David G. Armstrong

Abderrachid Hamrani, Daniela Leizaola, Renato Sousa et al.

Diabetic foot ulcers (DFUs) pose a significant challenge in healthcare, requiring precise and efficient wound assessment to enhance patient outcomes. This study introduces the Attention Diffusion Zero-shot Unsupervised System (ADZUS), a novel text-guided diffusion model that performs wound segmentation without relying on labeled training data. Unlike conventional deep learning models, which require extensive annotation, ADZUS leverages zero-shot learning to dynamically adapt segmentation based on descriptive prompts, offering enhanced flexibility and adaptability in clinical applications. Experimental evaluations demonstrate that ADZUS surpasses traditional and state-of-the-art segmentation models, achieving an IoU of 86.68\% and the highest precision of 94.69\% on the chronic wound dataset, outperforming supervised approaches such as FUSegNet. Further validation on a custom-curated DFU dataset reinforces its robustness, with ADZUS achieving a median DSC of 75\%, significantly surpassing FUSegNet's 45\%. The model's text-guided segmentation capability enables real-time customization of segmentation outputs, allowing targeted analysis of wound characteristics based on clinical descriptions. Despite its competitive performance, the computational cost of diffusion-based inference and the need for potential fine-tuning remain areas for future improvement. ADZUS represents a transformative step in wound segmentation, providing a scalable, efficient, and adaptable AI-driven solution for medical imaging.

Bill Cassidy, Connah Kendrick, Neil D. Reeves et al.

Diabetic foot ulcer classification systems use the presence of wound infection (bacteria present within the wound) and ischaemia (restricted blood supply) as vital clinical indicators for treatment and prediction of wound healing. Studies investigating the use of automated computerised methods of classifying infection and ischaemia within diabetic foot wounds are limited due to a paucity of publicly available datasets and severe data imbalance in those few that exist. The Diabetic Foot Ulcer Challenge 2021 provided participants with a more substantial dataset comprising a total of 15,683 diabetic foot ulcer patches, with 5,955 used for training, 5,734 used for testing and an additional 3,994 unlabelled patches to promote the development of semi-supervised and weakly-supervised deep learning techniques. This paper provides an evaluation of the methods used in the Diabetic Foot Ulcer Challenge 2021, and summarises the results obtained from each network. The best performing network was an ensemble of the results of the top 3 models, with a macro-average F1-score of 0.6307.

Bill Cassidy, Neil D. Reeves, Pappachan Joseph et al.

Every 20 seconds, a limb is amputated somewhere in the world due to diabetes. This is a global health problem that requires a global solution. The MICCAI challenge discussed in this paper, which concerns the automated detection of diabetic foot ulcers using machine learning techniques, will accelerate the development of innovative healthcare technology to address this unmet medical need. In an effort to improve patient care and reduce the strain on healthcare systems, recent research has focused on the creation of cloud-based detection algorithms. These can be consumed as a service by a mobile app that patients (or a carer, partner or family member) could use themselves at home to monitor their condition and to detect the appearance of a diabetic foot ulcer (DFU). Collaborative work between Manchester Metropolitan University, Lancashire Teaching Hospital and the Manchester University NHS Foundation Trust has created a repository of 4,000 DFU images for the purpose of supporting research toward more advanced methods of DFU detection. Based on a joint effort involving the lead scientists of the UK, US, India and New Zealand, this challenge will solicit original work, and promote interactions between researchers and interdisciplinary collaborations. This paper presents a dataset description and analysis, assessment methods, benchmark algorithms and initial evaluation results. It facilitates the challenge by providing useful insights into state-of-the-art and ongoing research. This grand challenge takes on even greater urgency in a peri and post-pandemic period, where stresses on resource utilization will increase the need for technology that allows people to remain active, healthy and intact in their home.