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Prediction of Plantar Shear Stress Distribution by Conditional GAN with Attention Mechanism

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Book cover Medical Image Computing and Computer Assisted Intervention – MICCAI 2020 (MICCAI 2020)

Part of the book series: Lecture Notes in Computer Science ((LNIP,volume 12262))

Abstract

Diabetic foot ulcers (DFUs) are known to have multifactorial etiology. Among the biomechanical factors that lead to plantar ulcers, shear stresses have been either neglected or unmeasured due to challenges in complexity and equipment availability. The purpose of this study is to develop a software that predicts plantar shear stress using plantar pressure and temperature distributions. Thirty-one subjects, 8 of them at risk of developing DFUs were recruited, and plantar thermography, pressure and shear stress distributions were collected. We introduce the conditional generative adversarial networks (cGAN) for shear stress distribution prediction and propose an attention mechanism to improve the model’s accuracy. The networks can learn the mapping from pressure to shear stress distribution. The attention mechanism can merge temperature distribution into GAN without resizing or aligning it manually. We then test on our dataset with 185 groups. The predicted anteroposterior shear stress distributions give \(72.97\%\) accuracy on peak location prediction and 14.12 kPa on global root mean square error. Our initial results are promising in terms of feasibility of our approach in predicting plantar shear stresses and this approach may benefit to address the DFU risks before ulceration.

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References

  1. Armstrong, D.G., Peters, E.J., Athanasiou, K.A., Lavery, L.A.: Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration? J. Foot Ankle Surg. 37(4), 303–307 (1998)

    Article  Google Scholar 

  2. Bloomgarden, Z.T.: The diabetic foot. Diabetes Care 31(2), 372–376 (2008)

    Article  Google Scholar 

  3. Boulton, A.J.: Diabetic foot-what can we learn from leprosy? Legacy of Dr Paul W. Brand. Diabetes Metab. Res. Rev. 28(Suppl 1), 3–7 (2012)

    Article  Google Scholar 

  4. Boulton, A.J.M.: The Diabetic Foot. MDText.com, Inc., South Dartmouth, MA (2000). Last Update: 26 October 2016

    Google Scholar 

  5. Breen, C., Khan, L., Ponnusamy, A.: Image classification using neural networks and ontologies. In: Proceedings of the 13th International Workshop on Database and Expert Systems Applications, pp. 98–102. IEEE (2002)

    Google Scholar 

  6. Delbridge, L., Ctercteko, G., Fowler, C., Reeve, T.S., Le Quesne, L.P.: The aetiology of diabetic neuropathic ulceration of the foot. Br. J. Surg. 72(1), 1–6 (1985)

    Article  Google Scholar 

  7. Dinsdale, S.M.: Decubitus ulcers: role of pressure and friction in causation. Arch. Phys. Med. Rehabil. 55(4), 147–152 (1974)

    Google Scholar 

  8. Goodfellow, I., et al.: Generative adversarial nets. In: Advances in Neural Information Processing Systems, pp. 2672–2680 (2014)

    Google Scholar 

  9. He, K., Zhang, X., Ren, S., Sun, J.: Deep residual learning for image recognition. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 770–778 (2016)

    Google Scholar 

  10. Isola, P., Zhu, J.Y., Zhou, T., Efros, A.A.: Image-to-image translation with conditional adversarial networks. In: IEEE Conference on Computer Vision and Pattern Recognition (2017)

    Google Scholar 

  11. Lavery, L.A., Armstrong, D.G., Wunderlich, R.P., Tredwell, J., Boulton, A.J.: Predictive value of foot pressure assessment as part of a population-based diabetes disease management program. Diabetes Care 26(4), 1069–1073 (2003)

    Article  Google Scholar 

  12. Ledoux, W.R., Shofer, J.B., Cowley, M.S., Ahroni, J.H., Cohen, V., Boyko, E.J.: Diabetic foot ulcer incidence in relation to plantar pressure magnitude and measurement location. J. Diabetes Complicat. 27(6), 621–626 (2013)

    Article  Google Scholar 

  13. McPoil, T.G., Cornwall, M.W., Dupuis, L., Cornwell, M.: Variability of plantar pressure data. A comparison of the two-step and midgait methods. J. Am. Podiatr. Med. Assoc. 89(10), 495–501 (1999)

    Article  Google Scholar 

  14. Mejjati, Y.A., Richardt, C., Tompkin, J., Cosker, D., Kim, K.I.: Unsupervised attention-guided image-to-image translation. In: Advances in Neural Information Processing Systems, pp. 3693–3703 (2018)

    Google Scholar 

  15. Mirza, M., Osindero, S.: Conditional generative adversarial nets. arXiv preprint arXiv:1411.1784 (2014)

  16. NPIAP (2016). http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/

  17. Pathak, D., Krahenbuhl, P., Donahue, J., Darrell, T., Efros, A.A.: Context encoders: feature learning by inpainting. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 2536–2544 (2016)

    Google Scholar 

  18. Rogers, L.C., Lavery, L.A., Armstrong, D.G.: The right to bear legs-an amendment to healthcare: how preventing amputations can save billions for the us health-care system. J. Am. Podiatr. Med. Assoc. 98(2), 166–168 (2008)

    Article  Google Scholar 

  19. Stucke, S., et al.: Spatial relationships between shearing stresses and pressure on the plantar skin surface during gait. J. Biomech. 45(3), 619–622 (2012)

    Article  Google Scholar 

  20. Vaswani, A., et al.: Attention is all you need. In: Advances in Neural Information Processing Systems, pp. 5998–6008 (2017)

    Google Scholar 

  21. Wang, X., Girshick, R., Gupta, A., He, K.: Non-local neural networks. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 7794–7803 (2018)

    Google Scholar 

  22. Yavuz, M.: American society of biomechanics clinical biomechanics award 2012: plantar shear stress distributions in diabetic patients with and without neuropathy. Clin. Biomech. (Bristol, Avon) 29(2), 223–229 (2014)

    Article  Google Scholar 

  23. Yavuz, M., et al.: Plantar shear stress in individuals with a history of diabetic foot ulcer: an emerging predictive marker for foot ulceration. Diabetes Care 40(2), e14–e15 (2017)

    Article  Google Scholar 

  24. Yavuz, M., Tajaddini, A., Botek, G., Davis, B.L.: Temporal characteristics of plantar shear distribution: relevance to diabetic patients. J. Biomech. 41(3), 556–559 (2008)

    Article  Google Scholar 

  25. Yavuz, M., Ocak, H., Hetherington, V.J., Davis, B.L.: Prediction of plantar shear stress distribution by artificial intelligence methods. J. Biomech. Eng. 131(9), 091007 (2009)

    Article  Google Scholar 

  26. Yen, I.L., Goluguri, J., Bastani, F., Khan, L., Linn, J.: A component-based approach for embedded software development. In: Proceedings Fifth IEEE International Symposium on Object-Oriented Real-Time Distributed Computing, ISIRC 2002, pp. 402–410. IEEE (2002)

    Google Scholar 

  27. Zhu, J.Y., Park, T., Isola, P., Efros, A.A.: Unpaired image-to-image translation using cycle-consistent adversarial networks. In: 2017 IEEE International Conference on Computer Vision (ICCV) (2017)

    Google Scholar 

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Acknowledgement

This material is based upon work supported by the National Institutes of Health: R15DK104257 & UL1TR001105; NSF awards DMS-1737978 & MRI-1828467 and FAIN award No 1906630; and an IBM faculty award (Research).

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Correspondence to Jinghui Guo .

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Guo, J., Ersen, A., Gao, Y., Lin, Y., Khan, L., Yavuz, M. (2020). Prediction of Plantar Shear Stress Distribution by Conditional GAN with Attention Mechanism. In: Martel, A.L., et al. Medical Image Computing and Computer Assisted Intervention – MICCAI 2020. MICCAI 2020. Lecture Notes in Computer Science(), vol 12262. Springer, Cham. https://doi.org/10.1007/978-3-030-59713-9_74

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  • DOI: https://doi.org/10.1007/978-3-030-59713-9_74

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-59713-9

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