Abstract

Diabetic foot ulcers (DFUs) are one of the most common complications of diabetes. Identifying the presence of infection and ischemia in DFU is important for ulcer examination and treatment planning. Recently, the computerized classification of infection and ischaemia of DFU based on deep learning methods has shown promising performance. Most state-of-the-art DFU image classification methods employ deep neural networks, especially convolutional neural networks, to extract discriminative features, and predict class probabilities from the extracted features by fully connected neural networks. In the testing, the prediction depends on an individual input image and trained parameters, where knowledge in the training data is not explicitly utilized. To better utilize the knowledge in the training data, we propose class knowledge banks (CKBs) consisting of trainable units that can effectively extract and represent class knowledge. Each unit in a CKB is used to compute similarity with a representation extracted from an input image. The averaged similarity between units in the CKB and the representation can be regarded as the logit of the considered input. In this way, the prediction depends not only on input images and trained parameters in networks but the class knowledge extracted from the training data and stored in the CKBs. Experimental results show that the proposed method can effectively improve the performance of DFU infection and ischaemia classifications.

Highlights

  • The diabetic foot ulcer (DFU) is a complication of diabetes with high incidence Armstrong et al (2017)

  • We show that the proposed class knowledge banks (CKBs) is good at handling class imbalance in the DFU image classification dataset

  • The DFU dataset includes ischaemia and infection parts that were collected from the Lancashire Teaching Hospitals

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Summary

Introduction

The diabetic foot ulcer (DFU) is a complication of diabetes with high incidence Armstrong et al (2017). According to the estimation of the International Diabetes Federation Atlas et al (2015), 9.1 million to 26.1 million people with diabetes develop foot ulcers each year in the world. The presence of DFU can result in amputation and even increase the risk of death Walsh et al (2016). Identifying whether the DFU is infection and ischaemia is important for its assessment, treatment, and management Jeffcoate and Harding (2003), where the infection is defined as bacterial soft tissue or bone infection in the DFU and ischaemia means inadequate blood supply Goyal et al (2020). Classification of DFU infection and ischaemia by computerized methods is a critical research problem for automatic DFU assessment

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