Abstract
Infrared thermography has been proven to be an effective non-invasive method in diabetic foot ulcer prevention, yet current image processing algorithms are inaccurate and impractical for clinical work. The aim of this study was to investigate the accuracy of our automated algorithm for feet outline detection and localization of potential inflammation regions in thermal images. Optical and thermal images were captured by a Flir OnePro camera connected with an Apple iPad Air tablet. Both thermal and optical images were merged into an edge image and used for the estimation of foot template transformations during the localization process. According to the feet template transformations, temperature maps were calculated and compared with each other to detect a set of regions exceeding the defined temperature threshold. Finally, a set of potential inflammation regions were filtered according to the blobs features to obtain the final list of inflammation regions. In this study, 168 thermal images were analyzed. The developed algorithm yielded 95.83% accuracy for foot outline detection and 94.28% accuracy for detection of the inflammation regions. The presented automated algorithm with enhanced detection accuracy can be used for developing a mobile thermal imaging system. Further studies with patients who have diabetes and are at risk of foot ulceration are needed to test the significance of our developed algorithm.
Highlights
Diabetes mellitus is one of the most prevalent chronic diseases
While diabetes itself is like the tip of an iceberg, diabetes-related complications, especially diabetic foot ulcers (DFUs), are the biggest concern
Cwajda-Białasik et al, a prolonged temperature increase of at least 1.11 ◦C at the wound site, could indicate the existence of infections [9]. These findings suggest that the application of Infrared thermography (IRT) could be expanded from screening to follow-up of patients with current ulcers and even suspected early infections
Summary
While diabetes itself is like the tip of an iceberg, diabetes-related complications, especially diabetic foot ulcers (DFUs), are the biggest concern. The DFUs are difficult to diagnose early and even more challenging to treat. A new diagnostic tool for early diagnosis of DFUs is fundamental to reduce adverse outcomes and economic cost [2,3]. Since Armstrong and colleagues determined that temperature changes in the foot can be an early indication of a DFU [4], researchers have been searching for a convenient and accurate way to identify these changes. The increased temperature may be presented even a week before a DFU appears [6], and frequent temperature assessment and treatment for these patients can prevent diabetic foot complications [7,8]
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