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MelaFind设备在实际临床环境中的诊断性能。

Diagnostic performance of the MelaFind device in a real-life clinical setting.

作者信息

Fink Christine, Jaeger Claudia, Jaeger Katharina, Haenssle Holger A

机构信息

Department of Dermatology, Venereology, and Allergology, University Medical Center, Ruprecht-Karl University, Heidelberg, Germany.

Dermatology Practice, Heidelberg, Germany.

出版信息

J Dtsch Dermatol Ges. 2017 Apr;15(4):414-419. doi: 10.1111/ddg.13220. Epub 2017 Mar 23.

Abstract

BACKGROUND

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.

OBJECTIVES

Analysis of the diagnostic performance of MelaFind in a real-life clinical setting.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

目的

分析MelaFind在实际临床环境中的诊断性能。

患者和方法

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。

结果

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。

结论

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。

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