University of Colorado School of Medicine, Aurora, Colorado.
Colorado State University, Fort Collins, Colorado.
J Am Acad Dermatol. 2018 May;78(5):927-934.e6. doi: 10.1016/j.jaad.2017.01.049.
Digital dermoscopic image analysis of pigmented skin lesions (PSLs) has become increasingly popular, despite its unclear clinical utility. Unbiased, high-powered studies investigating the efficacy of commercially available systems are limited.
To investigate the diagnostic performance of the FotoFinder Mole-Analyzer in assessing PSLs for cutaneous melanoma.
In this 15-year retrospective study, the histopathologies of 1076 biopsied PSLs among a total of 2500 imaged PSLs were collected. The biopsied PSLs were categorized as benign or malignant (cutaneous melanoma) based on histopathology. Analyzer scores (0-1.00) for these PSLs were obtained and grouped according to histopathology.
At an optimized cutoff score of 0.50, a sensitivity of 56% and a specificity of 74% were achieved. The area under the receiver operating characteristics curve was 0.698, indicating poor accuracy as a diagnostic tool.
This study had a retrospective design and involved only a single institution.
Our study reveals a low sensitivity of the scoring function of this digital dermoscopic image analyzer for detecting cutaneous melanomas. Physicians must apply keen clinical judgment when using such devices in the screening of suspicious PSLs.
尽管数字化皮肤镜分析的临床实用性尚不明确，但对色素性皮损（PSLs）的数字化皮肤镜分析已经越来越受欢迎。目前，关于商业化系统的有效性的研究，大多缺乏客观性和说服力。
评估 FotoFinder Mole-Analyzer 在评估色素性皮损是否为皮肤黑素瘤方面的诊断性能。
在这项为期 15 年的回顾性研究中，共采集了 2500 个经皮镜检查的 PSL 中 1076 个活检 PSL 的组织病理学资料。根据组织病理学将活检的 PSL 分为良性或恶性（皮肤黑素瘤）。对这些 PSL 获得了分析器评分（0-1.00），并根据组织病理学进行了分组。
在优化的截断评分 0.50 时，敏感性为 56%，特异性为 74%。受试者工作特征曲线下的面积为 0.698，表明作为诊断工具的准确性较差。
本研究为回顾性设计，仅涉及一家机构。
我们的研究表明，这种数字皮肤镜图像分析器的评分功能对检测皮肤黑素瘤的敏感性较低。医生在使用此类设备筛查可疑 PSL 时，必须谨慎应用敏锐的临床判断。
