期刊
SCIENCE TRANSLATIONAL MEDICINE
卷 13, 期 581, 页码 -出版社
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.abb3652
关键词
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资金
- Abdul Latif Jameel Clinic for Machine Learning in Health
- Consejeria de Educacion, Juventud y Deportes de la Comunidad de Madrid through the Madrid-MIT M+Vision Consortium
- People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme (FP7/2007-2013) under REA grant [291820]
- Mexico CONACyT [342369/40897]
- EU FP7-PEOPLE2011-COFUND Program within the M+Vision Project of Fundacion Madri+d from Comunidad de Madrid
- Ramon Areces Foundation
- DOE [DE-SC0008430]
The study presents a system using deep convolutional neural networks for SPL analysis, demonstrating high sensitivity and specificity, as well as a new method for extracting intrapatient lesion saliency. This method could aid primary care physicians in rapidly and accurately assessing the suspiciousness of pigmented lesions, improving patient triaging, resource utilization, and early melanoma treatment.
A reported 96,480 people were diagnosed with melanoma in the United States in 2019, leading to 7230 reported deaths. Early-stage identification of suspicious pigmented lesions (SPLs) in primary care settings can lead to improved melanoma prognosis and a possible 20-fold reduction in treatment cost. Despite this clinical and economic value, efficient tools for SPL detection are mostly absent. To bridge this gap, we developed an SPL analysis system for wide-field images using deep convolutional neural networks (DCNNs) and applied it to a 38,283 dermatological dataset collected from 133 patients and publicly available images. These images were obtained from a variety of consumer-grade cameras (15,244 nondermoscopy) and classified by three board-certified dermatologists. Our system achieved more than 90.3% sensitivity (95% confidence interval, 90 to 90.6) and 89.9% specificity (89.6 to 90.2%) in distinguishing SPLs from nonsuspicious lesions, skin, and complex backgrounds, avoiding the need for cumbersome individual lesion imaging. We also present a new method to extract intrapatient lesion saliency (ugly duckling criteria) on the basis of DCNN features from detected lesions. This saliency ranking was validated against three board-certified dermatologists using a set of 135 individual wide-field images from 68 dermatological patients not included in the DCNN training set, exhibiting 82.96% (67.88 to 88.26%) agreement with at least one of the top three lesions in the dermatological consensus ranking. This method could allow for rapid and accurate assessments of pigmented lesion suspiciousness within a primary care visit and could enable improved patient triaging, utilization of resources, and earlier treatment of melanoma.
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