28;9(7):676-82
references: 22743772
references: Magn Reson Med. 2009 Aug;62(2):488-99
references: 19466747
references: J Ultrasound Med. 2004 Jan;23(1):37-41
references: 14756351
references: Med Image Comput Comput Assist Interv. 2007;10(Pt 2):376-84
references: 18044591
references: Circ Res. 2001 Feb 16;88(3):340-6
references: 11179203
references: News Physiol Sci. 1988 Jan 1;3(1):5-10
references: 20871797
references: AJNR Am J Neuroradiol. 2003 Aug;24(7):1341-7
references: 12917125
references: J Appl Physiol (1985). 1990 Aug;69(2):532-45
references: 2228863
references: Br J Cancer. 2011 Jun 28;105(1):139-45
references: 21673686
references: PLoS One. 2012;7(11):e47443
references: 23139743
references: J Nucl Med. 2001 Feb;42(2):248-56
references: 11216523
references: IEEE Trans Med Imaging. 2006 Aug;25(8):1079-86
references: 16895000
references: World Neurosurg. 2012 May-Jun;77(5-6):785.e11-21
references: 22120276
references: Annu Rev Biomed Eng. 2004;6:427-52
references: 15255776
references: J Theor Biol. 2010 Feb 21;262(4):614-33
references: 19913557
references: Eur J Nucl Med Mol Imaging. 2005 Apr;32(4):516
references: 15750828
references: Radiology. 2012 Jun;263(3):865-73
references: 22438361
references: J Biomech Eng. 1999 Oct;121(5):480-6
references: 10529914
references: EJNMMI Res. 2012 Jul 20;2(1):40
references: 22818866