Venn Diagram Multi-label Class Interpretation of Diabetic Foot Ulcer with Color and Sharpness Enhancement

DFU is a severe complication of diabetes that can lead to amputation of the lower limb if not treated properly. Inspired by the 2021 Diabetic Foot Ulcer Grand Challenge, researchers designed automated multi-class classification of DFU, including infection, ischaemia, both of these conditions, and none of these conditions. However, it remains a challenge as classification accuracy is still not satisfactory. This paper proposes a Venn Diagram interpretation of multi-label CNN-based method, utilizing different image enhancement strategies, to improve the multi-class DFU classification. We propose to reduce the four classes into two since both class wounds can be interpreted as the simultaneous occurrence of infection and ischaemia and none class wounds as the absence of infection and ischaemia. We introduce a novel Venn Diagram representation block in the classifier to interpret all four classes from these two classes. To make our model more resilient, we propose enhancing the perceptual quality of DFU images, particularly blurry or inconsistently lit DFU images, by performing color and sharpness enhancements on them. We also employ a fine-tuned optimization technique, adaptive sharpness aware minimization, to improve the CNN model generalization performance. The proposed method is evaluated on the test dataset of DFUC2021, containing 5,734 images and the results are compared with the top-3 winning entries of DFUC2021. Our proposed approach outperforms these existing approaches and achieves Macro-Average F1, Recall and Precision scores of 0.6592, 0.6593, and 0.6652, respectively.Additionally, We perform ablation studies and image quality measurements to further interpret our proposed method. This proposed method will benefit patients with DFUs since it tackles the inconsistencies in captured images and can be employed for a more robust remote DFU wound classification.