# Automated detection of inflammation in foot thermographic images of patients with diabetes acquired in an uncontrolled clinical environment
> Wartakusumah R.

URL kanonis: https://discover.unhas.ac.id/publications/pub_scopus_105053710376
Jurnal / Konferensi: Diabetes Research and Clinical Practice
Tahun terbit: 2026
DOI: https://doi.org/10.1016/j.diabres.2026.113607
ISSN: 01688227
Kuartil SJR: Q1
Citations: 0

## Authors
- Wartakusumah R.

## Abstract
AIMS: Quantitative methods for detecting diabetic foot inflammation remain limited, though localized skin-temperature elevation is a promising early indicator. Because background variability can hinder AI-based foot identification, we evaluated AI-driven thermal imaging for diabetic foot inflammation under uncontrolled clinical backgrounds and assessed whether curtain-based background control and grayscale conversion improved detection. METHODS: Cross-sectional study design was conducted in Makassar, Indonesia, 100 plantar thermal images from 50 diabetic patients were acquired with and without a curtain, preprocessed (sensitivity, 1.5; emissivity, 0.98), and converted to grayscale. Expert-identified inflammatory hotspots were annotated and used to train a YOLO11n model with 5-fold cross-validation, evaluated using accuracy, precision, sensitivity, specificity, ROC-AUC, IoU, and case-error analysis. RESULTS: With a curtain, color-map images achieved sensitivity of 0.773, versus 0.455 without one. Grayscale images performed consistently across conditions, with best results in the mixed dataset (accuracy, 0.980; precision, 0.976; sensitivity, 0.932; specificity, 0.994; AUC 0.966 vs. 0.886 for color-map). Correctly detected cases showed IoU > 0.9. Low thermal contrast and small region of interest were the most frequent failure categories. CONCLUSIONS: AI-driven thermal imaging detects diabetic foot inflammation under uncontrolled conditions. A curtain improved color-map detection, but grayscale imaging provided robust, curtain-independent performance, supporting its use for clinical screening.

## Keywords
- Medicine
- Grayscale
- Diabetes mellitus
- Inflammation
- Diabetic foot
- Foot (prosody)
- Radiology
- Internal medicine
- Imaging technique
- Surgery
- Medical imaging
- Thermography
- Diabetic foot ulcer
- Pathology

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Sumber: Discover Unhas — RIMS Universitas Hasanuddin.
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