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ACTNet: asymmetric convolutional transformer network for diabetic foot ulcers classification

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Abstract

Most existing image classification methods have achieved significant progress in the field of natural images. However, in the field of diabetic foot ulcer (DFU) where data is scarce and complex, the accurate classification of data is still a thorny problem. In this paper, we propose an Asymmetric Convolutional Transformer Network (ACTNet) for the multi-class (4-class) classification task of DFU. Specifically, in order to strengthen the expressive ability of the network, we design an asymmetric convolutional module in the front part of the network to model the relationship between local pixels, extract the underlying features of the image, and guide the network to focus on the central region in the image that contains more information. Furthermore, a novel pooling layer is added between the encoder and the classification head in the Transformer, which weights the data sequence generated by the encoder to better correlate the features between the input data. Finally, to fully exploit the performance of the model, we pretrained our model on ImageNet and fine-tune it on DFU images. The model is validated on the DFUC2021 test set, and the F1-score and AUC value are 0.593 and 0.824, respectively. The experiments show that our model has excellent performance even in the case of a small dataset.

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References

  1. Armstrong DG, Lavery LA, Harkless LB (1998) Validation of a diabetic wound classification system. the contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 21(5):855–859

    Article  CAS  Google Scholar 

  2. Ingelfinger JR, Armstrong DG, Boulton A et al (2017) Diabetic foot ulcers and their recurrence. N Engl J Med 376:2367–2375

    Article  Google Scholar 

  3. Ince P, Abbas ZG, Lutale JK, Basit A, Ali SM, Chohan F, Morbach S, Mollenberg J, Game FL, Jeffcoate WJ (2008) Use of the SINBAD classification system and score in comparing outcome of foot ulcer management on three continents. Diabetes Care 31(5):964–967

    Article  Google Scholar 

  4. Lavery LA, Armstrong DG, Harkless LB (1996) Classification of diabetic foot wounds. J Foot Ankle Surg 35(6):528–31

    Article  CAS  Google Scholar 

  5. Wagner FW (1987) The diabetic foot. Orthopedics 10(1):163–172

    Article  Google Scholar 

  6. Andrew J, Gunne R, Jan A (2005) The global burden of diabetic foot disease. Lancet 366(9498):1719–1724

    Article  Google Scholar 

  7. Schaper NC, Apelqvist J, Bakker K (2003) The international consensus and practical guidelines on the management and prevention of the diabetic foot. Curr Diabetes Rep 3(6):475–479

    Article  Google Scholar 

  8. Zimmet PZ, Magliano DJ, Herman WH et al (2014) Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol 2(1):56–64

    Article  Google Scholar 

  9. Das D, Mahanta LB (2021) A comparative assessment of different approaches of segmentation and classification methods on childhood medulloblastoma images. J Med Biol Eng 41:379–392. https://doi.org/10.1007/s40846-021-00612-4

    Article  Google Scholar 

  10. Muruganantham P, Balakrishnan SM (2022) Attention aware deep learning model for wireless capsule endoscopy lesion classification and localization. J Med Biol Eng 42:157–168. https://doi.org/10.1007/s40846-022-00686-8

    Article  Google Scholar 

  11. Vinicor F (1998) The public health burden of diabetes and the reality of limits. Diabetes Care 21(Suppl 3):C15–C18

    Article  Google Scholar 

  12. Alqudah AM, Qazan S, Masad IS (2021) Artificial intelligence framework for efficient detection and classification of pneumonia using chest radiography images. J Med Biol Eng 41:599–609. https://doi.org/10.1007/s40846-021-00631-1

    Article  Google Scholar 

  13. Goyal M, Reeves ND, Davison AK et al (2020) Dfunet: convolutional neural networks for diabetic foot ulcer classification. IEEE Trans Emerg Top Comput Intell 4(5):728–739. https://doi.org/10.1109/TETCI.2018.2866254

    Article  Google Scholar 

  14. Alzubaidi L, Fadhel MA, Oleiwi SR et al (2020) Dfu_qutnet: diabetic foot ulcer classification using novel deep convolutional neural network. Multimed Tools Appl 79(21):15655–15677. https://doi.org/10.1007/s11042-019-07820-w

    Article  Google Scholar 

  15. Güley O, Pati S, Bakas S (2022) Classification of infection and ischemia in diabetic foot ulcers using vgg architectures. In: Yap MH, Cassidy B, Kendrick C (eds) Diabetic foot ulcers grand challenge, vol 13183. Springer, pp 76–89. https://doi.org/10.1007/978-3-030-94907-5_6

  16. Simonyan K, Zisserman A (2015) Very deep convolutional networks for large-scale image recognition. In: International Conference on Learning Representations

  17. Ag A, Re B, Afha A et al (2021) Diabetic foot ulcer classification using mapped binary patterns and convolutional neural networks. Comput Biol Med 140(105):055. https://doi.org/10.1016/j.compbiomed.2021.105055

    Article  Google Scholar 

  18. Qayyum A, Benzinou A, Mazher M, et al (2022) Efficient multi-model vision transformer based on feature fusion for classification of dfuc2021 challenge. In: Yap MH, Cassidy B, Kendrick C (eds) Diabetic foot ulcers grand challenge, vol 13183. Springer, Cham, pp 62–75. https://doi.org/10.1007/978-3-030-94907-5_5

  19. Dosovitskiy A, Beyer L, Kolesnikov A, et al (2021) An image is worth 16x16 words: transformers for image recognition at scale. In: International Conference on Learning Representations

  20. Jia D, Wei D, Socher R, et al (2009) Imagenet: A large-scale hierarchical image database. In: 2009 IEEE Conference on Computer Vision and Pattern Recognition, pp 248–255. https://doi.org/10.1109/CVPR.2009.5206848

  21. Jaderberg M, Vedaldi A, Zisserman A (2014) Speeding up convolutional neural networks with low rank expansions. In: British Machine Vision Conference

  22. Goyal M, Reeves ND, Rajbhandari S et al (2019) Robust methods for real-time diabetic foot ulcer detection and localization on mobile devices. IEEE J Biomed Health Inform 23(4):1730–1741. https://doi.org/10.1109/JBHI.2018.2868656

    Article  Google Scholar 

  23. Goyal M, Reeves ND, Rajbhandari S et al (2020) Recognition of ischaemia and infection in diabetic foot ulcers: dataset and techniques. Comput Biol Med 117(103):616. https://doi.org/10.1016/j.compbiomed.2020.103616

    Article  Google Scholar 

  24. Hassani A, Walton S, Shah N et al (2021) Escaping the big data paradigm with compact transformers. In: CVPR LLID Workshop 2021. https://arxiv.org/pdf/2104.05704.pdf

  25. Yap MH, Cassidy B, Pappachan JM, et al (2021) Analysis towards classification of infection and ischaemia of diabetic foot ulcers. In: 2021 IEEE EMBS International Conference on Biomedical and Health Informatics (BHI), pp 1–4. https://doi.org/10.1109/BHI50953.2021.9508563

  26. Cassidy B, Reeves ND, Pappachan JM et al (2021) The dfuc 2020 dataset: analysis towards diabetic foot ulcer detection. Eur Endocrinol 1(1):5

    Article  Google Scholar 

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Funding

This work was supported in part by National Natural Science Foundations of China under Grants 62271297, 61672021 and 61872227, and in part by the Major Project of the Science and Technology Ministry in China under Grant 2020YFB0204500.

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Authors

Contributions

LA: supervision, funding acquisition, conceptualization, methodology, participation in writing. MY: software, writing-original draft, visualization, investigation. ZX: formal analysis.

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Correspondence to Lingmei Ai.

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The authors have no relevant financial or non-financial interests to disclose.

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Ai, L., Yang, M. & Xie, Z. ACTNet: asymmetric convolutional transformer network for diabetic foot ulcers classification. Phys Eng Sci Med 45, 1175–1181 (2022). https://doi.org/10.1007/s13246-022-01185-5

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