Diagnosing diabetic foot with THz imaging: A progress report. G. G. Hernandez-Cardoso1, L. F. Amador-Medina2, I. Salas-Gutierrez3, B. Murillo-Ortiz2, E. Castro-Camus1* 1
Centro de Investigaciones en Óptica, A.C. Loma del Bosque 115, León, Guanajuato 37150, Mexico. Email: enrique@cio.mx 2 Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) No. 1 Bajío, Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, México 3 Hospital Angeles Leon, Av. Cerro Gordo 311, Lomas del Campestre, 37150 Leon, Guanajuato, Mexico Control
Diabetic
Abstract—During this presentation I will give an overview of recent progress in the use of THz for the diagnostics of the diabetic foot syndrome. There have been improvements from the instrumental aspects of the device and much broader control and diabetic populations have been imaged in comparison to our report from 2017, giving rise to a whole new set of conclusions both for the diabetics and non-diabetics.
In 2017 the terahertz time-domain imaging technique was reported as a potential tool in the diagnosis of the diabetic foot syndrome.[1,2] In that study, preliminary evidence of the correlation between the presence of diabetes and a decrease in the patient’s feet hydration which at its time was easy to detect and quantify by terahertz reflection imaging was presented. Yet, that initial study presented a few deficiencies in terms of the reduced size of the diabetic and control populations, the application of appropriate reference tests to the control group and a potential bias in terms of unequal age distribution between the control and diabetic groups. Additional measurements were recently made with a much more characterized cohort of diabetics and a random group of controls recruited in a hospital’s wait room that include non-diabetic patients with other conditions, and family members of patients with a better overlap of age distribution.
Figure 1. (top left) Hydration image of a non-diabetic patient. (top right) Hydration image of a diabetic patient. (bottom left) Red-Yellow-Green color coded image for the same non-diabetic patient. (bottom right) RedYellow-Green color coded image for the same diabetic patient according to the criteria of [2].
The feet terahertz imaging system underwent significant improvements with respect to the one used in 2017, images of the two feet of each patient are now acquired in a period of 9 minutes with a spatial resolution of 1mm (see Fig. 1). We will discuss the new findings of this new measurement campaign and how this shine new light in understanding the potential of the THz technique as a diagnostic tool for diabetic foot syndrome, and perhaps other conditions that reflect on the skin hydration, that could include vasculopathies and peripheral neuropathies.
ACKNOWLEDGMENT The authors acknowledge the financial support of CONACYT(Mexico) through grants 252939, 255114, 280392,294440. REFERENCES [1] G.G. Hernandez-Cardoso et al. “Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept.” Sci. Rep.7, 42124 (2017) [2] G. G. Hernandez-Cardoso et al. “Pixel statistical analysis of diabetic vs. non-diabetic foot-sole spectral terahertz reflection images.” J. Inf, Mill and THz Waves 39, 879–886 (2018).
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