Fractal dimension of cell clusters in effusion cytology

In this study, the fractal dimension (FD) of the ball-like tight clusters of known metastatic adenocarcinoma cells is compared with the tight cell clusters of the benign cells in the effusion fluid to find out the role of FD in differentiating malignant from benign cluster in effusion. A total of 68 and 72 images of cluster of cells from 12 cases of benign and 13 cases of metastatic pleural and peritoneal effusion were studied for FD. The mean FD of the cluster of cells of benign and malignant effusion was 1.4801 ± 0.23260 and 1.7175 ± 0.09006, respectively. Mann-Whitney U-test showed significant difference of FD between the cell clusters of malignant and benign effusion cases (P < 0.0001). Cytological features along with the measurement of FD of cell clusters in effusion cytology may be helpful in differentiating benign from malignant cases.