Semi-Automatic Tracking of Laser Speckle Contrast Images of Microcirculation in Diabetic Foot Ulcers

Onno A Mennes,Jeff G Van Baal,Jaap J Van Netten,Riemer H J A Slart,Mark Selles,Wiendelt Steenbergen

doi:10.3390/diagnostics10121054

Abstract

Foot ulcers are a severe complication of diabetes mellitus. Assessment of the vascular status of diabetic foot ulcers with Laser Speckle Contrast Imaging (LSCI) is a promising approach for diagnosis and prognosis. However, manual assessment during analysis of LSCI limits clinical applicability. Our aim was to develop and validate a fast and robust tracking algorithm for semi-automatic analysis of LSCI data. The feet of 33 participants with diabetic foot ulcers were recorded with LSCI, including at baseline, during the Post-Occlusive Reactive Hyperemia (PORH) test, and during the Buerger’s test. Different regions of interest (ROIs) were used to measure microcirculation in different areas of the foot. A tracking algorithm was developed in MATLAB to reposition the ROIs in the LSCI scans. Manual- and algorithm-tracking of all recordings were compared by calculating the Intraclass Correlation Coefficient (ICC). The algorithm was faster in comparison with the manual approach (90 s vs. 15 min). Agreement between manual- and algorithm-tracking was good to excellent during baseline (ICC = 0.896–0.984; p < 0.001), the PORH test (ICC = 0.790–0.960; p < 0.001), and the Buerger’s test (ICC = 0.851–0.978; p < 0.001), resulting in a tracking algorithm that delivers assessment of LSCI in diabetic foot ulcers with results comparable to a labor-intensive manual approach, but with a 10-fold workload reduction.

Highlights

The incidence of diabetes mellitus increases worldwide, followed by an increasing number of related complications such as diabetic foot disease [1]
Treatment of diabetic foot ulcers relies on five major factors, including: relief of pressure, and protection and care of the ulcer; restoration of skin perfusion; treatment of infection; metabolic control; and treatment of co-morbidities [6]
We aimed to develop and validate a fast and robust tracking algorithm for analysis of Laser Speckle Contrast Imaging (LSCI) data of diabetic foot ulcers, to improve clinical applicability of LSCI in vascular assessment in diabetic foot disease

Summary

Introduction

The incidence of diabetes mellitus increases worldwide, followed by an increasing number of related complications such as diabetic foot disease [1]. The most common aspect of this disease are diabetic foot ulcers, which are related to peripheral neuropathy and peripheral artery disease (PAD) [3]. To determine the need of restoration of skin perfusion, it is essential to determine the vascular status of a patient. Based on this assessment, treatment decisions such as the need for revascularization are taken. Treatment decisions such as the need for revascularization are taken This vascular assessment is one of the biggest challenges in the treatment of diabetic foot ulcers [6]

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