Purpose
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 in 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.
Methods
We proposed boundary-based labeling for datasets of total burn wounds and palm, whereas region-based labeling for the dataset of deep burn wounds. 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 the total burn wound area with respect to the palm size. The percentage of deep burn area could be obtained from the segmentation of the deep burn area from the entire wound.
Results
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: 0.9898, recall: 0.9903 for palm segmentation; and precision: 0.90152, recall: 0.9021 for deep burn segmentation. We built up a web-based server for burn wound diagnosis. From February 2022 to November 11th, 2022, the latest system diagnosed 419 images of burn wounds from 103 patients. It showed the results of accuracy: 0.9922, precision: 0.9439, recall: 0.9504, F1 score: 0.9420, loss: 0.0579.
Conclusion
Combining the segmentation results and clinical data, the %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.
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