Multifractal spectrum differentiation of well-differentiated adenocarcinoma from complex atypical hyperplasia of the uterus.

OBJECTIVE: To introduce a new field of multifractal spectrum in distinguishing between endometrial well-differentiated adenocarcinoma (WDAC) and complex atypical hyperplasia (CAH).

STUDY DESIGN: Thirteen cases of CAH and 16 of WDAC were selected from radical hysterectomy specimens, and multifractal spectrum was measured from at least 4-5 representative digitized images of each case. The data were collected from f(alpha) vs. alpha curves. The values of alpha max, alpha min, and their difference delta alpha (alpha max-alpha min) were recorded and the data compared.

RESULTS: The mean +/- SD of alpha max, alpha min, and delta alpha of CAH were 2.36357 +/- 0.111623, 1.71357 +/- 0.032160, and 0.64214 +/- 0.094248, respectively. The mean +/- SD of alpha max, alpha min, and delta of WDAC were 2.50640 +/- 0.104545, 1.72100 +/- 0.036436, and 0.77620 +/- 0.108268, respectively. The mean of alpha max, alpha min, and delta alpha of WDAC were higher than in CAH. Mann-Whitney U test showed significant difference (p < 0.0001) of alpha max and delta alpja of WDAC and CAH.

CONCLUSION: Multifractal dimension is significantly different in WDAC and CAH. The multifractal dimension is a new area in pathology. This study demonstrates the potential usefulness of multifractal analysis in histopathology.