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The object of the thesis is to analyze the potential of thermography in the early diagnosis of type 2 diabetic foot. The main advantages of thermography are that it is simple to use, non-invasive, contactless, non-irradiant, and fast. A robust acquisition protocol is proposed, as well as a dedicated image processing algorithm. The algorithm includes a pre-processing step, plus a segmentation and a rigid registration procedures. Various parameters are assessed: the mean and standard deviation of right and left feet plantar surfaces temperaure, as well as the percentage of pixels such that the absolute point to point temperature difference between right and left feet is greater than 2.2°C. A percentage greater than 1% indicates significative hyperthermia regions. A transversal clinical study is conducted on a population of 85 persons of type 2 diabetic foot. They are classified in one of these three groups: Low risk, Medium risk, and High risk. For the Low risk group, the mean temperature is close to 32°C. For the medium one, it goes down to 31°C, and increases for the High risk group to a value of 32°C. In the early stage of diabetic foot, i.e. from the Low risk group to Medium risk group, the plantar foot surface temperature is lowered by 1°C: if this result is confirmed by other clinical tests, this information can be useful for the early diagnosis of diabetic foot. Finally, 9 images out of the 85 show hyperthermia, mainly in the heel or toes regions. This hyperthermia indication may be of a substantial assistance in the early prevention of foot ulcer and can help in avoiding subsequent foot amputation.

L'objectif de cette thèse est d'analyser l’utilité de la thermographie dans le cadre du diagnostic précoce du pied diabétique. Un protocole d'acquisition robuste des images thermiques est proposé, ainsi qu'un algorithme spécifique de traitement de ces images. Cet algorithme comporte une étape de prétraitement, suivie d'une segmentation et d’un recalage rigide. Différents paramètres sont ensuite évalués : la moyenne et l'écart type de la température de la voute plantaire de chacun des pieds droit et gauche, de même que le pourcentage des pixels pour lesquels la différence de température entre les pieds droit et gauche est supérieure à 2,2°C. Cela permet de mettre en évidence les régions en hyperthermie. Une étude clinique est menée sur une population de 85 personnes diabétiques. Ces patients sont classés sur critères médicaux dans trois groupes : risque faible, moyen ou élevé. Pour le groupe à faible risque, la température des pieds est proche de 32°C. Pour le groupe à risque moyen, elle descend à 31°C et remonte à 32°C pour le groupe risque élevé. Au stade précoce du pied diabétique, c'est-à-dire entre le risque faible et le risque moyen, la température de la surface plantaire diminue de 1°C : si ce résultat est confirmé par d'autres essais cliniques, cette information peut être utile pour le diagnostic précoce du pied diabétique. Enfin, 9 images sur les 85 étudiées révèlent une hyperthermie significative : cette indication d'hyperthermie peut être d'une aide considérable dans la prévention précoce de l'ulcère du pied et pourrait éviter des complications graves chez ces patients. / The object of the thesis is to analyze the potential of thermography in the early diagnosis of type 2 diabetic foot. The main advantages of thermography are that it is simple to use, non-invasive, contactless, non-irradiant, and fast. A robust acquisition protocol is proposed, as well as a dedicated image processing algorithm. The algorithm includes a pre-processing step, plus a segmentation and a rigid registration procedures. Various parameters are assessed: the mean and standard deviation of right and left feet plantar surfaces temperaure, as well as the percentage of pixels such that the absolute point to point temperature difference between right and left feet is greater than 2.2°C. A percentage greater than 1% indicates significative hyperthermia regions. A transversal clinical study is conducted on a population of 85 persons of type 2 diabetic foot. They are classified in one of these three groups: Low risk, Medium risk, and High risk. For the Low risk group, the mean temperature is close to 32°C. For the medium one, it goes down to 31°C, and increases for the High risk group to a value of 32°C. In the early stage of diabetic foot, i.e. from the Low risk group to Medium risk group, the plantar foot surface temperature is lowered by 1°C: if this result is confirmed by other clinical tests, this information can be useful for the early diagnosis of diabetic foot. Finally, 9 images out of the 85 show hyperthermia, mainly in the heel or toes regions. This hyperthermia indication may be of a substantial assistance in the early prevention of foot ulcer and can help in avoiding subsequent foot amputation.

Mobile chest radiography remains the most appropriate test for critical care patients with cardiorespiratory changes and with patients who have chest tubes and lines as a monitoring tool, and to detect complications related to their use. However, one of the most frequent issues recognized radiographically with patients in critical care is chest tubes and lines malposition. This can be related to technical quality reasons which can affect their appearance in the chest radiography. This research considers how the technical quality of the ICU/CCU chest radiography can impact upon the appearance of chest tubes/lines and how that appearance can impact on the decision making. Results show that the methods used in the chest phantom experiment to estimate the degree of angulation have a large effect upon the appearance of anatomical structures, but it does not have a particularly large effect upon the apparent changes of tube/line position central venous catheter and endotracheal tube (CVC, ETT). The study also shows that there was a little difference between the two image processing algorithms, apart from the visualisation of sharp reproduction of the trachea and proximal bronchi, which was significantly better using the standard algorithm compared to the inverted algorithm. The two methods used to estimate the degree of angulation and the apparent position of the CVC/ETT on 17 mobile chest radiographs provide limited useful information to the image interpreter in estimating the degree of angulation and degree of malpositioning of the tube and line.

This work presents a computational tool to support the evaluation of displacement and strain fields by using Digital Image Correlation (DIC) techniques. Two images, referring to different stages of the problem, are analyzed in order to measure these fields. As most often experimental tests are on small scale, the required tools may interfere with the analisys results. Therefore, non-destructive techniques as the DIC can be used as supporting tools for these tests. Besides, DIC is also used in situations when the access doesn’t allow the proper positioning of the tool. The subset DIC algorithm is applied, which consists in splitting the images into subregions, in which the displacements and strains are evaluated. In order to obtain the unknown fields over the whole image, the results from each subregion are interpolated. Then, tests are performed to validate the proposed methodology through four examples, by comparing the results with analytical, numerical or experimental ones, presented in the literature, in which a good level of agreement is observed. Furthermore, two numerical examples are simulated, concerning a triaxial compression test and a diametral compression test. In both cases, the displacement values are obtained with minor errors. / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Este trabalho apresenta uma ferramenta computacional para auxiliar na análise de campos de deslocamentos e deformações através de técnicas de correlação de imagens digitais (DIC) e consiste na avaliação de duas imagens em estágios diferentes de um determinado problema para a obtenção desses campos. Como na maioria das vezes os ensaios experimentais são realizados em modelos reduzidos, as instrumentações normalmente utilizadas podem afetar os resultados da análise. Então, técnicas não destrutivas como a DIC podem ser utilizadas como ferramentas de apoio a esses ensaios. Além disso, a DIC também é utilizada na análise de elementos com difícil acesso para a colocação da instrumentação convencional. Neste trabalho utiliza-se a técnica Subset DIC Algorithm que divide as imagens em várias sub-regiões e analisa os deslocamentos e as deformações para cada sub-região. Para a obtenção do campo de deslocamentos e deformações da imagem faz-se uma interpolação dos resultados obtidos em cada sub-região. Em seguida, são realizados testes para a validação da metodologia proposta através de quatro exemplos, inclusive fazendo comparações dos resultados com respostas analíticas, numéricas ou experimentais encontradas na literatura, em que, obtiveram-se respostas satisfatórias na obtenção dos campos de deslocamentos e deformações. Também são realizados dois estudos de caso sendo um sobre o ensaio de compressão triaxial e o outro sobre o ensaio de compressão diametral. Em ambos os estudos de caso é possível obter os campos de deslocamentos com erros satisfatórios.

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