Non-invasive imaging techniques to assess diabetic foot ulcers: A state of the art review

This paper proposes a new photonic-based non-invasive device for managing of Diabetic Foot Ulcers (DFUs) for people suffering from diabetes. DFUs are one of the main severe complications of diabetes, which may lead to major disabilities, such as foot amputation, or even to the death. The proposed device exploits hyperspectral (HSI) and thermal imaging to measure the status of an ulcer, in contrast to the current practice where invasive biopsies are often applied. In particular, these two photonic-based imaging techniques can estimate the biomarkers of oxyhaemoglobin (HbO2) and deoxyhaemoglobin (Hb), through which the Peripheral Oxygen Saturation (SpO2) and Tissue Oxygen Saturation (StO2) is computed. These factors are very important for the early prediction and prognosis of a DFU. The device is implemented at two editions: the in-home edition suitable for patients and the PRO (professional) edition for the medical staff. The latter is equipped with active photonic tools, such as tuneable diodes, to permit detailed diagnosis and treatment of an ulcer and its progress. The device is enriched with embedding signal processing tools for noise removal and enhancing pixel accuracy using super resolution schemes. In addition, a machine learning framework is adopted, through deep learning structures, to assist the doctors and the patients in understanding the effect of the biomarkers on DFU. The device is to be validated at large scales at three European hospitals (Charité–University Hospital in Berlin, Germany; Attikon in Athens, Greece, and Victor Babes in Timisoara, Romania) for its efficiency and performance.

Download Full-text

Non-Invasive Microwave CSRR-Based Sensor for Diabetic Foot Ulcers Detection

2021 18th International Multi-Conference on Systems, Signals & Devices (SSD) ◽

10.1109/ssd52085.2021.9429469 ◽

2021 ◽

Author(s):

Mohammed M. Bait-Suwailam ◽

Issam Bahadur

Keyword(s):

Diabetic Foot ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Non Invasive

Download Full-text

The Association between Foot and Ulcer Microcirculation Measured with Laser Speckle Contrast Imaging and Healing of Diabetic Foot Ulcers

Journal of Clinical Medicine ◽

10.3390/jcm10173844 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3844

Author(s):

Onno A. Mennes ◽

Jaap J. van Netten ◽

Jeff G. van Baal ◽

Riemer H. J. A. Slart ◽

Wiendelt Steenbergen

Keyword(s):

Blood Pressure ◽

Diabetic Foot ◽

Blood Pressure Measurement ◽

Foot Ulcer ◽

Laser Speckle ◽

Foot Ulcers ◽

Pressure Measurements ◽

Diabetic Foot Ulcers ◽

Invasive Blood Pressure ◽

Non Invasive

Diagnosis of peripheral artery disease in people with diabetes and a foot ulcer using current non-invasive blood pressure measurements is challenging. Laser speckle contrast imaging (LSCI) is a promising non-invasive technique to measure cutaneous microcirculation. This study investigated the association between microcirculation (measured with both LSCI and non-invasive blood pressure measurement) and healing of diabetic foot ulcers 12 and 26 weeks after measurement. We included sixty-one patients with a diabetic foot ulcer in this prospective, single-center, observational cohort-study. LSCI scans of the foot, ulcer, and ulcer edge were conducted, during baseline and post-occlusion hyperemia. Non-invasive blood pressure measurement included arm, foot, and toe pressures and associated indices. Healing was defined as complete re-epithelialization and scored at 12 and 26 weeks. We found no significant difference between patients with healed or non-healed foot ulcers for both types of measurements (p = 0.135–0.989). ROC curves demonstrated moderate sensitivity (range of 0.636–0.971) and specificity (range of 0.464–0.889), for LSCI and non-invasive blood pressure measurements. Therefore, no association between diabetic foot ulcer healing and LSCI-measured microcirculation or non-invasive blood pressure measurements was found. The healing tendency of diabetic foot ulcers is difficult to predict based on single measurements using current blood pressure measurements or LSCI.

Download Full-text

Development of a novel non-invasive shockwave-based therapy to cure chronic diabetic foot ulcers

Proceedings of the 32nd International Symposium on Shock Waves (ISSW32 2019) ◽

10.3850/978-981-11-2730-4_0414-cd ◽

2019 ◽

Author(s):

Akshay Datey ◽

Dipshikha Chakravortty ◽

Jagadeesh Gopalan

Keyword(s):

Diabetic Foot ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Non Invasive

Download Full-text

Electromagnetic simulation of non-invasive approach for the diagnosis of diabetic foot ulcers

Journal of Orthopaedics ◽

10.1016/j.jor.2018.03.024 ◽

2018 ◽

Vol 15 (2) ◽

pp. 514-521 ◽

Cited By ~ 2

Author(s):

Roshen Borkar ◽

James Rizkalla ◽

Youngmin Kwon ◽

Paul Salama ◽

Maher Rizkalla

Keyword(s):

Diabetic Foot ◽

Foot Ulcers ◽

Electromagnetic Simulation ◽

Diabetic Foot Ulcers ◽

Invasive Approach ◽

Non Invasive

Download Full-text

Novel Optical Techniques for Imaging Microcirculation in the Diabetic Foot

Current Pharmaceutical Design ◽

10.2174/1381612824666180302141902 ◽

2018 ◽

Vol 24 (12) ◽

pp. 1304-1316 ◽

Cited By ~ 13

Author(s):

Onno A. Mennes ◽

Jaap J. van Netten ◽

Riemer H.J.A. Slart ◽

Wiendelt Steenbergen

Keyword(s):

Diabetic Foot ◽

Clinical Relevance ◽

Imaging Techniques ◽

Laser Speckle ◽

Foot Ulcers ◽

Future Research ◽

Diabetic Foot Ulcers ◽

Contrast Imaging ◽

Optical Techniques ◽

Advantages And Disadvantages

Background: The most severe diabetic foot ulcers are those related with critical ischemia, which is primarily diagnosed with non-invasive diagnostics. However, these diagnostics have several disadvantages. For example, they only provide global indications of the (macro)level of ischemia. A potential solution can be found in novel optical imaging techniques for local assessment of the microcirculation in diabetic foot ulcers. This review provides an overview of these imaging techniques (Laser Doppler Perfusion Imaging, Laser Speckle Contrast Imaging, Photoacoustic Imaging and Hyperspectral Imaging) and their applicability for the diagnostic assessment of microcirculation in diabetic foot ulcers. <p> Method: For each technique, the following parts are described: a) their technical background; b) general clinical applications; and, c) its application for microcirculation assessment in diabetic foot ulcers. Parts a-b are based on a narrative review of the literature, part c on a systematic review that was performed in the database Scopus, covering the period from January 1, 2000 to November 31, 2017. <p> Results: Each of these techniques has specific advantages and disadvantages for imaging microcirculation. Potential clinical use depends on measurement aims, and clinical relevance. However, none of the techniques has a strongly established clinical relevance yet: we found a limited number of publications describing clinical outcomes. Future research is needed to determine which technique is the most clinically relevant for the assessment of microcirculation in diabetic foot ulcers. Conclusion: Although promising, the currently available novel optical techniques need to be further improved technically and prospective trials are necessary to evaluate their clinical value.

Download Full-text