Fink Christine, Jaeger Claudia, Jaeger Katharina, Haenssle Holger A
Department of Dermatology, Venereology, and Allergology, University Medical Center, Ruprecht-Karl University, Heidelberg, Germany.
Dermatology Practice, Heidelberg, Germany.
J Dtsch Dermatol Ges. 2017 Apr;15(4):414-419. doi: 10.1111/ddg.13220. Epub 2017 Mar 23.
MelaFind is a multispectral computer vision system intended to -provide additional information on melanocytic lesions suspected of being melanoma by -objectively assessing their three-dimensional morphology.
Analysis of the diagnostic performance of MelaFind in a real-life clinical setting.
In this observational study, 360 pigmented skin lesions (PSL) in 111 patients were assessed by office-based dermatologists using MelaFind. Scores ≥ 2 were considered to be suspicious of malignancy. The decision for surgical excision was left to the discretion of the examining dermatologists.
MelaFind scores ≥ 2 were observed in 147 of 360 PSL (40.8 %). Of the 107 excised lesions with a MelaFind-score ≥ 2, the diagnosis of melanoma was made in three cases; 53 (49.5 %) lesions proved to be dysplastic nevi. Among all lesions biopsied (n = 113), the sensitivity and specificity of MelaFind was 100 % and 5.5 %, respectively. While a higher specificity of 68.5 % may be assumed with respect to the overall data set (n = 360), this assumption is limited by incomplete follow-up data required to confirm that all non-excised lesions with a score < 2 were actually benign.
The high sensitivity of MelaFind facilitated the detection of melanoma. The overall specificity and benign-to-malignant ratio of excised lesions were acceptable. These parameters may be improved by using higher cutoff scores for excisional biopsies, and by more vigorously selecting PSL for MelaFind examination.
MelaFind是一种多光谱计算机视觉系统，旨在通过客观评估黑素细胞性损害的三维形态，为怀疑为黑色素瘤的黑素细胞性损害提供更多信息。
分析MelaFind在实际临床环境中的诊断性能。
在这项观察性研究中，111例患者的360个色素沉着性皮肤损害（PSL）由门诊皮肤科医生使用MelaFind进行评估。评分≥2被认为可疑为恶性。手术切除的决定由检查的皮肤科医生自行决定。
360个PSL中有147个（40.8%）观察到MelaFind评分≥2。在107个MelaFind评分≥2的切除损害中，3例诊断为黑色素瘤；53个（49.5%）损害被证明是发育异常痣。在所有活检的损害中（n = 113），MelaFind的敏感性和特异性分别为100%和5.5%。虽然就整个数据集（n = 360）而言，可能假设特异性更高，为68.5%，但这一假设受到确认所有评分<2的未切除损害实际上为良性所需的不完整随访数据的限制。
MelaFind的高敏感性有助于黑色素瘤的检测。切除损害的总体特异性和良性与恶性比例是可以接受的。通过对切除活检使用更高的临界评分，以及更严格地选择PSL进行MelaFind检查，这些参数可能会得到改善。
