A Deep Learning Method for Early Detection of Diabetic Foot Using Decision Fusion and Thermal Images

Diabetes mellitus (DM) is one of the major diseases that cause death worldwide and lead to complications of diabetic foot ulcers (DFU). Improper and late handling of a diabetic foot patient can result in an amputation of the patient's foot. Early detection of DFU symptoms can be observed using thermal imaging with a computer-assisted classifier. Previous study of DFU detection using thermal image only achieved 97% of accuracy, and it has to be improved. This article proposes a novel framework for DFU classification based on thermal imaging using deep neural networks and decision fusion. Here, decision fusion combines the classification result from a parallel classifier. We used the convolutional neural network (CNN) model of ShuffleNet and MobileNetV2 as the baseline classifier. In developing the classifier model, firstly, the MobileNetV2 and ShuffleNet were trained using plantar thermogram datasets. Then, the classification results of those two models were fused using a novel decision fusion method to increase the accuracy rate. The proposed framework achieved 100% accuracy in classifying the DFU thermal images in binary classes of positive and negative cases. The accuracy of the proposed Decision Fusion (DF) was increased by about 3.4% from baseline ShuffleNet and MobileNetV2. Overall, the proposed framework outperformed in classifying the images compared with the state-of-the-art deep learning and the traditional machine-learning-based classifier.