Accuracy of dermatoscopy for the diagnosis of nonpigmented cancers of the skin

Sinz, Christoph; Tschandl, Philipp; Rosendahl, Cliff; Akay, Bengü Nisa; Argenziano, Giuseppe; Blum, Andreas; Braun, Ralph P.; Cabo, Horacio; Gourhant, Jean-Yves; Kreusch, J.; Lallas, Aimilios; Lapins, Jan; Marghoob, Ashfaq A.; Menzies, Scott W.; Paoli, John; Rabinovitz, Harold; Rinner, Claus; Scope, Alon; Soyer, H. Peter; Thomas, Luc; Zalaudek, Iris; Kittler, Harald

doi:10.1016/j.jaad.2017.07.022

Cited by 102 publications

(104 citation statements)

References 32 publications

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“…Analysing the characteristics of the incorrectly classified BCCs, we found that the presence of pigmentation was the most potent predictor of correct diagnosis. This finding is in line with previous evidence suggesting that, as a rule, the presence of pigmentation is very helpful for diagnosis, while the diagnostic accuracy even of experts is much lower when assessing non‐pigmented tumours . In contrast, the presence of dotted vessels and the location on the lower extremities represented potent predictors of wrong diagnosis.…”

Section: Discussionsupporting

confidence: 90%

“…This finding is in line with previous evidence suggesting that, as a rule, the presence of pigmentation is very helpful for diagnosis, while the diagnostic accuracy even of experts is much lower when assessing non-pigmented tumours. 15 In contrast, the presence of dotted vessels and the location on the lower extremities represented potent predictors of wrong diagnosis. Indeed, most of the misclassified BCCs were located on the lower extremities and displayed dotted vessels (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease

Papageorgiou

Apalla

Variaah

et al. 2018

Acad Dermatol Venereol

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease

Papageorgiou

Apalla

Variaah

et al. 2018

Acad Dermatol Venereol

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“…Although the majority of melanomas in our study revealed a polymorphic pattern, we found that some types of vessels more commonly co‐occur. The co‐occurrence of dotted and linear straight vessels as an indicator for melanoma of intermediate thickness is very well established, and our results again confirm this observation . A clue to differentiate between benign and malignant tumours showing dotted vessels lies particularly in the arrangement, as, for example, dots in melanocytic skin lesions commonly appear regularly distributed.…”

Section: Frequencies Of Different Vascular Patterns In Relation To Mesupporting

confidence: 86%

“…D ear E ditor , In nonpigmented skin tumours the diagnosis is based mainly on the evaluation of the vascular morphology and vessels’ distribution dermoscopically . However, to date, no study has formally correlated the prevailing vascular morphology with the Breslow thickness of the melanoma and the amount of pigmentation.…”

Section: Frequencies Of Different Vascular Patterns In Relation To Mementioning

confidence: 99%

“…It is well known that diagnosis of hypopigmented and amelanotic lesions may be challenging due to the lack of pigment and the paucity of distinct dermoscopic patterns . In a study focusing on hypopigmented and amelanotic lesions, a polymorphous vascular pattern was frequently observed dermoscopically.…”

Section: Frequencies Of Different Vascular Patterns In Relation To Mementioning

confidence: 99%

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The prevailing dermoscopic vascular pattern in melanoma is influenced by tumour thickness and pigmentation type

et al. 2019

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Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks

et al. 2019

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IMPORTANCE Convolutional neural networks (CNNs) achieve expert-level accuracy in the diagnosis of pigmented melanocytic lesions. However, the most common types of skin cancer are nonpigmented and nonmelanocytic, and are more difficult to diagnose. OBJECTIVE To compare the accuracy of a CNN-based classifier with that of physicians with different levels of experience. DESIGN, SETTING, AND PARTICIPANTS A CNN-based classification model was trained on 7895 dermoscopic and 5829 close-up images of lesions excised at a primary skin cancer clinic between January 1, 2008, and July 13, 2017, for a combined evaluation of both imaging methods. The combined CNN (cCNN) was tested on a set of 2072 unknown cases and compared with results from 95 human raters who were medical personnel, including 62 board-certified dermatologists, with different experience in dermoscopy. MAIN OUTCOMES AND MEASURES The proportions of correct specific diagnoses and the accuracy to differentiate between benign and malignant lesions measured as an area under the receiver operating characteristic curve served as main outcome measures. RESULTS Among 95 human raters (51.6% female; mean age, 43.4 years; 95% CI, 41.0-45.7 years), the participants were divided into 3 groups (according to years of experience with dermoscopy): beginner raters (<3 years), intermediate raters (3-10 years), or expert raters (>10 years). The area under the receiver operating characteristic curve of the trained cCNN was higher than human ratings (0.742; 95% CI, 0.729-0.755 vs 0.695; 95% CI, 0.676-0.713; P < .001). The specificity was fixed at the mean level of human raters (51.3%), and therefore the sensitivity of the cCNN (80.5%; 95% CI, 79.0%-82.1%) was higher than that of human raters (77.6%; 95% CI, 74.7%-80.5%). The cCNN achieved a higher percentage of correct specific diagnoses compared with human raters (37.6%; 95% CI, 36.6%-38.4% vs 33.5%; 95% CI, 31.5%-35.6%; P = .001) but not compared with experts (37.3%; 95% CI, 35.7%-38.8% vs 40.0%; 95% CI, 37.0%-43.0%; P = .18). CONCLUSIONS AND RELEVANCE Neural networks are able to classify dermoscopic and close-up images of nonpigmented lesions as accurately as human experts in an experimental setting.

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Accuracy of dermatoscopy for the diagnosis of nonpigmented cancers of the skin

Cited by 102 publications

References 32 publications

Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease

Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease

The prevailing dermoscopic vascular pattern in melanoma is influenced by tumour thickness and pigmentation type

Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks

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