Deep Learning Based Tongue Prickles Detection in Traditional Chinese Medicine

Tongue diagnosis is a convenient and noninvasive clinical practice of traditional Chinese medicine (TCM), having existed for thousands of years. Prickle, as an essential indicator in TCM, appears as a large number of red thorns protruding from the tongue. The term "prickly tongue" has been used to describe the flow of qi and blood in TCM and assess the conditions of disease as well as the health status of subhealthy people. Different location and density of prickles indicate different symptoms. As proved by modern medical research, the prickles originate in the fungiform papillae, which are enlarged and protrude to form spikes like awn. Prickle recognition, however, is subjective, burdensome, and susceptible to external factors. To solve this issue, an end-to-end prickle detection workflow based on deep learning is proposed. First, raw tongue images are fed into the Swin Transformer to remove interference information. Then, segmented tongues are partitioned into four areas: root, center, tip, and margin. We manually labeled the prickles on 224 tongue images with the assistance of an OpenCV spot detector. After training on the labeled dataset, the super-resolutionfaster-RCNN extracts advanced tongue features and predicts the bounding box of each single prickle. We show the synergy of deep learning and TCM by achieving a 92.42% recall, which is 2.52% higher than the previous work. This work provides a quantitative perspective for symptoms and disease diagnosis according to tongue characteristics. Furthermore, it is convenient to transfer this portable model to detect petechiae or tooth-marks on tongue images.