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Fractal Dimension (df) as a new structural biomarker -Davies N.pdf (539.5 kB)

Fractal Dimension (df) as a new structural biomarker of clot microstructure in lung cancer and its stages

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posted on 2022-03-28, 11:50 authored by Nia Anne Davies, Nicholas Kim Harrison, Keith Morris, Simon Noble, Matthew James Lawrence, Lindsay Antonio D’Silva, Laura Broome, Martin Rowan Brown, Karl M. Hawkins, Phylip Rhodri Williams, Simon Davidson, Phillip Adrian Evans
Venous thromboembolism (VTE) is common in cancer patients, and is the second commonest cause of death associated with the disease. Patients with chronic inflammation, such as cancer, have been shown to have pathological clot structures with modulated mechanical properties. Fractal dimension (df) is a new technique which has been shown to act as a marker of the microstructure and mechanical properties of blood clots, and can be performed more readily than current methods such as scanning electron microscopy (SEM). We measured df in 87 consecutive patients with newly diagnosed lung cancer prior to treatment and 47 matched-controls. Mean group values were compared for all patients with lung cancer vs controls and for limited disease vs extensive disease. Results were compared with conventional markers of coagulation, fibrinolysis and SEM images. Significantly higher values of df were observed in lung cancer patients compared with controls and patients with extensive disease had higher values than those with limited disease (p< 0.05), whilst conventional markers failed to distinguish between these groups. The relationship between df of the incipient clot and mature clot microstructure was confirmed by SEM and computational modelling: higher df was associated with highly dense clots formed of smaller fibrin fibres in lung cancer patients compared to controls. This study demonstrates that df is a sensitive technique which quantifies the structure and mechanical properties of blood clots in patients with lung cancer. Our data suggests that df has the potential to identify patients with an abnormal clot microstructure and greatest VTE risk


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Thrombosis and Haemostasis




  • AM (Accepted Manuscript)


Davies, N.A., Harrison, N.K., Morris, R.H.K., Noble, S., Lawrence, M.J., D'Silva, L.A., Broome, L., Brown, M.R., Hawkins, K.M., Williams, P.R., Davidson, S. & Evans, P.A. (2015) 'Fractal dimension (df) as a new structural biomarker of clot microstructure in different stages of lung cancer', Thrombosis and Haemostasis, 114(6), pp.1251-1259

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Keith Morris

Cardiff Met Research Centre/Group

  • Cardiovascular Metabolism and Inflammation

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