Guided Conditional Diffusion Classifier (ConDiff) for Enhanced Prediction of Infection in Diabetic Foot Ulcers

To detect infected wounds in Diabetic Foot Ulcers (DFUs) from photographs, preventing severe complications and amputations. Methods: This paper proposes the Guided Conditional Diffusion Classifier (ConDiff), a novel deep-learning infection detection model that combines guided image synthesis with a denoising diffusion model and distance-based classification. The process involves (1) generating guided conditional synthetic images by injecting Gaussian noise to a guide image, followed by denoising the noise-perturbed image through a reverse diffusion process, conditioned on infection status and (2) classifying infections based on the minimum Euclidean distance between synthesized images and the original guide image in embedding space. Results: ConDiff demonstrated superior performance with an accuracy of 83% and an F1-score of 0.858, outperforming state-of-the-art models by at least 3%. The use of a triplet loss function reduces overfitting in the distance-based classifier. Conclusions: ConDiff not only enhances diagnostic accuracy for DFU infections but also pioneers the use of generative discriminative models for detailed medical image analysis, offering a promising approach for improving patient outcomes.