# Recognition of Ischaemia and Infection in Diabetic Foot Ulcers: Dataset and Techniques

## TL;DR

This paper introduces a new dataset and computer vision techniques for detecting infection and ischaemia in diabetic foot ulcers, achieving high accuracy especially for ischaemia recognition using ensemble CNN models.

## Contribution

The work presents the first dataset with ground truth labels for infection and ischaemia in DFU, along with novel feature descriptors and a focus on salient region-based data augmentation.

## Key findings

- Ensemble CNN achieved 90% accuracy for ischaemia detection.
- Ensemble CNN achieved 73% accuracy for infection detection.
- Proposed methods outperform handcrafted features in classification tasks.

## Abstract

Recognition and analysis of Diabetic Foot Ulcers (DFU) using computerized methods is an emerging research area with the evolution of image-based machine learning algorithms. Existing research using visual computerized methods mainly focuses on recognition, detection, and segmentation of the visual appearance of the DFU as well as tissue classification. According to DFU medical classification systems, the presence of infection (bacteria in the wound) and ischaemia (inadequate blood supply) has important clinical implications for DFU assessment, which are used to predict the risk of amputation. In this work, we propose a new dataset and computer vision techniques to identify the presence of infection and ischaemia in DFU. This is the first time a DFU dataset with ground truth labels of ischaemia and infection cases is introduced for research purposes. For the handcrafted machine learning approach, we propose a new feature descriptor, namely the Superpixel Color Descriptor. Then we use the Ensemble Convolutional Neural Network (CNN) model for more effective recognition of ischaemia and infection. We propose to use a natural data-augmentation method, which identifies the region of interest on foot images and focuses on finding the salient features existing in this area. Finally, we evaluate the performance of our proposed techniques on binary classification, i.e. ischaemia versus non-ischaemia and infection versus non-infection. Overall, our method performed better in the classification of ischaemia than infection. We found that our proposed Ensemble CNN deep learning algorithms performed better for both classification tasks as compared to handcrafted machine learning algorithms, with 90% accuracy in ischaemia classification and 73% in infection classification.