Application of multiple deep learning models for automatic burn wound assessment

• Published in: Burns Vol. 49; no. 5; pp. 1039 - 1051
• Main Authors: Chang, Che Wei, Ho, Chun Yee, Lai, Feipei, Christian, Mesakh, Huang, Shih Chen, Chang, Dun Hao, Chen, Yo Shen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.08.2023
• Subjects: Artificial Intelligence; Body Surface Area; Burn wound segmentation; Burns - diagnosis; Deep burn segmentation; Deep Learning; Fluid Therapy - methods; Humans; Machine learning; Rule of palm; TBSA burned; Deep learning; Rule of palm; Deep burn segmentation; Burn wound segmentation; TBSA burned; Machine learning
• ISSN: 0305-4179; 1879-1409; 1879-1409
• DOI: 10.1016/j.burns.2022.07.006

Accurate assessment of the percentage of total body surface area (%TBSA) burned is crucial in managing burn injuries. It is difficult to estimate the size of an irregular shape by inspection. Many articles reported the discrepancy of estimating %TBSA burned by different doctors. We set up a system with multiple deep learning (DL) models for %TBSA estimation, as well as the segmentation of possibly poor-perfused deep burn regions from the entire wound. We proposed boundary-based labeling for datasets of total burn wound and palm, whereas region-based labeling for the dataset of deep burn wound. Several powerful DL models (U-Net, PSPNet, DeeplabV3+, Mask R-CNN) with encoders ResNet101 had been trained and tested from the above datasets. With the subject distances, the %TBSA burned could be calculated by the segmentation of total burn wound area with respect to the palm size. The percentage of deep burn area could be obtained from the segmentation of deep burn area from the entire wound. A total of 4991 images of early burn wounds and 1050 images of palms were boundary-based labeled. 1565 out of 4994 images with deep burn were preprocessed with superpixel segmentation into small regions before labeling. DeeplabV3+ had slightly better performance in three tasks with precision: 0.90767, recall: 0.90065 for total burn wound segmentation; precision: 0.98987, recall: 0.99036 for palm segmentation; and precision: 0.90152, recall: 0.90219 for deep burn segmentation. Combining the segmentation results and clinical data, %TBSA burned, the volume of fluid for resuscitation, and the percentage of deep burn area can be automatically diagnosed by DL models with a pixel-to-pixel method. Artificial intelligence provides consistent, accurate and rapid assessments of burn wounds. •The %TBSA burned could be calculated from the segmentation results of patients' burn wounds and palms.•Superpixel segmentation preprocessing is a helpful method for images that are difficult to be labeled.•Deep learning has the potential to be a tool providing instant and precise diagnoses for acute burn wound management.