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Explorative study of thermal footprint imaging as method to early detect diabetic foot ulcers in a domestic setting : the Bath Mat

Zoetelief, Eline (2023) Explorative study of thermal footprint imaging as method to early detect diabetic foot ulcers in a domestic setting : the Bath Mat.

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Abstract:Introduction: Due to a combination of Diabetes Mellitus (DM) related complications, 19- 34% of all DM patients develop a diabetic foot ulcer (DFU). The treatment of a DFU can take months, which could eventually result in a lower extremity amputation. Although 75% of all DFUs can be prevented with care, e.g. daily foot inspections, adherence is low in DM patients. In addition, monitoring is intensive and no low-threshold preventive tool is available to monitor high-risk patients. In recent years, several studies focused on measuring skin temperature on the plantar feet as low-threshold preventive tool, because increased local skin temperatures is believed to be an indication of inflammation. However, these studies primarily focused on the plantar foot side and used limited measuring locations, while only 50% of the DFUs occur at the plantar foot side. Therefore, the aim of this master’s thesis is to investigate a new thermographic (Bath Mat) method, which measures the temperature in the whole feet. Method: This thesis researched a new method for measuring foot temperature in an explorative pilot study. The temperature distribution of the dorsal side was captured directly, while the temperature distribution of the plantar side was captured indirectly from thermal footprints present on a mat after the feet were removed. To test this method in a clinical environment, a non-WMO patient study was conducted. The data collected from this study was used to investigate four main topics: (1) similarities in temperature distribution between direct plantar images and thermal footprints, (2) visibility of DFUs on thermal footprints, (3) quantify DFUs in thermographic features and (4) reproducibility of thermal footprints between days. Results: For this study 20 subjects without a DFU and 30 subjects with a DFU were included. In subjects without a DFU, similarities in temperature distribution were visible between direct plantar images and thermal footprints. In subjects with a DFU, a change in temperature distribution was shown at the DFU location. This change is visible in both direct and indirect images. Most of the subjects with a DFU had a hotspot on the ulcer location, others had a coldspot. The two features examined in this thesis to quantify DFUs were: (1) left-right differences in mean plantar/dorsal temperature and (2) left-right differences in contralateral spots. Furthermore, between different days, the temperature distribution is similar in thermal footprints, yet the measured mean temperature varies. The extent of temperature deviation differs between days and foot areas among healthy subjects. Discussion and Conclusion: In this thesis, a new, non-invasive, method to detect DFUs was developed and tested in a clinical environment. With the Bath Mat device, we were able to obtain thermal images of the whole foot showing differences between feet with and without a DFU. Among the investigated features, left-right differences in mean foot temperature do not appear to be sufficient to quantify DFUs for all patients. Conversely, temperature differences in contralateral spots potentially can determine if a DFU is present. Although this new method still needs additional research, the thermal images collected with the use of this device have the potential to identify features beyond left-right differences.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/96896
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