This chapter presents a region merging-based automatic tongue segmentation method. First, gradient vector flow
is modified as a scalar diffusion equation to diffuse the tongue image while preserving the edge structures of the tongue body. Then the diffused tongue image is segmented into many small regions by using the watershed algorithm. Third, maximal similarity-based region merging is used to
... [Show full abstract] extract the tongue body area under the control of the tongue marker. Finally, the snake algorithm is used to refine the region merging result by setting the extracted tongue contour as the initial curve. The proposed method was qualitatively tested on 200 images by Traditional Chinese Medicine
practitioners and quantitatively tested on 50 tongue images using the receiver operating characteristic
analysis. Compared with the previous active contour model-based bi-elliptical deformable contour algorithm, the proposed method greatly enhances the segmentation performance, and it can reliably extract the tongue body from different types of tongue images.