Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Computer Science, Bar-Ilan University, Ramat-Gan, Israel.
EBioMedicine. 2019 May;43:107-113. doi: 10.1016/j.ebiom.2019.04.055. Epub 2019 May 14.
Skin cancer (SC), especially melanoma, is a growing public health burden. Experimental studies have indicated a potential diagnostic role for deep learning (DL) algorithms in identifying SC at varying sensitivities. Previously, it was demonstrated that diagnostics by dermoscopy are improved by applying an additional sonification (data to sound waves conversion) layer on DL algorithms. The aim of the study was to determine the impact of image quality on accuracy of diagnosis by sonification employing a rudimentary skin magnifier with polarized light (SMP).
Dermoscopy images acquired by SMP were processed by a first deep learning algorithm and sonified. Audio output was further analyzed by a different secondary DL. Study criteria outcomes of SMP were specificity and sensitivity, which were further processed by a F2-score, i.e. applying a twice extra weight to sensitivity over positive predictive values.
Patients (n = 73) fulfilling inclusion criteria were referred to biopsy. SMP analysis metrics resulted in a receiver operator characteristic curve AUC's of 0.814 (95% CI, 0.798-0.831). SMP achieved a F2-score sensitivity of 91.7%, specificity of 41.8% and positive predictive value of 57.3%. Diagnosing the same set of patients' lesions by an advanced dermoscope resulted in a F2-score sensitivity of 89.5%, specificity of 57.8% and a positive predictive value of 59.9% (P=NS).
DL processing of dermoscopic images followed by sonification results in an accurate diagnostic output for SMP, implying that the quality of the dermoscope is not the major factor influencing DL diagnosis of skin cancer. Present system might assist all healthcare providers as a feasible computer-assisted detection system. FUND: Bostel Technologies. Trial Registration clinicaltrials.gov Identifier: NCT03362138.
皮肤癌(SC),尤其是黑色素瘤,是一个日益严重的公共卫生负担。实验研究表明,深度学习(DL)算法在不同的敏感性下识别 SC 具有潜在的诊断作用。此前,已经证明通过在 DL 算法上应用附加的声化(数据到声波的转换)层,可提高皮肤镜检查的诊断效果。本研究旨在确定使用具有偏振光的简易皮肤放大镜(SMP)进行声化对诊断准确性的影响。
使用 SMP 获取的皮肤镜图像由第一个深度学习算法进行处理,并进行声化。音频输出由另一个二级 DL 进一步分析。SMP 的研究标准结果为特异性和敏感性,进一步通过 F2 评分进行处理,即对敏感性给予比阳性预测值多两倍的权重。
符合纳入标准的患者(n=73)被转诊进行活检。SMP 分析指标得出的接收器操作特性曲线 AUC 为 0.814(95%CI,0.798-0.831)。SMP 的 F2 评分敏感性为 91.7%,特异性为 41.8%,阳性预测值为 57.3%。使用先进的皮肤镜对同一组患者的病变进行诊断,F2 评分的敏感性为 89.5%,特异性为 57.8%,阳性预测值为 59.9%(P=NS)。
对皮肤镜图像进行 DL 处理,然后进行声化,可为 SMP 提供准确的诊断结果,这意味着皮肤镜的质量不是影响皮肤癌 DL 诊断的主要因素。目前的系统可以作为一种可行的计算机辅助检测系统,帮助所有医疗保健提供者。
Bostel Technologies。临床试验注册临床Trials.gov 标识符:NCT03362138。