Association of bone mineral density with bone texture attributes extracted using routine magnetic resonance imaging

array:24 ["pii" => "S1807593222004732" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e1766" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "473" "copyright" => "CLINICS" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1807593222003428" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e1768" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "342" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL ARTICLE" "titulo" => "Response to fatigue observed through magnetic resonance imaging on the quadriceps muscle in postmenopausal women" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 775 "Ancho" => 976 "Tamanyo" => 26973 ] ] "descripcion" => array:1 [ "en" => "Correlation between average bilateral MRI (postexercise/fatigue) and 25-OH vitamin D levels." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Guilherme Carlos Brech, Thalita Sousa de Paula, Thiago Antônio Fedele, Aluane Silva Dias, José Maria Soares-Júnior, Marcelo Bordalo-Rodrigues, Edmund Chada Baracat, Angélica Castilho Alonso, Julia Maria D'Andréa Greve" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Guilherme Carlos" "apellidos" => "Brech" ] 1 => array:2 [ "nombre" => "Thalita Sousa de" "apellidos" => "Paula" ] 2 => array:2 [ "nombre" => "Thiago Antônio" "apellidos" => "Fedele" ] 3 => array:2 [ "nombre" => "Aluane Silva" "apellidos" => "Dias" ] 4 => array:2 [ "nombre" => "José Maria" "apellidos" => "Soares-Júnior" ] 5 => array:2 [ "nombre" => "Marcelo" "apellidos" => "Bordalo-Rodrigues" ] 6 => array:2 [ "nombre" => "Edmund Chada" "apellidos" => "Baracat" ] 7 => array:2 [ "nombre" => "Angélica Castilho" "apellidos" => "Alonso" ] 8 => array:2 [ "nombre" => "Julia Maria D'Andréa" "apellidos" => "Greve" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222003428?idApp=UINPBA00004N" "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222003428/v1_202211290815/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222004720" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e1764" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "472" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL ARTICLE" "titulo" => "Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 424 "Ancho" => 1248 "Tamanyo" => 47067 ] ] "descripcion" => array:1 [ "en" => "Halitosis scoring using a Breath-Alert™ device." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolina Cardoso Guedes, Sandra Kalil Bussadori, Ana Carolina Mota Garcia, Lara Jansiski Motta, Andréa Oliver Gomes, Raimar Weber, Olga Maria Silverio Amancio" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Carolina Cardoso" "apellidos" => "Guedes" ] 1 => array:2 [ "nombre" => "Sandra Kalil" "apellidos" => "Bussadori" ] 2 => array:2 [ "nombre" => "Ana Carolina Mota" "apellidos" => "Garcia" ] 3 => array:2 [ "nombre" => "Lara Jansiski" "apellidos" => "Motta" ] 4 => array:2 [ "nombre" => "Andréa Oliver" "apellidos" => "Gomes" ] 5 => array:2 [ "nombre" => "Raimar" "apellidos" => "Weber" ] 6 => array:2 [ "nombre" => "Olga Maria Silverio" "apellidos" => "Amancio" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004720?idApp=UINPBA00004N" "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004720/v1_202211290815/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL ARTICLE" "titulo" => "Association of bone mineral density with bone texture attributes extracted using routine magnetic resonance imaging" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jamilly Gomes Maciel, Iana Mizumukai de Araújo, Lucio C. Trazzi, Paulo Mazzoncini de Azevedo-Marques, Carlos Ernesto Garrido Salmon, Francisco José Albuquerque de Paula, Marcello Henrique Nogueira-Barbosa" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Jamilly Gomes" "apellidos" => "Maciel" "email" => array:2 [ 0 => "jamillygm@hotmail.com" 1 => "jamillygomes@fmrp.usp.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Iana Mizumukai de" "apellidos" => "Araújo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Lucio C." "apellidos" => "Trazzi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Paulo Mazzoncini de" "apellidos" => "Azevedo-Marques" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Carlos Ernesto Garrido" "apellidos" => "Salmon" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "III" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "Francisco José Albuquerque de" "apellidos" => "Paula" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "II" "identificador" => "aff2" ] ] ] 6 => array:3 [ "nombre" => "Marcello Henrique" "apellidos" => "Nogueira-Barbosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "I" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR" "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Medicina Interna, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR" "etiqueta" => "II" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Departamento de Fisica, Faculdade de Filosofia, Ciencias e Letras (FFCL), Universidade de São Paulo, Ribeirao Preto, SP, BR" "etiqueta" => "III" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1343 "Ancho" => 1300 "Tamanyo" => 149318 ] ] "descripcion" => array:1 [ "en" => "A 31-year-old female volunteer. Illustrated are the segmentation and positioning of the volume of interest (VOI) in the L3 vertebral body using the IBEX program for volumetric (three-dimensional) extraction of textural attributes (TAs)." ] ] ] "textoCompleto" => "INTRODUCTIONOsteoporosis is the most common metabolic bone disease and is characterized by reduced bone mineral density (BMD), deteriorated bone microarchitecture, and increased bone fragility and susceptibility to fractures (<a class="elsevierStyleCrossRef" href="#bib1">1</a>).BMD quantified with dual-energy X-ray absorptiometry (DXA) is used as a major determinant of osteoporosis; however, bone mass measurements are insufficient to correctly predict all osteoporotic fragility fractures. In spite of this, DXA continues to be an important tool in the clinical evaluation of osteoporosis. Moreover, DXA is still used as an initial, but insufficient, step in the evaluation of the efficacy of new drugs. This has encouraged the development of other techniques that can reveal bone strength abnormalities. Currently, several bone quality parameters are used with clinical data to improve the prediction of future fragility fractures (<a class="elsevierStyleCrossRefs" href="#bib2">2–4</a>).Together, bone geometry, cortical porosity, collagen properties, bone turnover rates, trabecular microarchitecture, and percentage of microdamage, and bone marrow adiposity (BMAT) are bone strength determinants. In addition, each property may independently contribute to an increased or decreased risk of fracture, even without changes in BMD (<a class="elsevierStyleCrossRefs" href="#bib5">5–10</a>). Recent studies have shown that texture-derived features extracted from multidetector computed tomography (MDCT) and DXA scans can indirectly quantify the trabecular bone microarchitecture and thus improve the traditional examination of bone quality and the prediction of fragility fractures (<a class="elsevierStyleCrossRef" href="#bib11">11</a>,<a class="elsevierStyleCrossRef" href="#bib12">12</a>).The gray-level co-occurrence matrix (GLCM) model is a texture analysis method that uses several statistical parameters to quantify the spatial relationship between diagnostic image pixels, allowing characterization of the morphological properties of underlying tissues (<a class="elsevierStyleCrossRef" href="#bib13">13</a>,<a class="elsevierStyleCrossRef" href="#bib14">14</a>). This model has been validated for characterizing textural attributes (TAs) from MDCT images; however, a few studies have used the same model to extract TAs from magnetic resonance imaging (MRI) scans. Most of these studies extracted texture patterns from the MRI scans of patients with tumors to improve diagnostic accuracy and prognostic prediction (<a class="elsevierStyleCrossRefs" href="#bib15">15–17</a>).MRI is a versatile imaging technique with great potential for enabling the multiparametric analysis of bone quality in a single examination. Advanced MRI sequences such as proton spectroscopy and gradient-echo sequences have been used to quantify BMAT and trabecular bone microarchitecture, respectively (<a class="elsevierStyleCrossRefs" href="#bib18">18–25</a>). However, to the best of our knowledge, no study has used routine MRI sequences to extract bone TA, a tool that can be used to indirectly study the microarchitecture of trabecular bone.This study investigated the interobserver reproducibility of bone texture parameters extracted from routine sagittal T2-weighted fast spin-echo (FSE) lumbar spine (LS) MRI sequences obtained from healthy eutrophic individuals by using GLCM texture features and evaluated their relationship with BMD.ETHICAL CONSIDERATIONSApproval by our institutional ethics committee was obtained (47580315.5.0000.5440). All the participants agreed to participate in the study and provided written informed consent. In addition, the procedures were performed in accordance with the Declaration of Helsinki.MATERIALS AND METHODSSubjectsThe study subjects were comprised 49 volunteers who underwent MRI and DXA between May 2011 and October 2014. Both examinations were performed on the same day. All the individuals were at least 18 years old and had a body mass index (BMI) between 18 and 25 kg/m2. Individuals who used medications that affect bone metabolism, reported histories of smoking and/or alcoholism in the last 10 years, and presented any structural abnormality in the LS that could affect MRI or DXA measurements were excluded from the study.Dual-energy X-ray absorptiometryThe BMD of the LS (L1-L4) was determined using DXA (Hologic Discovery Wi, QDR series, Hologic, Inc., Waltham, MA, USA). The precision error in the LS was 1.2%.MRI and TA extractionAll the subjects underwent LS MRI on a 1.5-Tesla system (Philips Achieva, Philips Medical Systems, Best, the Netherlands). Routine sagittal T2-weighted FSE sequences were used to extract TAs (echo time [TE], 120 ms; gap, 4.4 mm; echo-train length, 19; repetition time [TR], 3900 ms; slice thickness, 3.0 mm; scan duration, 2 min 16 s). The L3 vertebrae were manually segmented by two trained raters (JGM, a musculoskeletal radiologist with 3 years of experience in this area) and (LCT, a medical student research fellow). The GLCM characteristics were segmented and extracted using the radiomics analysis platform IBEX v 1.0 (<a class="elsevierStyleCrossRef" href="#bib26">26</a>) as demonstrated in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>.<elsevierMultimedia ident="fig1"></elsevierMultimedia>The IBEX software characterizes the spatial distribution of gray-level intensities in a region (ROI) or volume of interest (VOI) (<a class="elsevierStyleCrossRef" href="#bib27">27</a>). GLCMs obtained from a VOI or ROI are used to calculate the probability of occurrence of pixel/voxel pairs of gray-level intensities i and j given a distance d from an orientation θ (<a class="elsevierStyleCrossRef" href="#bib13">13</a>,<a class="elsevierStyleCrossRef" href="#bib28">28</a>).A total of 22 attributes were identified from the L3 segmented VOI. Thus, volumetric three-dimensional (3-D) GLCM (COM3Ds) analyses were performed for the vertebral body. COM3Ds directly computed the occurrence of intensity pairs in the orientation θ for the dimensions x and y, and in the orientation φ for the dimension z. The distances ranged from 1 to 5 voxels, and all 13 orientations of θ and φ (θ=0° and φ=0°, 45°, 90°, and 135°; θ=45° and φ=45°, 90°, and 135°; θ=90° and φ=45°, 90°, and 135°; and θ=135° and φ=45°, 90°, and 135°) were used, resulting in 65 COM3Ds. The 22 GLCM attributes extracted were autocorrelation, cluster prominence, cluster shade, cluster tendency, contrast, correlation, difference entropy, dissimilarity, energy, entropy, two measures of homogeneity (homogeneities 1 and 2), two measures of information correlation (IMC1 and IMC2), inverse difference moment normalized, inverse difference normalized, inverse variance, maximum probability, sum average, sum entropy, sum variance, and variance.Statistical analysesThe results were analyzed using one-way analysis of variance followed by the Duncan posttest. The confidence interval (CI) was 95%, and the level of significance was set at 0.05. Simple (model 1) and multiple (model 2) linear regression models were tested to verify the association of the parameters. Model 2 was adjusted by age and BMI. In addition, the Pearson correlation coefficient (r) was calculated to measure the strength of the relationship between the variables. The interobserver agreement was evaluated using the concordance test proposed by Lin in 1989 (<a class="elsevierStyleCrossRef" href="#bib29">29</a>). The levels of strength of the agreement associated with kappa statistics were described according to the corresponding kappa ranges as follows: poor, 0.00-0.19; fair, 0.20-0.39; moderate, 0.40-0.59; substantial, 0.60-0.79; and almost perfect, 0.80-1.00 (<a class="elsevierStyleCrossRef" href="#bib30">30</a>). All analyses were performed using the SAS 9.4 software (<a class="elsevierStyleCrossRef" href="#bib31">31</a>).RESULTSPatients' demographics, clinical characteristics, and BMDThe study subjects were comprised 49 healthy individuals with a mean age of 41±14.2 years (range, 20-68 years; median, 39 years) and a mean BMI of 22.6 kg/m2. Of the subjects, 20 were men (mean age, 41±15.5 years; range, 20-68 years) and 29 were women (mean age, 40.9±13.4 years; range, 21-66 years). All nine women aged >50 years were in the postmenopausal stage. The mean BMI was similar between the men and the women (<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>). The LS BMD results were available for all the subjects. No significant difference in BMD measured with DXA was found between the men and the women. In addition, the differences in the BMDs of the LS (L1-L4) and third lumbar vertebral body (L3) were not significant (p>0.05; <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>).<elsevierMultimedia ident="tbl1"></elsevierMultimedia>Correlation between BMD and bone TAsThe results revealed a fair-to-moderate significant correlation between BMD and 13 TAs derived from MRI scans (r=−0.20 to 0.39; p<0.05). Eight TAs (autocorrelation, energy, homogeneity 1, homogeneity 1.1, maximum probability, sum average, sum variance, and inverse difference normalized) negatively correlated with BMD (r=−0.20 to −0.38; p<0.05), and five TAs (dissimilarity, difference entropy, entropy, sum entropy, and information measure corr 1) positively correlated with BMD (r=0.29-0.39; p<0.05; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>).<elsevierMultimedia ident="tbl2"></elsevierMultimedia>Inter-rater reliabilityThis study evaluated the agreement between two observers (JGM and LCT) for the 13 significant TAs derived from MRI scans. Both researchers performed manual segmentation of the L3 vertebra using the IBEX software and extracted TAs using the software. Both researchers were blinded to the patients' clinical data and identification. The extracted values were tabulated in Excel, and the agreement coefficient was calculated using the Lin coefficient. The results demonstrated an almost perfect interobserver agreement for all 13 significant TAs extracted (95% CI, 0.92-1.00; p<0.05). The level of agreement of the two observers was greater for the following parameters: autocorrelation, cluster tendency, contrast, difference entropy, dissimilarity, energy, entropy, homogeneity 1, homogeneity 2, inverse different moment normalized, inverse different normalized, inverse variance, maximum probability, sum average, sum entropy, sum variance, and variance.DISCUSSIONRadiomics is a research area that has shown promising growth and usefulness in diagnostic and prognostic evaluations and therapeutic decision making (<a class="elsevierStyleCrossRefs" href="#bib32">32–34</a>). Texture-based quantitative features are used to characterize uniformity, randomness, and repetitive patterns in an image and have been used to detect pathologies and malignancies. Moreover, texture analysis using spectral and structural attributes extracted from MRI scans has been used to differentiate between osteoporotic and malignant compression fractures of vertebral bodies, with promising results reported in the literature (<a class="elsevierStyleCrossRef" href="#bib35">35</a>).Texture features have been used to study the microarchitectural characteristics of the trabecular bone from high-resolution quantitative computed tomography (HR-pQCT) images. However, no studies have been published using GLCM to extract TAs that may reflect the microarchitecture of the trabecular bone and bone fragility from spinal MRI scans. In our study, we used GLCM to characterize the spatial distribution of the gray-level within volumetric LS images from routine sagittal T2-weighted MRI scans. The choice of sagittal T2-weighted FSE sequences is justified because this sequence is widely available in many routine spinal MRI protocols. The distribution of gray levels is directly impacted by the spatial resolution of MRI sequences. The same attribute is expected to present different values for the same image obtained at different spatial resolutions. In fact, a reported methodology takes advantage of this possible variation and pattern recognition techniques, using attributes extracted from a pyramid of images taken from the same original image at different spatial resolutions. The extent of the effect of this variation on the results depends on the content of the image. We used standardized acquisitions to avoid significant variations in attribute values due to the acquisition parameters.In this work, the two observers showed good agreement for all TAs extracted from routine MRI, and we found a significant correlation between BMD and 13 TAs. Our results suggest that specific texture parameters could be reliably extracted from routine MRI scans, with clinically acceptable reproducibility for most of the parameters studied.Our results should encourage future studies to identify isolated attributes or a set of attributes to possibly differentiate subjects at risk of fragility fractures when used with clinical data and other bone quality parameters. Quantitative measurements based on TAs could potentially discriminate subjects with bone mass loss and those at risk of fragility fractures.This study has some limitations that deserve mention. The cervical and thoracic spinal segments were not studied. This is a relative limitation because currently, only the lumbar vertebrae are used to measure BMD. In addition, our study population was mainly composed of young volunteers with normal bone mass and without fragility fractures. Finally, our study used BMD as a surrogate parameter of fracture susceptibility and did not test the potential usefulness of textural features extracted from MRI scans to directly predict fracture risk. However, our study provides important preliminary data for a more comprehensive study to examine the role of the technique in the evaluation of fracture susceptibility. Future studies are necessary to evaluate the potential clinical application of texture analysis using spine MRI.CONCLUSIONIn summary, several specific TAs could be reliably extracted from routine sagittal T2-weighted MRI scans and showed a strong relationship with BMD in a healthy adult eutrophic population. Our results encourage future evaluations of MRI quantitative textural measurements to potentially discriminate subjects at risk of fragility fractures.AUTHOR CONTRIBUTIONSMaciel JG performed the experiments, analyzed the data, wrote the manuscript, and reviewed the manuscript. Araújo IM analyzed the data and reviewed/edited the manuscript. Trazzi LC analyzed the data and reviewed/edited the manuscript. Azevedo‐Marques PM analyzed the data and reviewed/edited the manuscript. Salmon CEG analyzed the data and reviewed/edited the manuscript. Paula FJA analyzed the data and reviewed/edited the manuscript. Nogueira‐Barbosa MH designed the study and reviewed/edited the manuscript." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xpalclavsec1580108" "titulo" => "KEYWORDS" ] 1 => array:2 [ "identificador" => "cesec10" "titulo" => "INTRODUCTION" ] 2 => array:2 [ "identificador" => "cesec20" "titulo" => "ETHICAL CONSIDERATIONS" ] 3 => array:3 [ "identificador" => "cesec30" "titulo" => "MATERIALS AND METHODS" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "cesec40" "titulo" => "Subjects" ] 1 => array:2 [ "identificador" => "cesec50" "titulo" => "Dual-energy X-ray absorptiometry" ] 2 => array:2 [ "identificador" => "cesec60" "titulo" => "MRI and TA extraction" ] 3 => array:2 [ "identificador" => "cesec70" "titulo" => "Statistical analyses" ] ] ] 4 => array:3 [ "identificador" => "cesec80" "titulo" => "RESULTS" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "cesec90" "titulo" => "Patients' demographics, clinical characteristics, and BMD" ] 1 => array:2 [ "identificador" => "cesec100" "titulo" => "Correlation between BMD and bone TAs" ] 2 => array:2 [ "identificador" => "cesec110" "titulo" => "Inter-rater reliability" ] ] ] 5 => array:2 [ "identificador" => "cesec120" "titulo" => "DISCUSSION" ] 6 => array:2 [ "identificador" => "cesec130" "titulo" => "CONCLUSION" ] 7 => array:2 [ "identificador" => "cesec140" "titulo" => "AUTHOR CONTRIBUTIONS" ] 8 => array:2 [ "identificador" => "xack638112" "titulo" => "ACKNOWLEDGMENTS" ] 9 => array:1 [ "titulo" => "REFERENCES" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-03-21" "fechaAceptado" => "2020-05-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec1580108" "palabras" => array:3 [ 0 => "Magnetic Resonance Imaging" 1 => "Textural Attribute" 2 => "Bone Mineral Density" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "OBJECTIVE:Dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) often fails to predict fragility fractures. Quantitative textural analysis using magnetic resonance imaging (MRI) may potentially yield useful radiomic features to predict fractures. We aimed to investigate the correlation between BMD and texture attributes (TAs) extracted from MRI scans and the interobserver reproducibility of the analysis. METHODS:Forty-nine volunteers underwent lumbar spine 1.5-T MRI and DXA. Three-dimensional (3-D) gray-level co-occurrence matrices were measured from routine sagittal T2 fast spin-echo images using the IBEX software. Twenty-two TAs were extracted from 3-D segmented L3 vertebrae. The estimated concordance coefficient was calculated using linear regression analysis. A Pearson correlation coefficient analysis was performed to evaluate the correlation between BMD and the TAs. Interobserver reproducibility was assessed with the concordance coefficient described by Lin. RESULTS:The results revealed a fair-to-moderate significant correlation between BMD and 13 TAs (r=−0.20 to 0.39; p<0.05). Eight TAs (autocorrelation, energy, homogeneity 1, homogeneity 1.1, maximum probability, sum average, sum variance, and inverse difference normalized) negatively correlated with BMD (r=−0.20 to −0.38; p<0.05), whereas five TAs (dissimilarity, difference entropy, entropy, sum entropy, and information measure corr 1) positively correlated with BMD (r=0.29-0.39; p<0.05). The interobserver agreement was almost perfect for all significant TAs (95% confidence interval, 0.92-1.00; p<0.05). CONCLUSION:Specific TAs could be reliably extracted from routine MRI and correlated with BMD. Our results encourage future evaluation of the potential usefulness of quantitative texture measurements from MRI scans for predicting fragility fractures." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "OBJECTIVE:" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "METHODS:" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "RESULTS:" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "CONCLUSION:" ] ] ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "No potential conflict of interest was reported." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1343 "Ancho" => 1300 "Tamanyo" => 149318 ] ] "descripcion" => array:1 [ "en" => "A 31-year-old female volunteer. Illustrated are the segmentation and positioning of the volume of interest (VOI) in the L3 vertebral body using the IBEX program for volumetric (three-dimensional) extraction of textural attributes (TAs)." ] ] 1 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Female (n=29) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Male (n=20) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) (Mean±SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.9±13.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41±15.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI (kg/m2) (Mean±SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.3±2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.0±1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bone mineral density (BMD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L1-L4 BMD (g/cm2) (Mean±SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.99±0.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00±0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L3 BMD (g/cm2) (Mean±SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.03±0.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.02±0.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Demographics, clinical characteristics, and bone mineral density of the study participants." ] ] 2 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="4" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Bone mineral density (g/cm2)</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Texture attribute \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Estimated coefficient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Pearson correlation coefficient (r) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Autocorrelation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.0000046 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0023 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Difference entropy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.076 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0087 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dissimilarity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0079 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0485 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Energy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0070 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.33 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Entropy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.028 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0024 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.38 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Homogeneity 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0020 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.38 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Homogeneity 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0020 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Information measure corr 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0281 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inverse different normalized \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−2.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0308 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Max probability \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0021 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sum average \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.00083 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0038 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sum entropy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.053 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0086 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sum variance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.0000012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0022 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Estimated coefficients of the association between bone mineral density and bone texture attributes." ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis prevention, diagnosis and therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1001/jama.285.6.785" "Revista" => array:7 [ "tituloSerie" => "JAMA" "fecha" => "2001" "volumen" => "285" "numero" => "6" "paginaInicial" => "785" "paginaFinal" => "795" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11176917" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1001/jama.285.6.785" "WWW" => array:1 [ "link" => "https://doi.org/10.1001/jama.285.6.785" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Relationship of Fat Distribution and Insulin Resistance with Lumbar Spine Bone Mass in Women" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ FJ de Paula \n \t\t\t\t\t\t\t\t """ 1 => """ IM de Araújo \n \t\t\t\t\t\t\t\t """ 2 => """ AL Carvalho \n \t\t\t\t\t\t\t\t """ 3 => """ J Elias \n \t\t\t\t\t\t\t\t """ 4 => """ CE Salmon \n \t\t\t\t\t\t\t\t """ 5 => """ MH Nogueira-Barbosa \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "PLoS One" "fecha" => "2015" "volumen" => "10" "numero" => "6" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.1371/journal.pone.0129764" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis. Current techniques and recent developments in quantitative bone densitometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ P Lang \n \t\t\t\t\t\t\t\t """ 1 => """ P Steiger \n \t\t\t\t\t\t\t\t """ 2 => """ K Faulkner \n \t\t\t\t\t\t\t\t """ 3 => """ C Glüer \n \t\t\t\t\t\t\t\t """ 4 => """ HK Genant \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Radiol Clin North Am" "fecha" => "1991" "volumen" => "29" "numero" => "1" "paginaInicial" => "49" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1985329" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advances in osteoporosis imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ JS Bauer \n \t\t\t\t\t\t\t\t """ 1 => """ TM Link \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2008.04.064" "Revista" => array:7 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2009" "volumen" => "71" "numero" => "3" "paginaInicial" => "440" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19651482" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.ejrad.2008.04.064" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.ejrad.2008.04.064" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ SC Schuit \n \t\t\t\t\t\t\t\t """ 1 => """ M van der Klift \n \t\t\t\t\t\t\t\t """ 2 => """ AE Weel \n \t\t\t\t\t\t\t\t """ 3 => """ CE de Laet \n \t\t\t\t\t\t\t\t """ 4 => """ H Burger \n \t\t\t\t\t\t\t\t """ 5 => """ E Seeman \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2003.10.001" "Revista" => array:7 [ "tituloSerie" => "Bone" "fecha" => "2004" "volumen" => "34" "numero" => "1" "paginaInicial" => "195" "paginaFinal" => "202" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14751578" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.bone.2003.10.001" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.bone.2003.10.001" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ E Dall’Ara \n \t\t\t\t\t\t\t\t """ 1 => """ D Pahr \n \t\t\t\t\t\t\t\t """ 2 => """ P Varga \n \t\t\t\t\t\t\t\t """ 3 => """ F Kainberger \n \t\t\t\t\t\t\t\t """ 4 => """ P Zysset \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1007/s00198-011-1568-3" "Revista" => array:7 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2012" "volumen" => "23" "numero" => "2" "paginaInicial" => "563" "paginaFinal" => "572" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21344244" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1007/s00198-011-1568-3" "WWW" => array:1 [ "link" => "https://doi.org/10.1007/s00198-011-1568-3" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Volumetric squantitative computed tomography of the proximal femur: relationships linking geometric and densitometric variables to bone strength. Role for compact bone" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ V Bousson \n \t\t\t\t\t\t\t\t """ 1 => """ A Le Bras \n \t\t\t\t\t\t\t\t """ 2 => """ F Roqueplan \n \t\t\t\t\t\t\t\t """ 3 => """ Y Kang \n \t\t\t\t\t\t\t\t """ 4 => """ D Mitton \n \t\t\t\t\t\t\t\t """ 5 => """ S Kolta \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1007/s00198-006-0074-5" "Revista" => array:7 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2006" "volumen" => "17" "numero" => "6" "paginaInicial" => "855" "paginaFinal" => "864" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16547689" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1007/s00198-006-0074-5" "WWW" => array:1 [ "link" => "https://doi.org/10.1007/s00198-006-0074-5" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods for assessing bone quality: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ E Donnelly \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1007/s11999-010-1702-0" "Revista" => array:7 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2011" "volumen" => "469" "numero" => "8" "paginaInicial" => "2128" "paginaFinal" => "2138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21116752" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1007/s11999-010-1702-0" "WWW" => array:1 [ "link" => "https://doi.org/10.1007/s11999-010-1702-0" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Marrow Fat Quality Differences by Sex in Healthy Adults" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ JG Maciel \n \t\t\t\t\t\t\t\t """ 1 => """ IM de Araújo \n \t\t\t\t\t\t\t\t """ 2 => """ AL Carvalho \n \t\t\t\t\t\t\t\t """ 3 => """ MN Simão \n \t\t\t\t\t\t\t\t """ 4 => """ CM Bastos \n \t\t\t\t\t\t\t\t """ 5 => """ LE Troncon \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2016.08.002" "Revista" => array:7 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2017" "volumen" => "20" "numero" => "1" "paginaInicial" => "106" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27637728" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.jocd.2016.08.002" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.jocd.2016.08.002" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis imaging: effects of bone preservation on MDCT-based trabecular bone microstructure parameters and finite element models" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ T Baum \n \t\t\t\t\t\t\t\t """ 1 => """ E Grande Garcia \n \t\t\t\t\t\t\t\t """ 2 => """ R Burgkart \n \t\t\t\t\t\t\t\t """ 3 => """ O Gordijenko \n \t\t\t\t\t\t\t\t """ 4 => """ H Liebl \n \t\t\t\t\t\t\t\t """ 5 => """ PM Jungmann \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1186/s12880-015-0066-z" "Revista" => array:5 [ "tituloSerie" => "BMC Med Imaging" "fecha" => "2015" "volumen" => "15" "paginaInicial" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26113362" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1186/s12880-015-0066-z" "WWW" => array:1 [ "link" => "https://doi.org/10.1186/s12880-015-0066-z" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three-dimensional texture analysis of cancellous bone cores evaluated at clinical CT resolutions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ C Showalter \n \t\t\t\t\t\t\t\t """ 1 => """ BD Clymer \n \t\t\t\t\t\t\t\t """ 2 => """ B Richmond \n \t\t\t\t\t\t\t\t """ 3 => """ K Powell \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1007/s00198-005-1994-1" "Revista" => array:7 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2006" "volumen" => "17" "numero" => "2" "paginaInicial" => "259" "paginaFinal" => "266" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16170445" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1007/s00198-005-1994-1" "WWW" => array:1 [ "link" => "https://doi.org/10.1007/s00198-005-1994-1" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Computational identification and quantification of trabecular microarchitecture classes by 3-D texture analysis-based clustering" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ A Valentinitsch \n \t\t\t\t\t\t\t\t """ 1 => """ JM Patsch \n \t\t\t\t\t\t\t\t """ 2 => """ AJ Burghardt \n \t\t\t\t\t\t\t\t """ 3 => """ TM Link \n \t\t\t\t\t\t\t\t """ 4 => """ S Majumdar \n \t\t\t\t\t\t\t\t """ 5 => """ L Fischer \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2012.12.047" "Revista" => array:7 [ "tituloSerie" => "Bone" "fecha" => "2013" "volumen" => "54" "numero" => "1" "paginaInicial" => "133" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23313281" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.bone.2012.12.047" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.bone.2012.12.047" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Textural Features for Image Classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ RM Haralick \n \t\t\t\t\t\t\t\t """ 1 => """ K Shanmugam \n \t\t\t\t\t\t\t\t """ 2 => """ I Dinstein \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "IEEE Trans Syst Man Cybern" "fecha" => "1973" "volumen" => "3" "paginaInicial" => "610" "paginaFinal" => "621" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.1109/TSMC.1973.4309314" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Statistical and Structural Approaches to Texture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ RM Haralick \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Proc IEEE" "fecha" => "1979" "volumen" => "67" "numero" => "5" "paginaInicial" => "786" "paginaFinal" => "804" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.1109/PROC.1979.11328" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A generic support vector machine model for preoperative glioma survival associations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ KE Emblem \n \t\t\t\t\t\t\t\t """ 1 => """ MC Pinho \n \t\t\t\t\t\t\t\t """ 2 => """ FG Zöllner \n \t\t\t\t\t\t\t\t """ 3 => """ P Due-Tonnessen \n \t\t\t\t\t\t\t\t """ 4 => """ JK Hald \n \t\t\t\t\t\t\t\t """ 5 => """ LR Schad \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1148/radiol.14140770" "Revista" => array:7 [ "tituloSerie" => "Radiology" "fecha" => "2015" "volumen" => "275" "numero" => "1" "paginaInicial" => "228" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25486589" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1148/radiol.14140770" "WWW" => array:1 [ "link" => "https://doi.org/10.1148/radiol.14140770" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Automatic classification of prostate cancer Gleason scores from multiparametric magnetic resonance images" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ D Fehr \n \t\t\t\t\t\t\t\t """ 1 => """ H Veeraraghavan \n \t\t\t\t\t\t\t\t """ 2 => """ A Wibmer \n \t\t\t\t\t\t\t\t """ 3 => """ T Gondo \n \t\t\t\t\t\t\t\t """ 4 => """ K Matsumoto \n \t\t\t\t\t\t\t\t """ 5 => """ HA Vargas \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1073/pnas.1505935112" "Revista" => array:7 [ "tituloSerie" => "Proc Natl Acad Sci U S A" "fecha" => "2015" "volumen" => "112" "numero" => "46" "paginaInicial" => "E6265" "paginaFinal" => "E6273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26578786" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1073/pnas.1505935112" "WWW" => array:1 [ "link" => "https://doi.org/10.1073/pnas.1505935112" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ HJ Aerts \n \t\t\t\t\t\t\t\t """ 1 => """ ER Velazquez \n \t\t\t\t\t\t\t\t """ 2 => """ RT Leijenaar \n \t\t\t\t\t\t\t\t """ 3 => """ C Parmar \n \t\t\t\t\t\t\t\t """ 4 => """ P Grossmann \n \t\t\t\t\t\t\t\t """ 5 => """ S Carvalho \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Nat Commun" "fecha" => "2014" "volumen" => "5" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.1038/ncomms5006" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone marrow imaging: magnetic resonance studies related to age and sex" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ GC Dooms \n \t\t\t\t\t\t\t\t """ 1 => """ MR Fisher \n \t\t\t\t\t\t\t\t """ 2 => """ H Hricak \n \t\t\t\t\t\t\t\t """ 3 => """ M Richardson \n \t\t\t\t\t\t\t\t """ 4 => """ LE Crooks \n \t\t\t\t\t\t\t\t """ 5 => """ HK Genant \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1148/radiology.155.2.3983394" "Revista" => array:7 [ "tituloSerie" => "Radiology" "fecha" => "1985" "volumen" => "155" "numero" => "2" "paginaInicial" => "429" "paginaFinal" => "432" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3983394" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1148/radiology.155.2.3983394" "WWW" => array:1 [ "link" => "https://doi.org/10.1148/radiology.155.2.3983394" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ JF Griffith \n \t\t\t\t\t\t\t\t """ 1 => """ DK Yeung \n \t\t\t\t\t\t\t\t """ 2 => """ GE Antonio \n \t\t\t\t\t\t\t\t """ 3 => """ FK Lee \n \t\t\t\t\t\t\t\t """ 4 => """ AW Hong \n \t\t\t\t\t\t\t\t """ 5 => """ SY Wong \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1148/radiol.2363041425" "Revista" => array:7 [ "tituloSerie" => "Radiology" "fecha" => "2005" "volumen" => "236" "numero" => "3" "paginaInicial" => "945" "paginaFinal" => "951" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055699" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1148/radiol.2363041425" "WWW" => array:1 [ "link" => "https://doi.org/10.1148/radiol.2363041425" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone marrow fat composition as a novel imaging biomarker in postmenopausal women with prevalent fragility fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ JM Patsch \n \t\t\t\t\t\t\t\t """ 1 => """ X Li \n \t\t\t\t\t\t\t\t """ 2 => """ T Baum \n \t\t\t\t\t\t\t\t """ 3 => """ SP Yap \n \t\t\t\t\t\t\t\t """ 4 => """ DC Karampinos \n \t\t\t\t\t\t\t\t """ 5 => """ AV Schwartz \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1002/jbmr.1950" "Revista" => array:7 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2013" "volumen" => "28" "numero" => "8" "paginaInicial" => "1721" "paginaFinal" => "1728" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23558967" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1002/jbmr.1950" "WWW" => array:1 [ "link" => "https://doi.org/10.1002/jbmr.1950" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis is associated with increased marrow fat content and decreased marrow fat unsaturation: a proton MR spectroscopy study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ DK Yeung \n \t\t\t\t\t\t\t\t """ 1 => """ JF Griffith \n \t\t\t\t\t\t\t\t """ 2 => """ GE Antonio \n \t\t\t\t\t\t\t\t """ 3 => """ FK Lee \n \t\t\t\t\t\t\t\t """ 4 => """ J Woo \n \t\t\t\t\t\t\t\t """ 5 => """ PC Leung \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1002/jmri.20367" "Revista" => array:7 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2005" "volumen" => "22" "numero" => "2" "paginaInicial" => "279" "paginaFinal" => "285" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028245" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1002/jmri.20367" "WWW" => array:1 [ "link" => "https://doi.org/10.1002/jmri.20367" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ X Li \n \t\t\t\t\t\t\t\t """ 1 => """ D Kuo \n \t\t\t\t\t\t\t\t """ 2 => """ AL Schafer \n \t\t\t\t\t\t\t\t """ 3 => """ A Porzig \n \t\t\t\t\t\t\t\t """ 4 => """ TM Link \n \t\t\t\t\t\t\t\t """ 5 => """ D Black \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1002/jmri.22489" "Revista" => array:7 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2011" "volumen" => "33" "numero" => "4" "paginaInicial" => "974" "paginaFinal" => "979" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21448966" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1002/jmri.22489" "WWW" => array:1 [ "link" => "https://doi.org/10.1002/jmri.22489" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative assessment of trabecular bone micro-architecture of the wrist via 7 Tesla MRI: preliminary results" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ G Chang \n \t\t\t\t\t\t\t\t """ 1 => """ L Wang \n \t\t\t\t\t\t\t\t """ 2 => """ G Liang \n \t\t\t\t\t\t\t\t """ 3 => """ JS Babb \n \t\t\t\t\t\t\t\t """ 4 => """ GC Wiggins \n \t\t\t\t\t\t\t\t """ 5 => """ PK Saha \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1007/s10334-011-0252-0" "Revista" => array:7 [ "tituloSerie" => "MAGMA" "fecha" => "2011" "volumen" => "24" "numero" => "4" "paginaInicial" => "191" "paginaFinal" => "199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21544680" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1007/s10334-011-0252-0" "WWW" => array:1 [ "link" => "https://doi.org/10.1007/s10334-011-0252-0" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative imaging methods in osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ L Oei \n \t\t\t\t\t\t\t\t """ 1 => """ F Koromani \n \t\t\t\t\t\t\t\t """ 2 => """ F Rivadeneira \n \t\t\t\t\t\t\t\t """ 3 => """ MC Zillikens \n \t\t\t\t\t\t\t\t """ 4 => """ EH Oei \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.21037/qims.2016.12.13" "Revista" => array:7 [ "tituloSerie" => "Quant Imaging Med Surg" "fecha" => "2016" "volumen" => "6" "numero" => "6" "paginaInicial" => "680" "paginaFinal" => "698" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28090446" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.21037/qims.2016.12.13" "WWW" => array:1 [ "link" => "https://doi.org/10.21037/qims.2016.12.13" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postmenopausal women with osteoporosis and osteoarthritis show different microstructural characteristics of trabecular bone in proximal tibia using high-resolution magnetic resonance imaging at 3 tesla" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ Y Shen \n \t\t\t\t\t\t\t\t """ 1 => """ YH Zhang \n \t\t\t\t\t\t\t\t """ 2 => """ L Shen \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1186/1471-2474-14-136" "Revista" => array:5 [ "tituloSerie" => "BMC Musculoskelet Disord" "fecha" => "2013" "volumen" => "14" "paginaInicial" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23587336" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1186/1471-2474-14-136" "WWW" => array:1 [ "link" => "https://doi.org/10.1186/1471-2474-14-136" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IBEX: an open infrastructure software platform to facilitate collaborative work in radiomics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ L Zhang \n \t\t\t\t\t\t\t\t """ 1 => """ DV Fried \n \t\t\t\t\t\t\t\t """ 2 => """ XJ Fave \n \t\t\t\t\t\t\t\t """ 3 => """ LA Hunter \n \t\t\t\t\t\t\t\t """ 4 => """ J Yang \n \t\t\t\t\t\t\t\t """ 5 => """ LE Court \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1118/1.4908210" "Revista" => array:7 [ "tituloSerie" => "Med Phys" "fecha" => "2015" "volumen" => "42" "numero" => "3" "paginaInicial" => "1341" "paginaFinal" => "1353" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25735289" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1118/1.4908210" "WWW" => array:1 [ "link" => "https://doi.org/10.1118/1.4908210" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Core samples for radiomics features that are insensitive to tumor segmentation: method and pilot study using CT images of hepatocellular carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ S Echegaray \n \t\t\t\t\t\t\t\t """ 1 => """ O Gevaert \n \t\t\t\t\t\t\t\t """ 2 => """ R Shah \n \t\t\t\t\t\t\t\t """ 3 => """ A Kamaya \n \t\t\t\t\t\t\t\t """ 4 => """ J Louie \n \t\t\t\t\t\t\t\t """ 5 => """ N Kothary \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Med Imaging" "fecha" => "2015" "volumen" => "2" "numero" => "4" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.1117/1.JMI.2.4.041011" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Computer and robot vision" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ R Haralick \n \t\t\t\t\t\t\t\t """ 1 => """ L Shapiro \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "1992" "editorial" => "Addison-Wesley" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A concordance correlation coefficient to evaluate reproducibility" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ LI Lin \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Biometrics" "fecha" => "1989" "volumen" => "45" "numero" => "1" "paginaInicial" => "255" "paginaFinal" => "268" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2720055" "web" => "Medline" ] ] ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.2307/2532051" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The measurement of observer agreement for categorical data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ JR Landis \n \t\t\t\t\t\t\t\t """ 1 => """ GG Koch \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Biometrics" "fecha" => "1977" "volumen" => "33" "numero" => "1" "paginaInicial" => "159" "paginaFinal" => "174" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/843571" "web" => "Medline" ] ] ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://doi.org/10.2307/2529310" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "SAS/STAT user’s guide, version 9.4" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ SAS Institute Inc \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "SAS Institute, Inc" "editorialLocalizacion" => "Cary, NC" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exploratory Study to Identify Radiomics Classifiers for Lung Cancer Histology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ W Wu \n \t\t\t\t\t\t\t\t """ 1 => """ C Parmar \n \t\t\t\t\t\t\t\t """ 2 => """ P Grossmann \n \t\t\t\t\t\t\t\t """ 3 => """ J Quackenbush \n \t\t\t\t\t\t\t\t """ 4 => """ P Lambin \n \t\t\t\t\t\t\t\t """ 5 => """ J Bussink \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.3389/fonc.2016.00071" "Revista" => array:5 [ "tituloSerie" => "Front Oncol" "fecha" => "2016" "volumen" => "6" "paginaInicial" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27064691" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.3389/fonc.2016.00071" "WWW" => array:1 [ "link" => "https://doi.org/10.3389/fonc.2016.00071" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiomics: Images Are More than Pictures, They Are Data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ RJ Gillies \n \t\t\t\t\t\t\t\t """ 1 => """ PE Kinahan \n \t\t\t\t\t\t\t\t """ 2 => """ H Hricak \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1148/radiol.2015151169" "Revista" => array:7 [ "tituloSerie" => "Radiology" "fecha" => "2016" "volumen" => "278" "numero" => "2" "paginaInicial" => "563" "paginaFinal" => "577" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26579733" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1148/radiol.2015151169" "WWW" => array:1 [ "link" => "https://doi.org/10.1148/radiol.2015151169" ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiomics: the process and the challenges" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ V Kumar \n \t\t\t\t\t\t\t\t """ 1 => """ Y Gu \n \t\t\t\t\t\t\t\t """ 2 => """ S Basu \n \t\t\t\t\t\t\t\t """ 3 => """ A Berglund \n \t\t\t\t\t\t\t\t """ 4 => """ SA Eschrich \n \t\t\t\t\t\t\t\t """ 5 => """ MB Schabath \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.mri.2012.06.010" "Revista" => array:7 [ "tituloSerie" => "Magn Reson Imaging" "fecha" => "2012" "volumen" => "30" "numero" => "9" "paginaInicial" => "1234" "paginaFinal" => "1248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22898692" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.mri.2012.06.010" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.mri.2012.06.010" ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shape, texture and statistical features for classification of benign and malignant vertebral compression fractures in magnetic resonance images" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ L Frighetto-Pereira \n \t\t\t\t\t\t\t\t """ 1 => """ RM Rangayyan \n \t\t\t\t\t\t\t\t """ 2 => """ GA Metzner \n \t\t\t\t\t\t\t\t """ 3 => """ PM de Azevedo-Marques \n \t\t\t\t\t\t\t\t """ 4 => """ MH Nogueira-Barbosa \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.compbiomed.2016.04.006" "Revista" => array:6 [ "tituloSerie" => "Comput Biol Med" "fecha" => "2016" "volumen" => "73" "paginaInicial" => "147" "paginaFinal" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27111110" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.compbiomed.2016.04.006" "WWW" => array:1 [ "link" => "https://doi.org/10.1016/j.compbiomed.2016.04.006" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack638112" "titulo" => "ACKNOWLEDGMENTS" "texto" => "The authors are indebted to Rita C. Varrichio, Luciana Mijoler, and Rodrigo Pessini for their competent technical assistance. Financial Support: JGM: CAPES CODE 1; FJAP: FAPESP 2018/14060-9; MHN-B: FAPESP 2018/04266-9, CNPq 307138/2017-8 and 404795/2018-8; IMA: CNPq 156950/2018-9. FAPESP: São Paulo Research Foundation, CNPq: National Council for Scientific and Technological Development. The funders had no role in the study design." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004732/v1_202211290815/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/000000750000000C/v1_202211290815/S1807593222004732/v1_202211290815/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004732?idApp=UINPBA00004N"]

Statistics

ORIGINAL ARTICLE

Jamilly Gomes MacielI,

Corresponding author

jamillygm@hotmail.com
jamillygomes@fmrp.usp.br

Corresponding author.

, Iana Mizumukai de AraújoII, Lucio C. TrazziI, Paulo Mazzoncini de Azevedo-MarquesI, Carlos Ernesto Garrido SalmonIII, Francisco José Albuquerque de PaulaII, Marcello Henrique Nogueira-BarbosaI

I Departamento de Imagens Medicas, Hematologia e Oncologia Clinica, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR

II Medicina Interna, Faculdade de Medicina de Ribeirao Preto (FMRP), Universidade de Sao Paulo, Ribeirao Preto, SP, BR

III Departamento de Fisica, Faculdade de Filosofia, Ciencias e Letras (FFCL), Universidade de São Paulo, Ribeirao Preto, SP, BR

Read

1447

Times
was read the article

648

Total PDF

799

Total HTML

Share statistics

 array:24 [
  "pii" => "S1807593222004732"
  "issn" => "18075932"
  "doi" => "10.6061/clinics/2020/e1766"
  "estado" => "S300"
  "fechaPublicacion" => "2020-01-01"
  "aid" => "473"
  "copyright" => "CLINICS"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "https://creativecommons.org/licenses/by/4.0/"
  "subdocumento" => "fla"
  "cita" => "Clinics. 2020;75C:"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1807593222003428"
    "issn" => "18075932"
    "doi" => "10.6061/clinics/2020/e1768"
    "estado" => "S300"
    "fechaPublicacion" => "2020-01-01"
    "aid" => "342"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2020;75C:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL ARTICLE</span>"
      "titulo" => "Response to fatigue observed through magnetic resonance imaging on the quadriceps muscle in postmenopausal women"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig2"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 775
              "Ancho" => 976
              "Tamanyo" => 26973
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Correlation between average bilateral MRI &#40;postexercise&#47;fatigue&#41; and 25-OH vitamin D levels&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Guilherme Carlos Brech, Thalita Sousa de Paula, Thiago Ant&#244;nio Fedele, Aluane Silva Dias, Jos&#233; Maria Soares-J&#250;nior, Marcelo Bordalo-Rodrigues, Edmund Chada Baracat, Ang&#233;lica Castilho Alonso, Julia Maria D&#39;Andr&#233;a Greve"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Guilherme Carlos"
              "apellidos" => "Brech"
            ]
            1 => array:2 [
              "nombre" => "Thalita Sousa de"
              "apellidos" => "Paula"
            ]
            2 => array:2 [
              "nombre" => "Thiago Ant&#244;nio"
              "apellidos" => "Fedele"
            ]
            3 => array:2 [
              "nombre" => "Aluane Silva"
              "apellidos" => "Dias"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233; Maria"
              "apellidos" => "Soares-J&#250;nior"
            ]
            5 => array:2 [
              "nombre" => "Marcelo"
              "apellidos" => "Bordalo-Rodrigues"
            ]
            6 => array:2 [
              "nombre" => "Edmund Chada"
              "apellidos" => "Baracat"
            ]
            7 => array:2 [
              "nombre" => "Ang&#233;lica Castilho"
              "apellidos" => "Alonso"
            ]
            8 => array:2 [
              "nombre" => "Julia Maria D&#39;Andr&#233;a"
              "apellidos" => "Greve"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222003428?idApp=UINPBA00004N"
    "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222003428/v1_202211290815/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1807593222004720"
    "issn" => "18075932"
    "doi" => "10.6061/clinics/2020/e1764"
    "estado" => "S300"
    "fechaPublicacion" => "2020-01-01"
    "aid" => "472"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2020;75C:"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL ARTICLE</span>"
      "titulo" => "Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig1"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 424
              "Ancho" => 1248
              "Tamanyo" => 47067
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Halitosis scoring using a Breath-Alert&#8482; device&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Carolina Cardoso Guedes, Sandra Kalil Bussadori, Ana Carolina Mota Garcia, Lara Jansiski Motta, Andr&#233;a Oliver Gomes, Raimar Weber, Olga Maria Silverio Amancio"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Carolina Cardoso"
              "apellidos" => "Guedes"
            ]
            1 => array:2 [
              "nombre" => "Sandra Kalil"
              "apellidos" => "Bussadori"
            ]
            2 => array:2 [
              "nombre" => "Ana Carolina Mota"
              "apellidos" => "Garcia"
            ]
            3 => array:2 [
              "nombre" => "Lara Jansiski"
              "apellidos" => "Motta"
            ]
            4 => array:2 [
              "nombre" => "Andr&#233;a Oliver"
              "apellidos" => "Gomes"
            ]
            5 => array:2 [
              "nombre" => "Raimar"
              "apellidos" => "Weber"
            ]
            6 => array:2 [
              "nombre" => "Olga Maria Silverio"
              "apellidos" => "Amancio"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004720?idApp=UINPBA00004N"
    "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004720/v1_202211290815/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL ARTICLE</span>"
    "titulo" => "Association of bone mineral density with bone texture attributes extracted using routine magnetic resonance imaging"
    "tieneTextoCompleto" => true
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jamilly Gomes Maciel, Iana Mizumukai de Ara&#250;jo, Lucio C&#46; Trazzi, Paulo Mazzoncini de Azevedo-Marques, Carlos Ernesto Garrido Salmon, Francisco Jos&#233; Albuquerque de Paula, Marcello Henrique Nogueira-Barbosa"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Jamilly Gomes"
            "apellidos" => "Maciel"
            "email" => array:2 [
              0 => "jamillygm@hotmail.com"
              1 => "jamillygomes@fmrp.usp.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">I</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Iana Mizumukai de"
            "apellidos" => "Ara&#250;jo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">II</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Lucio C&#46;"
            "apellidos" => "Trazzi"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">I</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Paulo Mazzoncini de"
            "apellidos" => "Azevedo-Marques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">I</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Carlos Ernesto Garrido"
            "apellidos" => "Salmon"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">III</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Francisco Jos&#233; Albuquerque de"
            "apellidos" => "Paula"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">II</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Marcello Henrique"
            "apellidos" => "Nogueira-Barbosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">I</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Departamento de Imagens Medicas&#44; Hematologia e Oncologia Clinica&#44; Faculdade de Medicina de Ribeirao Preto &#40;FMRP&#41;&#44; Universidade de Sao Paulo&#44; Ribeirao Preto&#44; SP&#44; BR"
            "etiqueta" => "I"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Medicina Interna&#44; Faculdade de Medicina de Ribeirao Preto &#40;FMRP&#41;&#44; Universidade de Sao Paulo&#44; Ribeirao Preto&#44; SP&#44; BR"
            "etiqueta" => "II"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Fisica&#44; Faculdade de Filosofia&#44; Ciencias e Letras &#40;FFCL&#41;&#44; Universidade de S&#227;o Paulo&#44; Ribeirao Preto&#44; SP&#44; BR"
            "etiqueta" => "III"
            "identificador" => "aff3"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1343
            "Ancho" => 1300
            "Tamanyo" => 149318
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A 31-year-old female volunteer&#46; Illustrated are the segmentation and positioning of the volume of interest &#40;VOI&#41; in the L3 vertebral body using the IBEX program for volumetric &#40;three-dimensional&#41; extraction of textural attributes &#40;TAs&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Osteoporosis is the most common metabolic bone disease and is characterized by reduced bone mineral density &#40;BMD&#41;&#44; deteriorated bone microarchitecture&#44; and increased bone fragility and susceptibility to fractures &#40;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#41;&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">BMD quantified with dual-energy X-ray absorptiometry &#40;DXA&#41; is used as a major determinant of osteoporosis&#59; however&#44; bone mass measurements are insufficient to correctly predict all osteoporotic fragility fractures&#46; In spite of this&#44; DXA continues to be an important tool in the clinical evaluation of osteoporosis&#46; Moreover&#44; DXA is still used as an initial&#44; but insufficient&#44; step in the evaluation of the efficacy of new drugs&#46; This has encouraged the development of other techniques that can reveal bone strength abnormalities&#46; Currently&#44; several bone quality parameters are used with clinical data to improve the prediction of future fragility fractures &#40;<a class="elsevierStyleCrossRefs" href="#bib2">2&#8211;4</a>&#41;&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">Together&#44; bone geometry&#44; cortical porosity&#44; collagen properties&#44; bone turnover rates&#44; trabecular microarchitecture&#44; and percentage of microdamage&#44; and bone marrow adiposity &#40;BMAT&#41; are bone strength determinants&#46; In addition&#44; each property may independently contribute to an increased or decreased risk of fracture&#44; even without changes in BMD &#40;<a class="elsevierStyleCrossRefs" href="#bib5">5&#8211;10</a>&#41;&#46; Recent studies have shown that texture-derived features extracted from multidetector computed tomography &#40;MDCT&#41; and DXA scans can indirectly quantify the trabecular bone microarchitecture and thus improve the traditional examination of bone quality and the prediction of fragility fractures &#40;<a class="elsevierStyleCrossRef" href="#bib11">11</a>&#44;<a class="elsevierStyleCrossRef" href="#bib12">12</a>&#41;&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">The gray-level co-occurrence matrix &#40;GLCM&#41; model is a texture analysis method that uses several statistical parameters to quantify the spatial relationship between diagnostic image pixels&#44; allowing characterization of the morphological properties of underlying tissues &#40;<a class="elsevierStyleCrossRef" href="#bib13">13</a>&#44;<a class="elsevierStyleCrossRef" href="#bib14">14</a>&#41;&#46; This model has been validated for characterizing textural attributes &#40;TAs&#41; from MDCT images&#59; however&#44; a few studies have used the same model to extract TAs from magnetic resonance imaging &#40;MRI&#41; scans&#46; Most of these studies extracted texture patterns from the MRI scans of patients with tumors to improve diagnostic accuracy and prognostic prediction &#40;<a class="elsevierStyleCrossRefs" href="#bib15">15&#8211;17</a>&#41;&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">MRI is a versatile imaging technique with great potential for enabling the multiparametric analysis of bone quality in a single examination&#46; Advanced MRI sequences such as proton spectroscopy and gradient-echo sequences have been used to quantify BMAT and trabecular bone microarchitecture&#44; respectively &#40;<a class="elsevierStyleCrossRefs" href="#bib18">18&#8211;25</a>&#41;&#46; However&#44; to the best of our knowledge&#44; no study has used routine MRI sequences to extract bone TA&#44; a tool that can be used to indirectly study the microarchitecture of trabecular bone&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">This study investigated the interobserver reproducibility of bone texture parameters extracted from routine sagittal T2-weighted fast spin-echo &#40;FSE&#41; lumbar spine &#40;LS&#41; MRI sequences obtained from healthy eutrophic individuals by using GLCM texture features and evaluated their relationship with BMD&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">ETHICAL CONSIDERATIONS</span><p id="para70" class="elsevierStylePara elsevierViewall">Approval by our institutional ethics committee was obtained &#40;47580315&#46;5&#46;0000&#46;5440&#41;&#46; All the participants agreed to participate in the study and provided written informed consent&#46; In addition&#44; the procedures were performed in accordance with the Declaration of Helsinki&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">MATERIALS AND METHODS</span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Subjects</span><p id="para80" class="elsevierStylePara elsevierViewall">The study subjects were comprised 49 volunteers who underwent MRI and DXA between May 2011 and October 2014&#46; Both examinations were performed on the same day&#46; All the individuals were at least 18 years old and had a body mass index &#40;BMI&#41; between 18 and 25 kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Individuals who used medications that affect bone metabolism&#44; reported histories of smoking and&#47;or alcoholism in the last 10 years&#44; and presented any structural abnormality in the LS that could affect MRI or DXA measurements were excluded from the study&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Dual-energy X-ray absorptiometry</span><p id="para90" class="elsevierStylePara elsevierViewall">The BMD of the LS &#40;L1-L4&#41; was determined using DXA &#40;Hologic Discovery Wi&#44; QDR series&#44; Hologic&#44; Inc&#46;&#44; Waltham&#44; MA&#44; USA&#41;&#46; The precision error in the LS was 1&#46;2&#37;&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle110">MRI and TA extraction</span><p id="para100" class="elsevierStylePara elsevierViewall">All the subjects underwent LS MRI on a 1&#46;5-Tesla system &#40;Philips Achieva&#44; Philips Medical Systems&#44; Best&#44; the Netherlands&#41;&#46; Routine sagittal T2-weighted FSE sequences were used to extract TAs &#40;echo time &#91;TE&#93;&#44; 120 ms&#59; gap&#44; 4&#46;4 mm&#59; echo-train length&#44; 19&#59; repetition time &#91;TR&#93;&#44; 3900 ms&#59; slice thickness&#44; 3&#46;0 mm&#59; scan duration&#44; 2 min 16 s&#41;&#46; The L3 vertebrae were manually segmented by two trained raters &#40;JGM&#44; a musculoskeletal radiologist with 3 years of experience in this area&#41; and &#40;LCT&#44; a medical student research fellow&#41;&#46; The GLCM characteristics were segmented and extracted using the radiomics analysis platform IBEX v 1&#46;0 &#40;<a class="elsevierStyleCrossRef" href="#bib26">26</a>&#41; as demonstrated in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para110" class="elsevierStylePara elsevierViewall">The IBEX software characterizes the spatial distribution of gray-level intensities in a region &#40;ROI&#41; or volume of interest &#40;VOI&#41; &#40;<a class="elsevierStyleCrossRef" href="#bib27">27</a>&#41;&#46; GLCMs obtained from a VOI or ROI are used to calculate the probability of occurrence of pixel&#47;voxel pairs of gray-level intensities <span class="elsevierStyleItalic">i</span> and <span class="elsevierStyleItalic">j</span> given a distance <span class="elsevierStyleItalic">d</span> from an orientation <span class="elsevierStyleItalic">&#952;</span> &#40;<a class="elsevierStyleCrossRef" href="#bib13">13</a>&#44;<a class="elsevierStyleCrossRef" href="#bib28">28</a>&#41;&#46;</p><p id="para120" class="elsevierStylePara elsevierViewall">A total of 22 attributes were identified from the L3 segmented VOI&#46; Thus&#44; volumetric three-dimensional &#40;3-D&#41; GLCM &#40;COM3Ds&#41; analyses were performed for the vertebral body&#46; COM3Ds directly computed the occurrence of intensity pairs in the orientation <span class="elsevierStyleItalic">&#952;</span> for the dimensions <span class="elsevierStyleItalic">x</span> and <span class="elsevierStyleItalic">y</span>&#44; and in the orientation <span class="elsevierStyleItalic">&#966;</span> for the dimension <span class="elsevierStyleItalic">z</span>&#46; The distances ranged from 1 to 5 voxels&#44; and all 13 orientations of <span class="elsevierStyleItalic">&#952;</span> and <span class="elsevierStyleItalic">&#966;</span> &#40;<span class="elsevierStyleItalic">&#952;</span>&#61;0&#176; and <span class="elsevierStyleItalic">&#966;</span>&#61;0&#176;&#44; 45&#176;&#44; 90&#176;&#44; and 135&#176;&#59; <span class="elsevierStyleItalic">&#952;</span>&#61;45&#176; and <span class="elsevierStyleItalic">&#966;</span>&#61;45&#176;&#44; 90&#176;&#44; and 135&#176;&#59; <span class="elsevierStyleItalic">&#952;</span>&#61;90&#176; and <span class="elsevierStyleItalic">&#966;</span>&#61;45&#176;&#44; 90&#176;&#44; and 135&#176;&#59; and <span class="elsevierStyleItalic">&#952;</span>&#61;135&#176; and <span class="elsevierStyleItalic">&#966;</span>&#61;45&#176;&#44; 90&#176;&#44; and 135&#176;&#41; were used&#44; resulting in 65 COM3Ds&#46; The 22 GLCM attributes extracted were autocorrelation&#44; cluster prominence&#44; cluster shade&#44; cluster tendency&#44; contrast&#44; correlation&#44; difference entropy&#44; dissimilarity&#44; energy&#44; entropy&#44; two measures of homogeneity &#40;homogeneities 1 and 2&#41;&#44; two measures of information correlation &#40;IMC1 and IMC2&#41;&#44; inverse difference moment normalized&#44; inverse difference normalized&#44; inverse variance&#44; maximum probability&#44; sum average&#44; sum entropy&#44; sum variance&#44; and variance&#46;</p></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">Statistical analyses</span><p id="para130" class="elsevierStylePara elsevierViewall">The results were analyzed using one-way analysis of variance followed by the Duncan posttest&#46; The confidence interval &#40;CI&#41; was 95&#37;&#44; and the level of significance was set at 0&#46;05&#46; Simple &#40;model 1&#41; and multiple &#40;model 2&#41; linear regression models were tested to verify the association of the parameters&#46; Model 2 was adjusted by age and BMI&#46; In addition&#44; the Pearson correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; was calculated to measure the strength of the relationship between the variables&#46; The interobserver agreement was evaluated using the concordance test proposed by Lin in 1989 &#40;<a class="elsevierStyleCrossRef" href="#bib29">29</a>&#41;&#46; The levels of strength of the agreement associated with kappa statistics were described according to the corresponding kappa ranges as follows&#58; poor&#44; 0&#46;00-0&#46;19&#59; fair&#44; 0&#46;20-0&#46;39&#59; moderate&#44; 0&#46;40-0&#46;59&#59; substantial&#44; 0&#46;60-0&#46;79&#59; and almost perfect&#44; 0&#46;80-1&#46;00 &#40;<a class="elsevierStyleCrossRef" href="#bib30">30</a>&#41;&#46; All analyses were performed using the SAS 9&#46;4 software &#40;<a class="elsevierStyleCrossRef" href="#bib31">31</a>&#41;&#46;</p></span></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">RESULTS</span><span id="cesec90" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Patients&#39; demographics&#44; clinical characteristics&#44; and BMD</span><p id="para140" class="elsevierStylePara elsevierViewall">The study subjects were comprised 49 healthy individuals with a mean age of 41&#177;14&#46;2 years &#40;range&#44; 20-68 years&#59; median&#44; 39 years&#41; and a mean BMI of 22&#46;6 kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Of the subjects&#44; 20 were men &#40;mean age&#44; 41&#177;15&#46;5 years&#59; range&#44; 20-68 years&#41; and 29 were women &#40;mean age&#44; 40&#46;9&#177;13&#46;4 years&#59; range&#44; 21-66 years&#41;&#46; All nine women aged &#62;50 years were in the postmenopausal stage&#46; The mean BMI was similar between the men and the women &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46; The LS BMD results were available for all the subjects&#46; No significant difference in BMD measured with DXA was found between the men and the women&#46; In addition&#44; the differences in the BMDs of the LS &#40;L1-L4&#41; and third lumbar vertebral body &#40;L3&#41; were not significant &#40;<span class="elsevierStyleItalic">p</span>&#62;0&#46;05&#59; <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia></span><span id="cesec100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Correlation between BMD and bone TAs</span><p id="para150" class="elsevierStylePara elsevierViewall">The results revealed a fair-to-moderate significant correlation between BMD and 13 TAs derived from MRI scans &#40;<span class="elsevierStyleItalic">r</span>&#61;&#8722;0&#46;20 to 0&#46;39&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#46; Eight TAs &#40;autocorrelation&#44; energy&#44; homogeneity 1&#44; homogeneity 1&#46;1&#44; maximum probability&#44; sum average&#44; sum variance&#44; and inverse difference normalized&#41; negatively correlated with BMD &#40;<span class="elsevierStyleItalic">r</span>&#61;&#8722;0&#46;20 to &#8722;0&#46;38&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#44; and five TAs &#40;dissimilarity&#44; difference entropy&#44; entropy&#44; sum entropy&#44; and information measure corr 1&#41; positively correlated with BMD &#40;<span class="elsevierStyleItalic">r</span>&#61;0&#46;29-0&#46;39&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#59; <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia></span><span id="cesec110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Inter-rater reliability</span><p id="para160" class="elsevierStylePara elsevierViewall">This study evaluated the agreement between two observers &#40;JGM and LCT&#41; for the 13 significant TAs derived from MRI scans&#46; Both researchers performed manual segmentation of the L3 vertebra using the IBEX software and extracted TAs using the software&#46; Both researchers were blinded to the patients&#39; clinical data and identification&#46; The extracted values were tabulated in Excel&#44; and the agreement coefficient was calculated using the Lin coefficient&#46; The results demonstrated an almost perfect interobserver agreement for all 13 significant TAs extracted &#40;95&#37; CI&#44; 0&#46;92-1&#46;00&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#46; The level of agreement of the two observers was greater for the following parameters&#58; autocorrelation&#44; cluster tendency&#44; contrast&#44; difference entropy&#44; dissimilarity&#44; energy&#44; entropy&#44; homogeneity 1&#44; homogeneity 2&#44; inverse different moment normalized&#44; inverse different normalized&#44; inverse variance&#44; maximum probability&#44; sum average&#44; sum entropy&#44; sum variance&#44; and variance&#46;</p></span></span><span id="cesec120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">DISCUSSION</span><p id="para170" class="elsevierStylePara elsevierViewall">Radiomics is a research area that has shown promising growth and usefulness in diagnostic and prognostic evaluations and therapeutic decision making &#40;<a class="elsevierStyleCrossRefs" href="#bib32">32&#8211;34</a>&#41;&#46; Texture-based quantitative features are used to characterize uniformity&#44; randomness&#44; and repetitive patterns in an image and have been used to detect pathologies and malignancies&#46; Moreover&#44; texture analysis using spectral and structural attributes extracted from MRI scans has been used to differentiate between osteoporotic and malignant compression fractures of vertebral bodies&#44; with promising results reported in the literature &#40;<a class="elsevierStyleCrossRef" href="#bib35">35</a>&#41;&#46;</p><p id="para180" class="elsevierStylePara elsevierViewall">Texture features have been used to study the microarchitectural characteristics of the trabecular bone from high-resolution quantitative computed tomography &#40;HR-pQCT&#41; images&#46; However&#44; no studies have been published using GLCM to extract TAs that may reflect the microarchitecture of the trabecular bone and bone fragility from spinal MRI scans&#46; In our study&#44; we used GLCM to characterize the spatial distribution of the gray-level within volumetric LS images from routine sagittal T2-weighted MRI scans&#46; The choice of sagittal T2-weighted FSE sequences is justified because this sequence is widely available in many routine spinal MRI protocols&#46; The distribution of gray levels is directly impacted by the spatial resolution of MRI sequences&#46; The same attribute is expected to present different values for the same image obtained at different spatial resolutions&#46; In fact&#44; a reported methodology takes advantage of this possible variation and pattern recognition techniques&#44; using attributes extracted from a pyramid of images taken from the same original image at different spatial resolutions&#46; The extent of the effect of this variation on the results depends on the content of the image&#46; We used standardized acquisitions to avoid significant variations in attribute values due to the acquisition parameters&#46;</p><p id="para190" class="elsevierStylePara elsevierViewall">In this work&#44; the two observers showed good agreement for all TAs extracted from routine MRI&#44; and we found a significant correlation between BMD and 13 TAs&#46; Our results suggest that specific texture parameters could be reliably extracted from routine MRI scans&#44; with clinically acceptable reproducibility for most of the parameters studied&#46;</p><p id="para200" class="elsevierStylePara elsevierViewall">Our results should encourage future studies to identify isolated attributes or a set of attributes to possibly differentiate subjects at risk of fragility fractures when used with clinical data and other bone quality parameters&#46; Quantitative measurements based on TAs could potentially discriminate subjects with bone mass loss and those at risk of fragility fractures&#46;</p><p id="para210" class="elsevierStylePara elsevierViewall">This study has some limitations that deserve mention&#46; The cervical and thoracic spinal segments were not studied&#46; This is a relative limitation because currently&#44; only the lumbar vertebrae are used to measure BMD&#46; In addition&#44; our study population was mainly composed of young volunteers with normal bone mass and without fragility fractures&#46; Finally&#44; our study used BMD as a surrogate parameter of fracture susceptibility and did not test the potential usefulness of textural features extracted from MRI scans to directly predict fracture risk&#46; However&#44; our study provides important preliminary data for a more comprehensive study to examine the role of the technique in the evaluation of fracture susceptibility&#46; Future studies are necessary to evaluate the potential clinical application of texture analysis using spine MRI&#46;</p></span><span id="cesec130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">CONCLUSION</span><p id="para220" class="elsevierStylePara elsevierViewall">In summary&#44; several specific TAs could be reliably extracted from routine sagittal T2-weighted MRI scans and showed a strong relationship with BMD in a healthy adult eutrophic population&#46; Our results encourage future evaluations of MRI quantitative textural measurements to potentially discriminate subjects at risk of fragility fractures&#46;</p></span><span id="cesec140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle190">AUTHOR CONTRIBUTIONS</span><p id="para230" class="elsevierStylePara elsevierViewall">Maciel JG performed the experiments&#44; analyzed the data&#44; wrote the manuscript&#44; and reviewed the manuscript&#46; Ara&#250;jo IM analyzed the data and reviewed&#47;edited the manuscript&#46; Trazzi LC analyzed the data and reviewed&#47;edited the manuscript&#46; Azevedo&#8208;Marques PM analyzed the data and reviewed&#47;edited the manuscript&#46; Salmon CEG analyzed the data and reviewed&#47;edited the manuscript&#46; Paula FJA analyzed the data and reviewed&#47;edited the manuscript&#46; Nogueira&#8208;Barbosa MH designed the study and reviewed&#47;edited the manuscript&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:2 [
          "identificador" => "xpalclavsec1580108"
          "titulo" => "KEYWORDS"
        ]
        1 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        2 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "ETHICAL CONSIDERATIONS"
        ]
        3 => array:3 [
          "identificador" => "cesec30"
          "titulo" => "MATERIALS AND METHODS"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "cesec40"
              "titulo" => "Subjects"
            ]
            1 => array:2 [
              "identificador" => "cesec50"
              "titulo" => "Dual-energy X-ray absorptiometry"
            ]
            2 => array:2 [
              "identificador" => "cesec60"
              "titulo" => "MRI and TA extraction"
            ]
            3 => array:2 [
              "identificador" => "cesec70"
              "titulo" => "Statistical analyses"
            ]
          ]
        ]
        4 => array:3 [
          "identificador" => "cesec80"
          "titulo" => "RESULTS"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "cesec90"
              "titulo" => "Patients&#39; demographics&#44; clinical characteristics&#44; and BMD"
            ]
            1 => array:2 [
              "identificador" => "cesec100"
              "titulo" => "Correlation between BMD and bone TAs"
            ]
            2 => array:2 [
              "identificador" => "cesec110"
              "titulo" => "Inter-rater reliability"
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "cesec120"
          "titulo" => "DISCUSSION"
        ]
        6 => array:2 [
          "identificador" => "cesec130"
          "titulo" => "CONCLUSION"
        ]
        7 => array:2 [
          "identificador" => "cesec140"
          "titulo" => "AUTHOR CONTRIBUTIONS"
        ]
        8 => array:2 [
          "identificador" => "xack638112"
          "titulo" => "ACKNOWLEDGMENTS"
        ]
        9 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-03-21"
    "fechaAceptado" => "2020-05-26"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec1580108"
          "palabras" => array:3 [
            0 => "Magnetic Resonance Imaging"
            1 => "Textural Attribute"
            2 => "Bone Mineral Density"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">OBJECTIVE&#58;</span><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Dual-energy X-ray absorptiometry &#40;DXA&#41;-derived bone mineral density &#40;BMD&#41; often fails to predict fragility fractures&#46; Quantitative textural analysis using magnetic resonance imaging &#40;MRI&#41; may potentially yield useful radiomic features to predict fractures&#46; We aimed to investigate the correlation between BMD and texture attributes &#40;TAs&#41; extracted from MRI scans and the interobserver reproducibility of the analysis&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS&#58;</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Forty-nine volunteers underwent lumbar spine 1&#46;5-T MRI and DXA&#46; Three-dimensional &#40;3-D&#41; gray-level co-occurrence matrices were measured from routine sagittal T2 fast spin-echo images using the IBEX software&#46; Twenty-two TAs were extracted from 3-D segmented L3 vertebrae&#46; The estimated concordance coefficient was calculated using linear regression analysis&#46; A Pearson correlation coefficient analysis was performed to evaluate the correlation between BMD and the TAs&#46; Interobserver reproducibility was assessed with the concordance coefficient described by Lin&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS&#58;</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">The results revealed a fair-to-moderate significant correlation between BMD and 13 TAs &#40;<span class="elsevierStyleItalic">r</span>&#61;&#8722;0&#46;20 to 0&#46;39&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#46; Eight TAs &#40;autocorrelation&#44; energy&#44; homogeneity 1&#44; homogeneity 1&#46;1&#44; maximum probability&#44; sum average&#44; sum variance&#44; and inverse difference normalized&#41; negatively correlated with BMD &#40;<span class="elsevierStyleItalic">r</span>&#61;&#8722;0&#46;20 to &#8722;0&#46;38&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#44; whereas five TAs &#40;dissimilarity&#44; difference entropy&#44; entropy&#44; sum entropy&#44; and information measure corr 1&#41; positively correlated with BMD &#40;<span class="elsevierStyleItalic">r</span>&#61;0&#46;29-0&#46;39&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#46; The interobserver agreement was almost perfect for all significant TAs &#40;95&#37; confidence interval&#44; 0&#46;92-1&#46;00&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSION&#58;</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Specific TAs could be reliably extracted from routine MRI and correlated with BMD&#46; Our results encourage future evaluation of the potential usefulness of quantitative texture measurements from MRI scans for predicting fragility fractures&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "OBJECTIVE&#58;"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "METHODS&#58;"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "RESULTS&#58;"
          ]
          3 => array:2 [
            "identificador" => "ceabs40"
            "titulo" => "CONCLUSION&#58;"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1343
            "Ancho" => 1300
            "Tamanyo" => 149318
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A 31-year-old female volunteer&#46; Illustrated are the segmentation and positioning of the volume of interest &#40;VOI&#41; in the L3 vertebral body using the IBEX program for volumetric &#40;three-dimensional&#41; extraction of textural attributes &#40;TAs&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Female &#40;n&#61;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Male &#40;n&#61;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p-</span>value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41; &#40;Mean&#177;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;9&#177;13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#177;15&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41; &#40;Mean&#177;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;3&#177;2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;0&#177;1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bone mineral density &#40;BMD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L1-L4 BMD &#40;g&#47;cm<span class="elsevierStyleSup">2</span>&#41; &#40;Mean&#177;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&#177;0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;00&#177;0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L3 BMD &#40;g&#47;cm<span class="elsevierStyleSup">2</span>&#41; &#40;Mean&#177;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;03&#177;0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;02&#177;0&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Demographics&#44; clinical characteristics&#44; and bone mineral density of the study participants&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl2"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Bone mineral density &#40;g&#47;cm<span class="elsevierStyleSup">2</span>&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Texture attribute&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Estimated coefficient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Pearson correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autocorrelation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;0000046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Difference entropy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0087&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dissimilarity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0485&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Energy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0070&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Entropy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Homogeneity 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Homogeneity 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Information measure corr 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inverse different normalized&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0308&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Max probability&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sum average&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;00083&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sum entropy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;053&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sum variance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;0000012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Estimated coefficients of the association between bone mineral density and bone texture attributes&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:35 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis prevention&#44; diagnosis and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              NIH Consensus Development Panel on Osteoporosis Prevention&#44; Diagnosis&#44; and Therapy \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.285.6.785"
                      "Revista" => array:7 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2001"
                        "volumen" => "285"
                        "numero" => "6"
                        "paginaInicial" => "785"
                        "paginaFinal" => "795"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11176917"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1001/jama.285.6.785"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1001&#47;jama&#46;285&#46;6&#46;785"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Relationship of Fat Distribution and Insulin Resistance with Lumbar Spine Bone Mass in Women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              FJ de Paula \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              IM de Ara&#250;jo \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AL Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              J Elias \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              CE Salmon \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              MH Nogueira-Barbosa \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "numero" => "6"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1371&#47;journal&#46;pone&#46;0129764"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis&#46; Current techniques and recent developments in quantitative bone densitometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              P Lang \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Steiger \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              K Faulkner \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              C Gl&#252;er \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              HK Genant \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Radiol Clin North Am"
                        "fecha" => "1991"
                        "volumen" => "29"
                        "numero" => "1"
                        "paginaInicial" => "49"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1985329"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advances in osteoporosis imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              JS Bauer \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              TM Link \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejrad.2008.04.064"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Radiol"
                        "fecha" => "2009"
                        "volumen" => "71"
                        "numero" => "3"
                        "paginaInicial" => "440"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19651482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.ejrad.2008.04.064"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;ejrad&#46;2008&#46;04&#46;064"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fracture incidence and association with bone mineral density in elderly men and women&#58; the Rotterdam Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              SC Schuit \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M van der Klift \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AE Weel \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              CE de Laet \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              H Burger \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              E Seeman \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2003.10.001"
                      "Revista" => array:7 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2004"
                        "volumen" => "34"
                        "numero" => "1"
                        "paginaInicial" => "195"
                        "paginaFinal" => "202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14751578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.bone.2003.10.001"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;bone&#46;2003&#46;10&#46;001"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              E Dall&#8217;Ara \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Pahr \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Varga \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              F Kainberger \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Zysset \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-011-1568-3"
                      "Revista" => array:7 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "numero" => "2"
                        "paginaInicial" => "563"
                        "paginaFinal" => "572"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21344244"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00198-011-1568-3"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1007&#47;s00198-011-1568-3"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Volumetric squantitative computed tomography of the proximal femur&#58; relationships linking geometric and densitometric variables to bone strength&#46; Role for compact bone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              V Bousson \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Le Bras \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              F Roqueplan \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              Y Kang \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              D Mitton \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              S Kolta \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-006-0074-5"
                      "Revista" => array:7 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2006"
                        "volumen" => "17"
                        "numero" => "6"
                        "paginaInicial" => "855"
                        "paginaFinal" => "864"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16547689"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00198-006-0074-5"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1007&#47;s00198-006-0074-5"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Methods for assessing bone quality&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              E Donnelly \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s11999-010-1702-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2011"
                        "volumen" => "469"
                        "numero" => "8"
                        "paginaInicial" => "2128"
                        "paginaFinal" => "2138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21116752"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s11999-010-1702-0"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1007&#47;s11999-010-1702-0"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Marrow Fat Quality Differences by Sex in Healthy Adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              JG Maciel \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              IM de Ara&#250;jo \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AL Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              MN Sim&#227;o \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              CM Bastos \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              LE Troncon \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jocd.2016.08.002"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2017"
                        "volumen" => "20"
                        "numero" => "1"
                        "paginaInicial" => "106"
                        "paginaFinal" => "113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27637728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.jocd.2016.08.002"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;jocd&#46;2016&#46;08&#46;002"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis imaging&#58; effects of bone preservation on MDCT-based trabecular bone microstructure parameters and finite element models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              T Baum \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              E Grande Garcia \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              R Burgkart \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              O Gordijenko \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              H Liebl \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              PM Jungmann \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/s12880-015-0066-z"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med Imaging"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26113362"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/s12880-015-0066-z"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1186&#47;s12880-015-0066-z"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Three-dimensional texture analysis of cancellous bone cores evaluated at clinical CT resolutions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              C Showalter \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              BD Clymer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              B Richmond \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              K Powell \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-005-1994-1"
                      "Revista" => array:7 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2006"
                        "volumen" => "17"
                        "numero" => "2"
                        "paginaInicial" => "259"
                        "paginaFinal" => "266"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16170445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00198-005-1994-1"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1007&#47;s00198-005-1994-1"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Computational identification and quantification of trabecular microarchitecture classes by 3-D texture analysis-based clustering"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Valentinitsch \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JM Patsch \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AJ Burghardt \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              TM Link \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              S Majumdar \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              L Fischer \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2012.12.047"
                      "Revista" => array:7 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2013"
                        "volumen" => "54"
                        "numero" => "1"
                        "paginaInicial" => "133"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23313281"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.bone.2012.12.047"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;bone&#46;2012&#46;12&#46;047"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Textural Features for Image Classification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              RM Haralick \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              K Shanmugam \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              I Dinstein \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "IEEE Trans Syst Man Cybern"
                        "fecha" => "1973"
                        "volumen" => "3"
                        "paginaInicial" => "610"
                        "paginaFinal" => "621"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1109&#47;TSMC&#46;1973&#46;4309314"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Statistical and Structural Approaches to Texture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              RM Haralick \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc IEEE"
                        "fecha" => "1979"
                        "volumen" => "67"
                        "numero" => "5"
                        "paginaInicial" => "786"
                        "paginaFinal" => "804"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1109&#47;PROC&#46;1979&#46;11328"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A generic support vector machine model for preoperative glioma survival associations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              KE Emblem \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MC Pinho \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              FG Z&#246;llner \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              P Due-Tonnessen \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              JK Hald \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              LR Schad \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.14140770"
                      "Revista" => array:7 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2015"
                        "volumen" => "275"
                        "numero" => "1"
                        "paginaInicial" => "228"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25486589"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1148/radiol.14140770"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1148&#47;radiol&#46;14140770"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Automatic classification of prostate cancer Gleason scores from multiparametric magnetic resonance images"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              D Fehr \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              H Veeraraghavan \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Wibmer \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              T Gondo \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              K Matsumoto \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              HA Vargas \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.1505935112"
                      "Revista" => array:7 [
                        "tituloSerie" => "Proc Natl Acad Sci U S A"
                        "fecha" => "2015"
                        "volumen" => "112"
                        "numero" => "46"
                        "paginaInicial" => "E6265"
                        "paginaFinal" => "E6273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26578786"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1073/pnas.1505935112"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1073&#47;pnas&#46;1505935112"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              HJ Aerts \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              ER Velazquez \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RT Leijenaar \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              C Parmar \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Grossmann \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              S Carvalho \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Nat Commun"
                        "fecha" => "2014"
                        "volumen" => "5"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1038&#47;ncomms5006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone marrow imaging&#58; magnetic resonance studies related to age and sex"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              GC Dooms \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MR Fisher \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              H Hricak \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Richardson \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              LE Crooks \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              HK Genant \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1148/radiology.155.2.3983394"
                      "Revista" => array:7 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "1985"
                        "volumen" => "155"
                        "numero" => "2"
                        "paginaInicial" => "429"
                        "paginaFinal" => "432"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3983394"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1148/radiology.155.2.3983394"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1148&#47;radiology&#46;155&#46;2&#46;3983394"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vertebral bone mineral density&#44; marrow perfusion&#44; and fat content in healthy men and men with osteoporosis&#58; dynamic contrast-enhanced MR imaging and MR spectroscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              JF Griffith \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              DK Yeung \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              GE Antonio \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              FK Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              AW Hong \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              SY Wong \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2363041425"
                      "Revista" => array:7 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2005"
                        "volumen" => "236"
                        "numero" => "3"
                        "paginaInicial" => "945"
                        "paginaFinal" => "951"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1148/radiol.2363041425"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1148&#47;radiol&#46;2363041425"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone marrow fat composition as a novel imaging biomarker in postmenopausal women with prevalent fragility fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              JM Patsch \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              X Li \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              T Baum \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              SP Yap \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              DC Karampinos \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              AV Schwartz \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.1950"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "numero" => "8"
                        "paginaInicial" => "1721"
                        "paginaFinal" => "1728"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23558967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1002/jbmr.1950"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1002&#47;jbmr&#46;1950"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis is associated with increased marrow fat content and decreased marrow fat unsaturation&#58; a proton MR spectroscopy study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              DK Yeung \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JF Griffith \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              GE Antonio \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              FK Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Woo \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              PC Leung \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1002/jmri.20367"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "numero" => "2"
                        "paginaInicial" => "279"
                        "paginaFinal" => "285"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028245"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1002/jmri.20367"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1002&#47;jmri&#46;20367"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy&#58; reproducibility&#44; vertebral variation&#44; and applications in osteoporosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              X Li \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Kuo \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AL Schafer \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Porzig \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              TM Link \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              D Black \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1002/jmri.22489"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2011"
                        "volumen" => "33"
                        "numero" => "4"
                        "paginaInicial" => "974"
                        "paginaFinal" => "979"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21448966"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1002/jmri.22489"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1002&#47;jmri&#46;22489"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative assessment of trabecular bone micro-architecture of the wrist via 7 Tesla MRI&#58; preliminary results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              G Chang \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              L Wang \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              G Liang \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              JS Babb \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              GC Wiggins \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              PK Saha \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s10334-011-0252-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "MAGMA"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "numero" => "4"
                        "paginaInicial" => "191"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21544680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s10334-011-0252-0"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1007&#47;s10334-011-0252-0"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative imaging methods in osteoporosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              L Oei \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              F Koromani \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              F Rivadeneira \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              MC Zillikens \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              EH Oei \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.21037/qims.2016.12.13"
                      "Revista" => array:7 [
                        "tituloSerie" => "Quant Imaging Med Surg"
                        "fecha" => "2016"
                        "volumen" => "6"
                        "numero" => "6"
                        "paginaInicial" => "680"
                        "paginaFinal" => "698"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28090446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.21037/qims.2016.12.13"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;21037&#47;qims&#46;2016&#46;12&#46;13"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postmenopausal women with osteoporosis and osteoarthritis show different microstructural characteristics of trabecular bone in proximal tibia using high-resolution magnetic resonance imaging at 3 tesla"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              Y Shen \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              YH Zhang \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              L Shen \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2474-14-136"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Musculoskelet Disord"
                        "fecha" => "2013"
                        "volumen" => "14"
                        "paginaInicial" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23587336"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/1471-2474-14-136"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1186&#47;1471-2474-14-136"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IBEX&#58; an open infrastructure software platform to facilitate collaborative work in radiomics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              L Zhang \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              DV Fried \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              XJ Fave \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              LA Hunter \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Yang \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              LE Court \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1118/1.4908210"
                      "Revista" => array:7 [
                        "tituloSerie" => "Med Phys"
                        "fecha" => "2015"
                        "volumen" => "42"
                        "numero" => "3"
                        "paginaInicial" => "1341"
                        "paginaFinal" => "1353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25735289"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1118/1.4908210"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1118&#47;1&#46;4908210"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Core samples for radiomics features that are insensitive to tumor segmentation&#58; method and pilot study using CT images of hepatocellular carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              S Echegaray \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              O Gevaert \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              R Shah \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Kamaya \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Louie \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              N Kothary \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Med Imaging"
                        "fecha" => "2015"
                        "volumen" => "2"
                        "numero" => "4"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1117&#47;1&#46;JMI&#46;2&#46;4&#46;041011"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Computer and robot vision"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              R Haralick \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              L Shapiro \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "1992"
                        "editorial" => "Addison-Wesley"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A concordance correlation coefficient to evaluate reproducibility"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              LI Lin \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Biometrics"
                        "fecha" => "1989"
                        "volumen" => "45"
                        "numero" => "1"
                        "paginaInicial" => "255"
                        "paginaFinal" => "268"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2720055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;2307&#47;2532051"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The measurement of observer agreement for categorical data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              JR Landis \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              GG Koch \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Biometrics"
                        "fecha" => "1977"
                        "volumen" => "33"
                        "numero" => "1"
                        "paginaInicial" => "159"
                        "paginaFinal" => "174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/843571"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;2307&#47;2529310"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "SAS&#47;STAT user&#8217;s guide&#44; version 9&#46;4"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              SAS Institute Inc \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2013"
                        "editorial" => "SAS Institute&#44; Inc"
                        "editorialLocalizacion" => "Cary&#44; NC"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exploratory Study to Identify Radiomics Classifiers for Lung Cancer Histology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              W Wu \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              C Parmar \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Grossmann \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              J Quackenbush \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Lambin \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              J Bussink \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.3389/fonc.2016.00071"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Oncol"
                        "fecha" => "2016"
                        "volumen" => "6"
                        "paginaInicial" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27064691"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.3389/fonc.2016.00071"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;3389&#47;fonc&#46;2016&#46;00071"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiomics&#58; Images Are More than Pictures&#44; They Are Data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              RJ Gillies \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              PE Kinahan \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              H Hricak \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2015151169"
                      "Revista" => array:7 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2016"
                        "volumen" => "278"
                        "numero" => "2"
                        "paginaInicial" => "563"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26579733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1148/radiol.2015151169"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1148&#47;radiol&#46;2015151169"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiomics&#58; the process and the challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              V Kumar \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              Y Gu \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              S Basu \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Berglund \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              SA Eschrich \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              MB Schabath \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mri.2012.06.010"
                      "Revista" => array:7 [
                        "tituloSerie" => "Magn Reson Imaging"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "numero" => "9"
                        "paginaInicial" => "1234"
                        "paginaFinal" => "1248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22898692"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.mri.2012.06.010"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;mri&#46;2012&#46;06&#46;010"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Shape&#44; texture and statistical features for classification of benign and malignant vertebral compression fractures in magnetic resonance images"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              L Frighetto-Pereira \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              RM Rangayyan \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              GA Metzner \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              PM de Azevedo-Marques \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              MH Nogueira-Barbosa \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.compbiomed.2016.04.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Comput Biol Med"
                        "fecha" => "2016"
                        "volumen" => "73"
                        "paginaInicial" => "147"
                        "paginaFinal" => "156"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27111110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.compbiomed.2016.04.006"
                      "WWW" => array:1 [
                        "link" => "https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;compbiomed&#46;2016&#46;04&#46;006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack638112"
        "titulo" => "ACKNOWLEDGMENTS"
        "texto" => "<p id="para240" class="elsevierStylePara elsevierViewall">The authors are indebted to Rita C&#46; Varrichio&#44; Luciana Mijoler&#44; and Rodrigo Pessini for their competent technical assistance&#46; Financial Support&#58; JGM&#58; CAPES CODE 1&#59; FJAP&#58; FAPESP 2018&#47;14060-9&#59; MHN-B&#58; FAPESP 2018&#47;04266-9&#44; CNPq 307138&#47;2017-8 and 404795&#47;2018-8&#59; IMA&#58; CNPq 156950&#47;2018-9&#46; FAPESP&#58; S&#227;o Paulo Research Foundation&#44; CNPq&#58; National Council for Scientific and Technological Development&#46; The funders had no role in the study design&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004732/v1_202211290815/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/18075932/000000750000000C/v1_202211290815/S1807593222004732/v1_202211290815/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004732?idApp=UINPBA00004N"
]

Article information

ISSN: 18075932
Original language: English

DOI:10.6061/clinics/2020/e1766

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	16	302	318
2024 September	39	22	61
2024 August	45	37	82
2024 July	33	23	56
2024 June	29	20	49
2024 May	32	13	45
2024 April	43	24	67
2024 March	33	17	50
2024 February	79	14	93
2024 January	71	17	88
2023 December	29	22	51
2023 November	33	17	50
2023 October	30	36	66
2023 September	26	24	50
2023 August	27	5	32
2023 July	23	24	47
2023 June	25	13	38
2023 May	35	2	37
2023 April	55	2	57
2023 March	31	5	36
2023 February	29	0	29
2023 January	22	6	28
2022 December	13	3	16
2022 November	1	0	1

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter