Hyperspectral Imaging in the Healing Prognosis of Diabetes Related Foot Ulcers. A Systematic Review and Meta-Analysis

Microcirculation. 2025 Apr;32(3):e70005. doi: 10.1111/micc.70005.

Abstract

Objective: The diagnostic capability of hyperspectral (HSI) imaging has been focused on the prognosis of wound healing in patients with peripheral artery disease and diabetic foot ulcers (DFUs). The aim of this study was to evaluate the performance characteristics of HSI to determine the pretest probability for the prognosis of DFU healing.

Methods: A systematic search was performed on the PubMed, Medline, and Cochrane databases to identify studies evaluating HSI in predicting the prognosis of DFUs. This study was registered with PROSPERO (CRD42023495391). All selected studies were evaluated using the STROBE guidelines to assess the reporting quality for observational studies. Meta-DiSc software was used to analyze the collected data.

Results: Nine publications (142 participants) were evaluated for systematic review. The meta-analysis included four publications examining the prospective diagnostic capability of HSI. Concerning the prognostic accuracy of HSI, it had a pooled sensitivity of 0.84 (0.75-0.9) and a specificity of 0.79 (0.66-0.88) for predicting DFU healing, as well as an odds ratio of 20.4, resulting in a positive likelihood ratio of 4.1 and a negative likelihood ratio of 0.2 (heterogeneity I2 = 0).

Conclusions: The meta-analysis revealed promising prognostic capability of HSI for the healing of DFU. More randomized clinical trials need to be published as our results are based on only prospective and comparative studies.

Keywords: diabetic foot; foot ulcer; hyperspectral imaging; peripheral artery disease.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Diabetic Foot* / diagnostic imaging
  • Humans
  • Hyperspectral Imaging* / methods
  • Prognosis
  • Wound Healing*