Quantitative interpretation of infrared images of lower limbs in individuals with and without type 2 diabetes mellitus.

IF 2 4区 医学 Q3 DERMATOLOGY
Edgar I Fuentes-Oliver, Rosalinda Ortiz-Sosa, Raúl Serrano-Loyola, Rebeca Solalinde-Vargas, Crescencio García-Segundo
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引用次数: 0

Abstract

Background: The quantitative interpretation of the radiometric information extracted from infrared (IR) images in individuals with and without type 2 diabetes mellitus (DM2) is an open problem yet to be solved. This is of particular value given that DM2 is a worldwide health problem and onset for evolution toward diabetic foot disease (DFD). Since DM2 causes changes at the vascular and neurological levels, the metabolic heat distribution on the outer skin is modified as a consequence of such alterations. Of particular interest in this contribution are those alterations displayed over the skin's heat patterns at the lower limbs. At the core of such alterations is the deterioration of the vascular and neurological networks responsible for procuring systemic thermoregulation. It is within this context that IR imaging is introduced as a likely aiding tool to assist with the clinical diagnosis of DM2 at stages early enough to prevent the evolution of the DFD.

Methods: IR images of lower limbs are acquired from a cohort of individuals clinically diagnosed with and without DM2. Additional inclusion criteria for patients are to be free from any visible wound or tissue-related trauma (e.g., injuries, edema, and so forth), and also free from non-metabolic comorbidities. All images and data are equally processed and analyzed using indices that evaluate the spatial and temporal evolution of temperature distribution in lower limbs. We studied the temporal response of individuals' legs after inducing an external stimulus. For this purpose, we combine the information of the asymmetry and thermal response index (ATR) and the thermal response index (TRI), computed using images at different times, improving the results previously obtained individually with ATR and TRI.

Results: A novel representation of the information extracted from IR images of the lower limbs in individuals with and without DM2 is presented. This representation was built using the ATR and TRI indices for the anterior and posterior views (PVs), individually and combining the information from both views. In all cases, the information of each index and each view presents linearity properties that allow said information to be interpreted quantitatively in a well-defined and limited space. This representation, built in a polar coordinate space, allows obtaining sensitivity values of 86%, 97%, and 97%, and specificity values of 83%, 72%, and 78% for the anterior view (AV), the PV, and the combined views, respectively. Additionally, it was observed that the angular variable that defines this new representation space allows to significantly (p < 0.01) differentiate the groups, while correlating with clinical variables of interest, such as glucose and glycated hemoglobin.

Conclusion: The linearity properties that exist between the ATR and TRI indices allow a quantitative interpretation of the information extracted from IR images of the lower extremities of individuals with and without DM2, and allow the construction of a representation space that eliminates possible ambiguities in the interpretation, while simplifying it, making it accessible for clinical use.

对 2 型糖尿病患者和非 2 型糖尿病患者下肢红外图像的定量解读。
背景:如何定量解读从 2 型糖尿病(DM2)患者和非 2 型糖尿病患者的红外图像中提取的辐射信息,是一个有待解决的难题。鉴于 DM2 是一个世界性的健康问题,也是向糖尿病足病(DFD)演变的起始因素,因此这一问题尤为重要。由于 DM2 会导致血管和神经系统发生变化,因此外层皮肤的代谢热分布也会随之改变。本文特别关注的是下肢皮肤热模式的变化。这种变化的核心是负责提供全身体温调节的血管和神经网络的恶化。正是在这种背景下,红外成像被作为一种可能的辅助工具引入临床,以帮助在早期阶段诊断 DM2,从而防止 DFD 的演变:方法:从临床诊断为 DM2 和非 DM2 的人群中采集下肢红外图像。患者的其他纳入标准是没有任何明显的伤口或组织相关创伤(如外伤、水肿等),也没有非代谢性合并症。所有图像和数据都经过同样的处理,并使用评估下肢温度分布空间和时间演变的指数进行分析。我们研究了个体腿部在受到外部刺激后的时间反应。为此,我们将利用不同时间的图像计算出的不对称和热反应指数(ATR)和热反应指数(TRI)的信息结合起来,改进了之前单独使用 ATR 和 TRI 得出的结果:结果:本文介绍了从 DM2 患者和非 DM2 患者下肢红外图像中提取的信息的新表征。该表征是使用前视图和后视图(PVs)的 ATR 和 TRI 指数单独建立的,并结合了两个视图的信息。在所有情况下,每个指数和每个视图的信息都具有线性特性,可以在一个定义明确的有限空间内对上述信息进行定量解释。在极坐标空间中建立的这种表示方法,可使前视图(AV)、后视图和组合视图的灵敏度分别达到 86%、97% 和 97%,特异度分别达到 83%、72% 和 78%。此外,还观察到定义这一新表征空间的角度变量可以显著地(p 结论:"角度变量是一个新的表征空间":ATR 和 TRI 指数之间存在的线性特性允许对从 DM2 患者和非 DM2 患者下肢红外图像中提取的信息进行定量解释,并允许构建一个表示空间,以消除解释中可能存在的歧义,同时简化解释,使其便于临床使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Skin Research and Technology
Skin Research and Technology 医学-皮肤病学
CiteScore
3.30
自引率
9.10%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Skin Research and Technology is a clinically-oriented journal on biophysical methods and imaging techniques and how they are used in dermatology, cosmetology and plastic surgery for noninvasive quantification of skin structure and functions. Papers are invited on the development and validation of methods and their application in the characterization of diseased, abnormal and normal skin. Topics include blood flow, colorimetry, thermography, evaporimetry, epidermal humidity, desquamation, profilometry, skin mechanics, epiluminiscence microscopy, high-frequency ultrasonography, confocal microscopy, digital imaging, image analysis and computerized evaluation and magnetic resonance. Noninvasive biochemical methods (such as lipids, keratin and tissue water) and the instrumental evaluation of cytological and histological samples are also covered. The journal has a wide scope and aims to link scientists, clinical researchers and technicians through original articles, communications, editorials and commentaries, letters, reviews, announcements and news. Contributions should be clear, experimentally sound and novel.
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