Improved active contour models with application to measurement of leg ulcers

Leg ulcers are chronic skin wounds that affect many people and take a long time to heal. The progress of wound healing and the effect of clinical treatments can be monitored partly by mea- suring the area of the wound. Measurements taken via manually based methods, such as using a computer pointing device to delin- eate the wound boundary in a digitized image, suffer from variations due to manual dexterity and differences of opinion between observ- ers. Two active contour models are presented, and their measure- ment performances are compared with that of the existing manual delineation method. The models make use of manual delineation to initialize the solution and are shown to reduce the effect of the in- herent variations on the repeatability (precision) of area measure- ments in most cases. Measurements made by both algorithms are often biased with respect to the manual measurements, although the bias is limited generally to less than 5% of the wound's area.