Algorithm for automated foot detection in thermal and optical Images for temperature asymmetry analysis

Infrared thermography has been proven to be an effective non-invasive method in diabetic foot ulcer prevention, yet current image processing algorithms are inaccurate and impractical for clinical work. The aim of this study was to investigate the accuracy of our automated algorithm for feet outline detection and localization of potential inflammation regions in thermal images. Optical and thermal images were captured by a Flir OnePro camera connected with an Apple iPad Air tablet. Both thermal and optical images were merged into an edge image and used for the estimation of foot template transformations during the localization process. According to the feet template transformations, temperature maps were calculated and compared with each other to detect a set of regions exceeding the defined temperature threshold. Finally, a set of potential inflammation regions were filtered according to the blobs features to obtain the final list of inflammation regions. In this study, 168 thermal images were analyzed. The developed algorithm yielded 95.83% accuracy for foot outline detection and 94.28% accuracy for detection of the inflammation regions. The presented automated algorithm with enhanced detection accuracy can be used for developing a mobile thermal imaging system. Further studies with patients who have diabetes and are at risk of foot ulceration are needed to test the significance of our developed algorithm