Is Thermal Imaging a Useful Predictor of the Healing Status of Diabetes-Related Foot Ulcers? A Pilot Study

Aliahmad, B, Tint, A, Poosapadi Arjunan, S, Rani, P, Kumar, D, Miller, J, Zajac, J, Wang, G and Ekinci, E 2018, 'Is Thermal Imaging a Useful Predictor of the Healing Status of Diabetes-Related Foot Ulcers? A Pilot Study', Journal of Diabetes Science and Technology, pp. 1-10.


Document type: Journal Article
Collection: Journal Articles

Title Is Thermal Imaging a Useful Predictor of the Healing Status of Diabetes-Related Foot Ulcers? A Pilot Study
Author(s) Aliahmad, B
Tint, A
Poosapadi Arjunan, S
Rani, P
Kumar, D
Miller, J
Zajac, J
Wang, G
Ekinci, E
Year 2018
Journal name Journal of Diabetes Science and Technology
Start page 1
End page 10
Total pages 10
Publisher Sage Publications, Inc.
Abstract Introduction: In clinical practice, both area and temperature of the ulcer have been shown to be effective in tracking the healing status of diabetes-related foot ulcer (DRFU). However, traditionally, the area of the DRFU is measured regardless of the temperature distribution. The current prospective, observational study used thermal imaging, as a more accurate tool, to measure both the area and the temperature of DRFU. We aimed to predict healing of DRFU using thermal imaging within the first 4 weeks of ulceration. Method: A pilot study was conducted where thermal and color images of 26 neuropathic DRFUs (11 healing vs 15 nonhealing) from individuals with type 1 or 2 diabetes were taken at the initial clinic visit (baseline), at week 2, and at week 4. The thermal images were segmented into isothermal patches to identify the wound boundary and area corresponding to temperature distribution. Five parameters were obtained: temperature of the wound bed, area of the isothermal patch of the wound bed, area of isothermal patch of periwound, number of isolated isothermal patches of the wound region, and physical wound bed area from color image. The ulcers were also measured by experienced podiatrists over 4 consecutive weeks and used as the healing reference. Results: For healing cases, the ratio of the area of the wound bed to its baseline measured using thermal images was found to be significantly lower at 2 weeks compared to nonhealing cases and this corresponded with a 50% reduction in area of DRFU at 4 weeks (group rank-based nonparametric analysis of variance P = .036). In comparison, neither the planimetric area measured using color images nor the temperature of the wound bed was associated with the healing. Conclusion: This study of 26 patients demonstrates that change in the isothermal area of DRFU can predict the healing status at week 4. Thermal imaging of DRFUs has the advantage of incorporating both area and temperature allowing for early prediction of the
Subject Image Processing
DOI - identifier 10.1177/1932296818803115
Copyright notice © 2018 Diabetes Technology Society
ISSN 1932-2968
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