Rationale and objectives: Fractal analysis of digitized images has been investigated in recent years as a potential measure of structural bone strength. Several technical issues associated with such measurements are assessed.
Methods: In a series of experiments using a hand phantom, the effects of system noise and modulation transfer function on fractal dimension were explored. The authors evaluated a method for correcting the estimated power spectrum using a step-wedge image exposed and digitized under identical conditions as a reference.
Results: System noise and modulation transfer function significantly affect estimated fractal dimension in bony regions computed from conventional radiographs.
Conclusions: Before conventional radiographs are used for fractal analysis in the clinical environment, many of the technical problems associated with this methodology must be addressed.