Abstract

BackgroundVisual inspection for tongue analysis is a diagnostic method in traditional Chinese medicine (TCM). Owing to the variations in tongue features, such as color, texture, coating, and shape, it is difficult to precisely extract the tongue region in images. This study aims to quantitatively evaluate tongue diagnosis via automatic tongue segmentation.MethodsExperiments were conducted using a clinical image dataset provided by the Laboratory of Traditional Medical Syndromes, Shanghai University of TCM. First, a clinical tongue image was refined by a saliency window. Second, we initialized the tongue area as the upper binary part and lower level set matrix. Third, a double geo-vector flow (DGF) was proposed to detect the tongue edge and segment the tongue region in the image, such that the geodesic flow was evaluated in the lower part, and the geo-gradient vector flow was evaluated in the upper part.ResultsThe performance of the DGF was evaluated using 100 images. The DGF exhibited better results compared with other representative studies, with its true-positive volume fraction reaching 98.5%, its false-positive volume fraction being 1.51%, and its false-negative volume fraction being 1.42%. The errors between the proposed automatic segmentation results and manual contours were 0.29 and 1.43% in terms of the standard boundary error metrics of Hausdorff distance and mean distance, respectively.ConclusionsBy analyzing the time complexity of the DGF and evaluating its performance via standard boundary and area error metrics, we have shown both efficiency and effectiveness of the DGF for automatic tongue image segmentation.

Highlights

  • Visual inspection for tongue analysis is a diagnostic method in traditional Chinese medicine (TCM)

  • The current practice in TCM is mainly subjective, and the quality of the visual inspection varies among medical professionals

  • The double geo-vector flow (DGF) was proposed to detect the tongue edge and segment the tongue region in the image, such that the geodesic flow was evaluated in the under part, and the geo-gradient vector flow (Geo-gradient vector flow (GVF)) was evaluated in the upper part

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Summary

Introduction

Visual inspection for tongue analysis is a diagnostic method in traditional Chinese medicine (TCM). Non-invasive, and inexpensive visual inspection of the human tongue has been a unique diagnostic method of traditional Chinese medicine (TCM) [1], through observing any abnormal changes in the tongue properties and coating. It is beneficial to devise objective quantitative evaluation methods for the color, texture, and surface of the tongue and define their relationships with patients’ health conditions [5,6]. Some other computerized systems, such as the tongue computing model, computerized system for tongue diagnosis, and automatic tongue diagnosis system, were built in [11,12,13], of which Gao et al [12] established a mapping relationship between quantitative tongue features and diseases via the support vector machine and obtained promising performances

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