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      Hyperspectral imaging in automated digital dermoscopy screening for melanoma

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          Abstract

          Objectives

          Early melanoma detection decreases morbidity and mortality. Early detection classically involves dermoscopy to identify suspicious lesions for which biopsy is indicated. Biopsy and histological examination then diagnose benign nevi, atypical nevi, or cancerous growths. With current methods, a considerable number of unnecessary biopsies are performed as only 11% of all biopsied, suspicious lesions are actually melanomas. Thus, there is a need for more advanced noninvasive diagnostics to guide the decision of whether or not to biopsy. Artificial intelligence can generate screening algorithms that transform a set of imaging biomarkers into a risk score that can be used to classify a lesion as a melanoma or a nevus by comparing the score to a classification threshold. Melanoma imaging biomarkers have been shown to be spectrally dependent in Red, Green, Blue (RGB) color channels, and hyperspectral imaging may further enhance diagnostic power. The purpose of this study was to use the same melanoma imaging biomarkers previously described, but over a wider range of wavelengths to determine if, in combination with machine learning algorithms, this could result in enhanced melanoma detection.

          Methods

          We used the melanoma advanced imaging dermatoscope (mAID) to image pigmented lesions assessed by dermatologists as requiring a biopsy. The mAID is a 21‐wavelength imaging device in the 350–950 nm range. We then generated imaging biomarkers from these hyperspectral dermoscopy images, and, with the help of artificial intelligence algorithms, generated a melanoma Q‐score for each lesion (0 = nevus, 1 = melanoma). The Q‐score was then compared to the histopathologic diagnosis.

          Results

          The overall sensitivity and specificity of hyperspectral dermoscopy in detecting melanoma when evaluated in a set of lesions selected by dermatologists as requiring biopsy was 100% and 36%, respectively.

          Conclusion

          With widespread application, and if validated in larger clinical trials, this non‐invasive methodology could decrease unnecessary biopsies and potentially increase life‐saving early detection events. Lasers Surg. Med. 51:214–222, 2019. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

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          Most cited references25

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          Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting.

          Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta-analyses including studies performed in experimental and clinical settings. To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta-analysis exclusively on studies performed in a clinical setting. We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15.6 [95% confidence interval (CI) 2.9-83.7, P = 0.016]; removal of two outlier studies changed this to 9.0 (95% CI 1.5-54.6, P = 0.03). Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.
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            Model-based boosting in R: a hands-on tutorial using the R package mboost

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              The performance of MelaFind: a prospective multicenter study.

              To demonstrate the safety and effectiveness of MelaFind, a noninvasive and objective computer-vision system designed to aid in detection of early pigmented cutaneous melanoma. A prospective, multicenter, blinded study. The diagnostic performance of MelaFind and of study clinicians was evaluated using the histologic reference standard. Standard images and patient information for a subset of 50 randomly selected lesions (25 melanomas) were used in a reader study of 39 independent dermatologists to estimate clinicians' biopsy sensitivity to melanoma. Three academic and 4 community practices in the United States with expertise in management of pigmented skin lesions. A total of 1383 patients with 1831 lesions enrolled from January 2007 to July 2008; 1632 lesions (including 127 melanomas-45% in situ-with median Breslow thickness of invasive lesions, 0.36 mm) were eligible and evaluable for the study end points. Sensitivity of MelaFind; specificities and biopsy ratios for MelaFind and the study investigators; and biopsy sensitivities of independent dermatologists in the reader study. The measured sensitivity of MelaFind was 98.4% (125 of 127 melanomas) with a 95% lower confidence bound at 95.6% and a biopsy ratio of 10.8:1; the average biopsy sensitivity of dermatologists was 78% in the reader study. Including borderline lesions (high-grade dysplastic nevi, atypical melanocytic proliferations, or hyperplasias), MelaFind's sensitivity was 98.3% (172 of 175), with a biopsy ratio of 7.6:1. On lesions biopsied mostly to rule out melanoma, MelaFind's average specificity (9.9%) was superior to that of clinicians (3.7%) (P=.02). MelaFind is a safe and effective tool to assist in the evaluation of pigmented skin lesions. clinicaltrials.gov Identifier: NCT00434057. ©2011 American Medical Association. All rights reserved.
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                Author and article information

                Contributors
                dgareau@rockefeller.edu
                Journal
                Lasers Surg Med
                Lasers Surg Med
                10.1002/(ISSN)1096-9101
                LSM
                Lasers in Surgery and Medicine
                John Wiley and Sons Inc. (Hoboken )
                0196-8092
                1096-9101
                17 January 2019
                March 2019
                : 51
                : 3 ( doiID: 10.1002/lsm.v51.3 )
                : 214-222
                Affiliations
                [ 1 ] Department of Dermatology University of California Irvine Irvine California
                [ 2 ] Laboratory for Investigative Dermatology The Rockefeller University New York New York
                [ 3 ] Department of Computer Science Columbia University New York New York
                [ 4 ] Department of Physics Harvard University Cambridge Massachusetts
                [ 5 ] Department of Biomedical Engineering Tufts University Medford Massachusetts
                [ 6 ] Chao Family Comprehensive Cancer Center University of California Irvine Irvine California
                Author notes
                [*] [* ] Correspondence to: Daniel S. Gareau, PhD, Department of Investigative Dermatology, The Rockefeller University, 1230 York Ave, New York, NY 10065. E‐mail: dgareau@ 123456rockefeller.edu

                Author information
                http://orcid.org/0000-0002-7857-3373
                Article
                LSM23055
                10.1002/lsm.23055
                6519386
                30653684
                e762b15d-c96f-457f-8b5e-fe1637f5bec4
                © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 12 December 2018
                Page count
                Figures: 4, Tables: 2, Pages: 9, Words: 5843
                Funding
                Funded by: Paul and Irma Milstein Foundation
                Funded by: Howard and Abby Milstein Foundation
                Funded by: National Center for Advancing Translational Sciences (NCATS)
                Funded by: National Institutes of Health (NIH)
                Funded by: Clinical and Translational Science Award (CTSA) program
                Award ID: UL1 TR001866
                Categories
                Clinical Report
                Clinical Reports
                Custom metadata
                2.0
                lsm23055
                March 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.2.1 mode:remove_FC converted:15.05.2019

                melanoma,dermoscopy,artificial intelligence,machine learning,hyperspectral imaging

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