Share:
Share this content in WeChat
X
• Review •
Research progress of MRI fractal analysis in glioma
LI Wenhui  TAN Yan 

Cite this article as: LI W H, TAN Y. Research progress of MRI fractal analysis in glioma[J]. Chin J Magn Reson Imaging, 2026, 17(10): 182-187. DOI:10.12015/issn.1674-8034.2026.10.022.


[Abstract] Glioma is the most common primary malignant tumor in the central nervous system. Accurate preoperative grading, molecular subtyping, and prognostic evaluation are crucial for developing individualized treatment strategies. Fractal analysis, a quantitative method based on fractal geometry theory, enables the characterization of structural complexity, irregularity, and spatial heterogeneity by calculating parameters such as fractal dimension (FD) and lacunarity (LAC), and has been increasingly applied in MRI studies of gliomas in recent years. This review summarizes the current applications of fractal analysis in glioma MRI, highlights the limitations of inconsistent research findings and insufficient evidence for clinical translation, and discusses future directions, including standardized analytical workflows, multicenter validation, and prospective studies, to further clarify its clinical utility. It aims to provide insights into preoperative non-invasive assessment of gliomas and further research on MRI-based fractal analysis in gliomas.
[Keywords] glioma;magnetic resonance imaging;fractal analysis;fractal dimension;lacunarity

LI Wenhui1   TAN Yan2*  

1 College of Basic Medicine, Shanxi Medical University, Jinzhong 030600, China

2 Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan 030001, China

Corresponding author: TAN Y, E-mail: tanyan123456@sina.com

Conflicts of interest   None.

Received  2026-07-06
Accepted  2026-09-14
DOI: 10.12015/issn.1674-8034.2026.10.022
Cite this article as: LI W H, TAN Y. Research progress of MRI fractal analysis in glioma[J]. Chin J Magn Reson Imaging, 2026, 17(10): 182-187. DOI:10.12015/issn.1674-8034.2026.10.022.

[1]
PRICE M, BALLARD C A P, BENEDETTI J R, et al. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2018-2022[J]. Neuro Oncol, 2025, 27(Supplement_4): iv1-iv66. DOI: 10.1093/neuonc/noaf194.
[2]
BALLESTÍN A, ARMOCIDA D, RIBECCO V, et al. Peritumoral brain zone in glioblastoma: biological, clinical and mechanical features[J/OL]. Front Immunol, 2024, 15: 1347877 [2026-06-25]. https://doi.org/10.3389/fimmu.2024.1347877. DOI: 10.3389/fimmu.2024.1347877.
[3]
DI IEVA A. Fractals in Neuroanatomy and Basic Neurosciences: An Overview[J]. Adv Neurobiol, 2024, 36: 141-147. DOI: 10.1007/978-3-031-47606-8_6.
[4]
DI IEVA A. The Fractal Geometry of the Brain: An Overview[J]. Adv Neurobiol, 2024, 36: 3-13. DOI: 10.1007/978-3-031-47606-8_1.
[5]
JANG K, RUSSO C, DI IEVA A. Radiomics in gliomas: clinical implications of computational modeling and fractal-based analysis[J]. Neuroradiology, 2020, 62(7): 771-790. DOI: 10.1007/s00234-020-02403-1.
[6]
LAHMIRI S, BOUKADOUM M, DI IEVA A. Fractals in Neuroimaging[J]. Adv Neurobiol, 2024, 36: 429-444. DOI: 10.1007/978-3-031-47606-8_22.
[7]
LOPES R. Multifractal Analysis in Neuroimaging[J]. Adv Neurobiol, 2024, 36: 79-93. DOI: 10.1007/978-3-031-47606-8_4.
[8]
MILLER K J, BERENDSEN S, SEUTE T, et al. Fractal structure in the volumetric contrast enhancement of malignant gliomas as a marker of oxidative metabolic pathway gene expression[J]. Transl Cancer Res, 2017, 6(6): 1275-1282. DOI: 10.21037/tcr.2017.10.15.
[9]
LIU S, WANG Y, XU K, et al. Relationship between necrotic patterns in glioblastoma and patient survival: fractal dimension and lacunarity analyses using magnetic resonance imaging[J/OL]. Sci Rep, 2017, 7(1): 8302 [2026-06-25]. https://doi.org/10.1038/s41598-017-08862-6. DOI: 10.1038/s41598-017-08862-6.
[10]
SHBOUL Z A, CHEN J, IFTEKHARUDDIN K M. Prediction of Molecular Mutations in Diffuse Low-Grade Gliomas using MR Imaging Features[J/OL]. Sci Rep, 2020, 10(1): 3711 [2026-06-25]. https://doi.org/10.1038/s41598-020-60550-0. DOI: 10.1038/s41598-020-60550-0.
[11]
YEBOA D N, BRAUNSTEIN S E, CABRERA A, et al. Radiation Therapy for WHO Grade 4 Adult-Type Diffuse Glioma: An ASTRO Clinical Practice Guideline[J]. Pract Radiat Oncol, 2025, 15(5): 451-471. DOI: 10.1016/j.prro.2025.05.014.
[12]
SMITHA K A, GUPTA A K, JAYASREE R S. Fractal analysis: fractal dimension and lacunarity from MR images for differentiating the grades of glioma[J]. Phys Med Biol, 2015, 60(17): 6937-6947. DOI: 10.1088/0031-9155/60/17/6937.
[13]
ALPAR O. Nakagami-fuzzy imaging for grading brain tumors by analyzing fractal complexity[J/OL]. Applied Soft Computing, 2024, 165: 112097 [2026-06-25]. https://doi.org/10.1016/j.asoc.2024.112097. DOI: 10.1016/j.asoc.2024.112097.
[14]
DI IEVA A, GÖD S, GRABNER G, et al. Three-dimensional susceptibility-weighted imaging at 7 T using fractal-based quantitative analysis to grade gliomas[J]. Neuroradiology, 2013, 55(1): 35-40. DOI: 10.1007/s00234-012-1081-1.
[15]
DI IEVA A, LE RESTE P J, CARSIN-NICOL B, et al. Diagnostic Value of Fractal Analysis for the Differentiation of Brain Tumors Using 3-Tesla Magnetic Resonance Susceptibility-Weighted Imaging[J]. Neurosurgery, 2016, 79(6): 839-846. DOI: 10.1227/neu.0000000000001308.
[16]
SCHMITZ-ABECASSIS B, CORNELISSEN I, JACOBS R, et al. Extension of T(2) Hyperintense Areas in Patients With a Glioma: A Comparison Between High-Quality 7 T MRI and Clinical Scans[J/OL]. NMR Biomed, 2025, 38(3): e5316 [2026-06-25]. https://doi.org/10.1002/nbm.5316. DOI: 10.1002/nbm.5316.
[17]
YADAV N, MOHANTY A, V A, et al. Fractal dimension and lacunarity measures of glioma subcomponents are discriminative of the grade of gliomas and IDH status[J/OL]. NMR Biomed, 2024, 37(12): e5272 [2026-06-25]. https://doi.org/10.1002/nbm.5272. DOI: 10.1002/nbm.5272.
[18]
BATTALAPALLI D, VIDYADHARAN S, PRABHAKAR RAO B, et al. Fractal dimension: analyzing its potential as a neuroimaging biomarker for brain tumor diagnosis using machine learning[J/OL]. Front Physiol, 2023, 14: 1201617 [2026-06-25]. https://doi.org/10.3389/fphys.2023.1201617. DOI: 10.3389/fphys.2023.1201617.
[19]
REZA S M S, SAMAD M D, SHBOUL Z A, et al. Glioma grading using structural magnetic resonance imaging and molecular data[J/OL]. J Med Imaging (Bellingham), 2019, 6(2): 024501 [2026-06-25]. https://doi.org/10.1117/1.Jmi.6.2.024501. DOI: 10.1117/1.Jmi.6.2.024501.
[20]
LOUIS D N, PERRY A, WESSELING P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary[J]. Neuro Oncol, 2021, 23(8): 1231-1251. DOI: 10.1093/neuonc/noab106.
[21]
TANG F, WANG D W, XI C, et al. Local and systemic effects of IDH mutations on primary glioma patients[J]. Immunology, 2023, 169(4): 503-514. DOI: 10.1111/imm.13649.
[22]
ASHKAN K, BAIG MIRZA A, SOUMPASIS C, et al. MGMT Promoter Methylation: Prognostication beyond Treatment Response[J/OL]. J Pers Med, 2023, 13(6): 999 [2026-06-25]. https://doi.org/10.3390/jpm13060999. DOI: 10.3390/jpm13060999.
[23]
XI H Z, ZHOU J L. Value of fractal dimension in evaluating IDH-1 mutation status and Ki-67 index of high-grade gliomas[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine, 2024, 22(2): 127-132. DOI: 10.3969/j.issn.1672-0512.2024.02.001.
[24]
WANG Y Y, ZHANG J, QIAO S Q, et al. Study of conventional MRI fractal parameters in predicting IDH1 mutation status of adult grade 2-3 diffuse gliomas[J]. Diagnostic Imaging & Interventional Radiology, 2024, 33(2): 120-127. DOI: 10.3969/j.issn.1005-8001.2024.02.007.
[25]
HAN Y, ZHANG J, XI Y B, et al. IDH mutation prediction in non-enhancing gliomas with relaxed T2-FLAIR mismatch and fractal dimension: a two-center study[J/OL]. BMC Med Imaging, 2026, 26(1): 61 [2026-06-25]. https://doi.org/10.1186/s12880-025-02140-y. DOI: 10.1186/s12880-025-02140-y.
[26]
SÁNCHEZ J, MARTÍN-LANDROVE M. Multifractal Analysis of Brain Tumor Interface in Glioblastoma[J]. Adv Neurobiol, 2024, 36: 487-499. DOI: 10.1007/978-3-031-47606-8_25.
[27]
XUE C, WANG K, DONG W, et al. Magnetic resonance imaging fractal analysis of O(6)-methylguanine-DNA methyltransferase promoter methylation status in isocitrate dehydrogenase wild-type glioblastoma[J]. Quant Imaging Med Surg, 2025, 15(11): 11398-11407. DOI: 10.21037/qims-2025-726.
[28]
LONG C, XU D, SUN W, et al. Nomogram prediction of molecular characteristics in WHO grade 3-4 diffuse gliomas based on fractal analysis and VASARI features[J/OL]. Sci Rep, 2025, 15(1): 15485 [2026-06-25]. https://doi.org/10.1038/s41598-025-00113-3. DOI: 10.1038/s41598-025-00113-3.
[29]
FENG A, LI L, HUANG T, et al. Differentiating glioblastoma from primary central nervous system lymphoma of atypical manifestation using multiparametric magnetic resonance imaging: A comparative study[J/OL]. Heliyon, 2023, 9(4): e15150 [2026-06-25]. https://doi.org/10.1016/j.heliyon.2023.e15150. DOI: 10.1016/j.heliyon.2023.e15150.
[30]
LI Y, LIU Y, LIANG Y, et al. Radiomics can differentiate high-grade glioma from brain metastasis: a systematic review and meta-analysis[J]. Eur Radiol, 2022, 32(11): 8039-8051. DOI: 10.1007/s00330-022-08828-x.
[31]
LIU S, FAN X, ZHANG C, et al. MR imaging based fractal analysis for differentiating primary CNS lymphoma and glioblastoma[J]. Eur Radiol, 2019, 29(3): 1348-1354. DOI: 10.1007/s00330-018-5658-x.
[32]
PETRUJKIĆ K, MILOŠEVIĆ N, RAJKOVIĆ N, et al. Computational quantitative MR image features - a potential useful tool in differentiating glioblastoma from solitary brain metastasis[J/OL]. Eur J Radiol, 2019, 119: 108634 [2026-06-25]. https://doi.org/10.1016/j.ejrad.2019.08.003. DOI: 10.1016/j.ejrad.2019.08.003.
[33]
WANG Y Y, YANG Y, QIAO S Q, et al. Conventional MRI fractal analysis in differentiating glioblastoma from solitary metastatic brain tumor[J]. Radiologic Practice, 2024, 39(11): 1442-1447. DOI: 10.13609/j.cnki.1000-0313.2024.11.003.
[34]
YADAV N, BAIBHAV J, SUBHADARSHINI S, et al. Brain metastases converge on shared geometric architecture and transcriptomic landscape yet remain distinct from gliomas[J/OL]. iScience, 2026, 29(4): 115329 [2026-06-25]. https://doi.org/10.1016/j.isci.2026.115329. DOI: 10.1016/j.isci.2026.115329.
[35]
PARK Y W, KIM S, AHN S S, et al. Magnetic resonance imaging-based 3-dimensional fractal dimension and lacunarity analyses may predict the meningioma grade[J]. Eur Radiol, 2020, 30(8): 4615-4622. DOI: 10.1007/s00330-020-06788-8.
[36]
CHEN Y, LIU H, YUAN P, et al. MicroRNA-based integrated diagnosis and therapy for GBM: current status and advances[J/OL]. Front Immunol, 2026, 17: 1806864 [2026-06-25]. https://doi.org/10.3389/fimmu.2026.1806864. DOI: 10.3389/fimmu.2026.1806864.
[37]
FRIEDES C, BERGER M, LINKOWSKI L, et al. Clinical, molecular, and immunologic determinants of survival in WHO-defined IDH-wildtype glioblastoma treated with radiotherapy: a large real-world cohort study[J/OL]. J Neurooncol, 2026, 177(3): 125 [2026-06-25]. https://doi.org/10.1007/s11060-026-05572-w. DOI: 10.1007/s11060-026-05572-w.
[38]
CURTIN L, WHITMIRE P, WHITE H, et al. Shape matters: morphological metrics of glioblastoma imaging abnormalities as biomarkers of prognosis[J/OL]. Sci Rep, 2021, 11(1): 23202 [2026-06-25]. https://doi.org/10.1038/s41598-021-02495-6. DOI: 10.1038/s41598-021-02495-6.
[39]
CURTIN L. Fractal-Based Morphometrics of Glioblastoma[J]. Adv Neurobiol, 2024, 36: 545-555. DOI: 10.1007/978-3-031-47606-8_28.
[40]
ZHAO H, ZHANG B, XUE B, et al. The specific linear or curved boundaries between WHO grade II-III insular gliomas and the basal ganglia indicate distinct biological features, survival outcomes, and surgical strategies: evidence from 330 cases[J/OL]. Neuroimage Clin, 2026, 50: 103995 [2026-06-25]. https://doi.org/10.1016/j.nicl.2026.103995. DOI: 10.1016/j.nicl.2026.103995.
[41]
DI IEVA A, MATULA C, GRIZZI F, et al. Fractal analysis of the susceptibility weighted imaging patterns in malignant brain tumors during antiangiogenic treatment: technical report on four cases serially imaged by 7 T magnetic resonance during a period of four weeks[J/OL]. World Neurosurg, 2012, 77(5-6): 785.e11-785.e21 [2026-06-25]. https://doi.org/10.1016/j.wneu.2011.09.006. DOI: 10.1016/j.wneu.2011.09.006.
[42]
XI H Z, JING M Y, CHAI Y J, et al. The value of DWI-based fractal dimension in evaluating the clinical efficacy of 3D printingtechnology for gliomas after surgery[J]. Chin J Magn Reson Imaging, 2024, 15(4): 32-37, 44. DOI: 10.12015/issn.1674-8034.2024.04.006.
[43]
KINNO R, MURAGAKI Y, MARUYAMA T, et al. Differential Effects of a Left Frontal Glioma on the Cortical Thickness and Complexity of Both Hemispheres[J/OL]. Cereb Cortex Commun, 2020, 1(1): tgaa027 [2026-06-25]. https://doi.org/10.1093/texcom/tgaa027. DOI: 10.1093/texcom/tgaa027.
[44]
KINNO R, MURAGAKI Y, MARUYAMA T, et al. Diffuse glioma-induced structural reorganization in close association with preexisting syntax-related networks[J]. Cortex, 2023, 167: 283-302. DOI: 10.1016/j.cortex.2023.07.005.
[45]
KINNO R, TAMURA M, MARUYAMA T, et al. Sentence-level language processing speed in diffuse glioma: lesion location and contralesional structural variability[J/OL]. Brain Lang, 2026, 277: 105751 [2026-06-25]. https://doi.org/10.1016/j.bandl.2026.105751. DOI: 10.1016/j.bandl.2026.105751.
[46]
PEREIRA D C, SILVA A B, LONGO L H C, et al. Evaluation of fractal descriptors, deep features and XAI representations with LASSO-regularized Hermite polynomial classifier for H&E histological image classification[J/OL]. Biomed Signal Process Control, 2026, 112: 108393 [2026-06-25]. https://doi.org/10.1016/j.bspc.2025.108393. DOI: 10.1016/j.bspc.2025.108393.

PREV Advances in neuroimaging studies of acupuncture for Alzheimer<sup><sup>,</sup></sup>s disease
NEXT Research progress on multimodal MRI and radiomics for predicting postoperative recurrence/progression in meningioma
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn