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Software-Based Method for Automated Segmentation and Measurement of Wounds on Photographs Using Mask R-CNN: a Validation Study


In clinical routine, wound documentation is one of the most important contributing factors to treating patients with acute or chronic wounds. The wound documentation process is currently very time-consuming, often examiner-dependent, and therefore imprecise. This study aimed to validate a software-based method for automated segmentation and measurement of wounds on photographic images using the Mask R-CNN (Region-based Convolutional Neural Network). During the validation, five medical experts manually segmented an independent dataset with 35 wound photographs at two different points in time with an interval of 1 month. Simultaneously, the dataset was automatically segmented using the Mask R-CNN. Afterwards, the segmentation results were compared, and intra- and inter-rater analyses performed. In the statistical evaluation, an analysis of variance (ANOVA) was carried out and dice coefficients were calculated. The ANOVA showed no statistically significant differences throughout all raters and the network in the first segmentation round (F = 1.424 and p > 0.228) and the second segmentation round (F = 0.9969 and p > 0.411). The repeated measure analysis demonstrated no statistically significant differences in the segmentation quality of the medical experts over time (F = 6.05 and p > 0.09). However, a certain intra-rater variability was apparent, whereas the Mask R-CNN consistently provided identical segmentations regardless of the point in time. Using the software-based method for segmentation and measurement of wounds on photographs can accelerate the documentation process and improve the consistency of measured values while maintaining quality and precision.

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Corresponding author

Correspondence to Sven Yves Vetter.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

As only existing anonymized image data was used, no informed consent was required for the present study.

Conflict of Interest

The authors declare the following potential conflicts of interest concerning the research, authorship, and publication of this article: The BG Trauma Center Ludwigshafen and mbits imaging GmbH (Heidelberg, Germany) cooperate in the field of medical digitalization. This cooperation influenced neither the outcome of the study nor the manuscript. Michael Müller and Hannah Syrek are employees of mbits imaging GmbH. They provided us with the software prototypes for wound segmentation and supported us in the use of these.

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Privalov, M., Beisemann, N., Barbari, J.E. et al. Software-Based Method for Automated Segmentation and Measurement of Wounds on Photographs Using Mask R-CNN: a Validation Study. J Digit Imaging 34, 788–797 (2021).

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  • Medical image processing
  • Convolutional neural networks
  • Wound segmentation
  • Wound measurement