Analysis of segmentation techniques on ulcer images Abstract

Ulcered lesions on the legs and feet caused by venous insufficiency and other conditions require long-term clinical treatment and follow-up. To facilitate the analysis of the tissue composition of a lesion, we propose color imaging and image processing methods. In this paper we propose edge detection and active contour methods. The edge of image is one of the most basic characteristic of image. Edge detection techniques play a major role in the image analysis, image segmentation and image identification. There exists no universal edge detection method which works well under all conditions. This project introduces analysis of some classical edge detection and active contour methods on ulcer images.

Submitted by V. Ravi Kumar Roll No: 201350851 PGSSP

Introduction
Ulcers are chronic wounds that fail to heal within a specified period of time causing severe pain and discomfort to the patients. The chronic wounds environment is rich in inflammatory products that result from excessive enzymatic and reduction in extracellular matrix production. Ulcers are normally trapped in this inflammatory state which causes impairment to the normal course of healing. According to the underlying etiologies that cause them, ulcers are generally divided into three categories: Vascular Pressure Diabetic ulcers Venous ulcers: Venous ulcers usually occur in the legs, account for the majority of chronic wounds, and mostly affect the elderly. They are caused by improper function of tiny valves in the veins that normally prevent blood from flowing backward. The dysfunction of these valves impedes the normal circulation of blood in the legs, causing tissue damage and impaired wound healing.

Diabetic ulcers: Diabetic patients are particularly susceptible to developing ulcers. People with advanced diabetes have a diminished perception of pain in the extremities due to nerve damage, and therefore may not initially notice small scratches or bruises on their legs and feet. Diabetes also impairs the immune system and damages capillaries. Repeated injury, compounded by impaired healing, can cause even the smallest cut or bruise to become dangerously infected. Pressure ulcers: Pressure ulcers comprise the third main type of chronic wounds. These typically occur in people who are bedridden or whose mobility is severely limited. Pressure ulcers are caused by a loss of blood circulation that occurs when pressure on the tissue is greater than the pressure in capillaries, thereby cutting off circulation. Parts of the body that are particularly susceptible to

pressure ulcers include the heels, shoulder blades, and sacrum (the triangular bone at the base of the spine forming the posterior of the pelvis). Ulcers are most commonly found on the lower extremity below the knee and account for up to 98% of all lower extremity wounds. Ulcers at the lower limb affect around 1% of adult population and 3.6% of people older than 65 years. Non-healing ulcers cause severe pain and discomfort to the patients and put them in the risk of limb amputation. Many characteristics such as skin, tissues, temperature, and smell, can be observed in order to diagnose the pathological state of the wound. Three kinds of tissues are monitored: a) Granulation tissue, which has a reddish hue, shows the growing of new tissue. b) Slough, with a yellowish color, is the result of infection. c) Necrosed tissue, with a dark color, represents the area of dead tissue. Among these tissues, the most common are the granulation and the slough ones. An important characteristic is that the slough tissue generally superposes the granulation tissue forming a layer. The density and thickness of this layer varies along the wound area.

Figure 1: Leg Ulcers Figure 1 shows two chronic leg ulcers. The ulcer color changes from black to yellow to red gradually as it heals. Depending on its initial severity, the ulcer might appear mostly covered with black necrotic tissue or overlaying layers of black necrotic tissue and yellow slough.

The first indication of ulcer healing is the growth of the new red granulation tissue from the base of the ulcer which gradually fills its cavity. Pink epithelial tissue then starts growing from the edges of the ulcer moving gradually across the granulation tissue and eventually covering the ulcer. The appearance of the ulcer is very crucial in assessing its healing status. In this project we propose some classical edge detection methods such as Canny, Sobel, Prewitt, LOG, Robert, Entropic threshold and Wavelet Based Edge Detection and also introduce few active contours algorithms such as Localized Region Based Active Contours, Chan-Vese active contour method.