# Wound Tissue Segmentation in Diabetic Foot Ulcer Images Using Deep Learning: A Pilot Study

arXiv: https://arxiv.org/abs/2406.16012 · HTML: https://mlsanity.com/paper/2406.16012/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 25 of its 50 references that are in the map.
- First posted on arXiv 23 Jun 2024.

## Builds on (most cited first, 25 of 25)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Training Generative Adversarial Networks with Limited Data](https://mlsanity.com/paper/2006.06676/) (2020)
- [Semi-Supervised Semantic Segmentation with Cross-Consistency Training](https://mlsanity.com/paper/2003.09005/) (2020)
- [Adversarial Learning for Semi-Supervised Semantic Segmentation](https://mlsanity.com/paper/1802.07934/) (2018)
- [How Much Position Information Do Convolutional Neural Networks Encode?](https://mlsanity.com/paper/2001.08248/) (2020)
- [Semantic Segmentation with Generative Models: Semi-Supervised Learning and Strong Out-of-Domain Generalization](https://mlsanity.com/paper/2104.05833/) (2021)
- [A Simple Baseline for Semi-supervised Semantic Segmentation with Strong Data Augmentation](https://mlsanity.com/paper/2104.07256/) (2021)
- [Re-distributing Biased Pseudo Labels for Semi-supervised Semantic Segmentation: A Baseline Investigation](https://mlsanity.com/paper/2107.11279/) (2021)
- [Recalibrating Fully Convolutional Networks with Spatial and Channel 'Squeeze & Excitation' Blocks](https://mlsanity.com/paper/1808.08127/) (2018)
- [Fully Automatic Wound Segmentation with Deep Convolutional Neural Networks](https://mlsanity.com/paper/2010.05855/) (2020)
- [FUSeg: The Foot Ulcer Segmentation Challenge](https://mlsanity.com/paper/2201.00414/) (2022)
- [Translating Clinical Delineation of Diabetic Foot Ulcers into Machine Interpretable Segmentation](https://mlsanity.com/paper/2204.11618/) (2022)
- [A Survey on Semi-Supervised Semantic Segmentation](https://mlsanity.com/paper/2302.09899/) (2023)
- [FUSegNet: A Deep Convolutional Neural Network for Foot Ulcer Segmentation](https://mlsanity.com/paper/2305.02961/) (2023)
- [Detect-and-Segment: a Deep Learning Approach to Automate Wound Image Segmentation](https://mlsanity.com/paper/2111.01590/) (2021)
- [Automatic Foot Ulcer Segmentation Using an Ensemble of Convolutional Neural Networks](https://mlsanity.com/paper/2109.01408/) (2021)
- [Integrated Image and Location Analysis for Wound Classification: A Deep Learning Approach](https://mlsanity.com/paper/2308.11877/) (2023)

## Built on by (most cited first, 5 of 5)

- [TransUNet-GradCAM: A Hybrid Transformer-U-Net with Self-Attention and Explainable Visualizations for Foot Ulcer Segmentation](https://mlsanity.com/paper/2508.03758/) (2025)
- [Beyond Labels: Zero-Shot Diabetic Foot Ulcer Wound Segmentation with Self-attention Diffusion Models and the Potential for Text-Guided Customization](https://mlsanity.com/paper/2504.17628/) (2025)
- [Automated multi-class wound assessment using dedicated instance segmentation models for boundary detection and classification](https://mlsanity.com/paper/2603.27325/) (2026)
- [WoundFormer: Multi-Scale Spatial Feature Fusion for Multi-Class Wound Tissue Segmentation](https://mlsanity.com/paper/2605.19868/) (2026)
- [LUTSeg: A Longitudinal Multi-Expert Dataset for Ulcer Tissue Segmentation](https://mlsanity.com/paper/2608.25866/) (2026)

## Abstract (arXiv)

Identifying individual tissues, so-called tissue segmentation, in diabetic foot ulcer (DFU) images is a challenging task and little work has been published, largely due to the limited availability of a clinical image dataset. To address this gap, we have created a DFUTissue dataset for the research community to evaluate wound tissue segmentation algorithms. The dataset contains 110 images with tissues labeled by wound experts and 600 unlabeled images. Additionally, we conducted a pilot study on segmenting wound characteristics including fibrin, granulation, and callus using deep learning. Due to the limited amount of annotated data, our framework consists of both supervised learning (SL) and semi-supervised learning (SSL) phases. In the SL phase, we propose a hybrid model featuring a Mix Transformer (MiT-b3) in the encoder and a CNN in the decoder, enhanced by the integration of a parallel spatial and channel squeeze-and-excitation (P-scSE) module known for its efficacy in improving boundary accuracy. The SSL phase employs a pseudo-labeling-based approach, iteratively identifying and incorporating valuable unlabeled images to enhance overall segmentation performance. Comparative evaluations with state-of-the-art methods are conducted for both SL and SSL phases. The SL achieves a Dice Similarity Coefficient (DSC) of 84.89%, which has been improved to 87.64% in the SSL phase. Furthermore, the results are benchmarked against two widely used SSL approaches: Generative Adversarial Networks and Cross-Consistency Training. Additionally, our hybrid model outperforms the state-of-the-art methods with a 92.99% DSC in performing binary segmentation of DFU wound areas when tested on the Chronic Wound dataset. Codes and data are available at https://github.com/uwm-bigdata/DFUTissueSegNet.