Birkenfeld Judith S, Tucker-Schwartz Jason M, Soenksen Luis R, Avilés-Izquierdo José A, Marti-Fuster Berta
Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA; Brigham and Women's Hospital - Harvard Medical School, 75 Francis St, Boston, MA 02115, United States; Massachusetts General Hospital - Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States.
MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA.
Comput Methods Programs Biomed. 2020 Oct;195:105631. doi: 10.1016/j.cmpb.2020.105631. Epub 2020 Jul 1.
Early identification of melanoma is conducted through whole-body visual examinations to detect suspicious pigmented lesions, a situation that fluctuates in accuracy depending on the experience and time of the examiner. Computer-aided diagnosis tools for skin lesions are typically trained using pre-selected single-lesion images, taken under controlled conditions, which limits their use in wide-field scenes. Here, we propose a computer-aided classifier system with such input conditions to aid in the rapid identification of suspicious pigmented lesions at the primary care level.
133 patients with a multitude of skin lesions were recruited for this study. All lesions were examined by a board-certified dermatologist and classified into "suspicious" and "non-suspicious". A new clinical database was acquired and created by taking Wide-Field images of all major body parts with a consumer-grade camera under natural illumination condition and with a consistent source of image variability. 3-8 images were acquired per patient on different sites of the body, and a total of 1759 pigmented lesions were extracted. A machine learning classifier was optimized and build into a computer aided classification system to binary classify each lesion using a suspiciousness score.
In a testing set, our computer-aided classification system achieved a sensitivity of 100% for suspicious pigmented lesions that were later confirmed by dermoscopy examination ("SPL_A") and 83.2% for suspicious pigmented lesions that were not confirmed after examination ("SPL_B"). Sensitivity for non-suspicious lesions was 72.1%, and accuracy was 75.9%. With these results we defined a suspiciousness score that is aligned with common macro-screening (naked eye) practices.
This work demonstrates that wide-field photography combined with computer-aided classification systems can distinguish suspicious from non-suspicious pigmented lesions, and might be effective to assess the severity of a suspicious pigmented lesions. We believe this approach could be useful to support skin screenings at a population-level.
黑色素瘤的早期识别通过全身视觉检查来检测可疑色素沉着病变,其准确性会因检查者的经验和时间而有所波动。用于皮肤病变的计算机辅助诊断工具通常使用在受控条件下拍摄的预先选择的单病变图像进行训练,这限制了它们在广域场景中的应用。在此,我们提出一种具有此类输入条件的计算机辅助分类系统,以帮助在基层医疗水平快速识别可疑色素沉着病变。
本研究招募了133例患有多种皮肤病变的患者。所有病变均由经过委员会认证的皮肤科医生进行检查,并分为“可疑”和“非可疑”两类。通过在自然光照条件下使用消费级相机对所有主要身体部位拍摄广域图像,并保持一致的图像变异性来源,获取并创建了一个新的临床数据库。每位患者在身体的不同部位采集3 - 8张图像,共提取出1759个色素沉着病变。优化了一个机器学习分类器,并将其构建到计算机辅助分类系统中,使用可疑度评分对每个病变进行二元分类。
在一个测试集中,我们的计算机辅助分类系统对后来经皮肤镜检查确诊的可疑色素沉着病变(“SPL_A”)的敏感度为100%,对检查后未确诊的可疑色素沉着病变(“SPL_B”)的敏感度为83.2%。对非可疑病变的敏感度为72.1%,准确率为75.9%。基于这些结果,我们定义了一个与常见宏观筛查(裸眼)实践一致的可疑度评分。
这项工作表明,广域摄影与计算机辅助分类系统相结合可以区分可疑和非可疑色素沉着病变,并且可能有效地评估可疑色素沉着病变的严重程度。我们相信这种方法可能有助于在人群层面支持皮肤筛查。