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Meta-Analysis
. 2018 Dec 4;12(12):CD013186.
doi: 10.1002/14651858.CD013186.

Computer-assisted diagnosis techniques (dermoscopy and spectroscopy-based) for diagnosing skin cancer in adults

Affiliations
Meta-Analysis

Computer-assisted diagnosis techniques (dermoscopy and spectroscopy-based) for diagnosing skin cancer in adults

Lavinia Ferrante di Ruffano et al. Cochrane Database Syst Rev. .

Abstract

Background: Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and cutaneous squamous cell carcinoma (cSCC) are high-risk skin cancers which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised with potential to infiltrate and damage surrounding tissue. Anxiety around missing early curable cases needs to be balanced against inappropriate referral and unnecessary excision of benign lesions. Computer-assisted diagnosis (CAD) systems use artificial intelligence to analyse lesion data and arrive at a diagnosis of skin cancer. When used in unreferred settings ('primary care'), CAD may assist general practitioners (GPs) or other clinicians to more appropriately triage high-risk lesions to secondary care. Used alongside clinical and dermoscopic suspicion of malignancy, CAD may reduce unnecessary excisions without missing melanoma cases.

Objectives: To determine the accuracy of CAD systems for diagnosing cutaneous invasive melanoma and atypical intraepidermal melanocytic variants, BCC or cSCC in adults, and to compare its accuracy with that of dermoscopy.

Search methods: We undertook a comprehensive search of the following databases from inception up to August 2016: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; CINAHL; CPCI; Zetoc; Science Citation Index; US National Institutes of Health Ongoing Trials Register; NIHR Clinical Research Network Portfolio Database; and the World Health Organization International Clinical Trials Registry Platform. We studied reference lists and published systematic review articles.

Selection criteria: Studies of any design that evaluated CAD alone, or in comparison with dermoscopy, in adults with lesions suspicious for melanoma or BCC or cSCC, and compared with a reference standard of either histological confirmation or clinical follow-up.

Data collection and analysis: Two review authors independently extracted all data using a standardised data extraction and quality assessment form (based on QUADAS-2). We contacted authors of included studies where information related to the target condition or diagnostic threshold were missing. We estimated summary sensitivities and specificities separately by type of CAD system, using the bivariate hierarchical model. We compared CAD with dermoscopy using (a) all available CAD data (indirect comparisons), and (b) studies providing paired data for both tests (direct comparisons). We tested the contribution of human decision-making to the accuracy of CAD diagnoses in a sensitivity analysis by removing studies that gave CAD results to clinicians to guide diagnostic decision-making.

Main results: We included 42 studies, 24 evaluating digital dermoscopy-based CAD systems (Derm-CAD) in 23 study cohorts with 9602 lesions (1220 melanomas, at least 83 BCCs, 9 cSCCs), providing 32 datasets for Derm-CAD and seven for dermoscopy. Eighteen studies evaluated spectroscopy-based CAD (Spectro-CAD) in 16 study cohorts with 6336 lesions (934 melanomas, 163 BCC, 49 cSCCs), providing 32 datasets for Spectro-CAD and six for dermoscopy. These consisted of 15 studies using multispectral imaging (MSI), two studies using electrical impedance spectroscopy (EIS) and one study using diffuse-reflectance spectroscopy. Studies were incompletely reported and at unclear to high risk of bias across all domains. Included studies inadequately address the review question, due to an abundance of low-quality studies, poor reporting, and recruitment of highly selected groups of participants.Across all CAD systems, we found considerable variation in the hardware and software technologies used, the types of classification algorithm employed, methods used to train the algorithms, and which lesion morphological features were extracted and analysed across all CAD systems, and even between studies evaluating CAD systems. Meta-analysis found CAD systems had high sensitivity for correct identification of cutaneous invasive melanoma and atypical intraepidermal melanocytic variants in highly selected populations, but with low and very variable specificity, particularly for Spectro-CAD systems. Pooled data from 22 studies estimated the sensitivity of Derm-CAD for the detection of melanoma as 90.1% (95% confidence interval (CI) 84.0% to 94.0%) and specificity as 74.3% (95% CI 63.6% to 82.7%). Pooled data from eight studies estimated the sensitivity of multispectral imaging CAD (MSI-CAD) as 92.9% (95% CI 83.7% to 97.1%) and specificity as 43.6% (95% CI 24.8% to 64.5%). When applied to a hypothetical population of 1000 lesions at the mean observed melanoma prevalence of 20%, Derm-CAD would miss 20 melanomas and would lead to 206 false-positive results for melanoma. MSI-CAD would miss 14 melanomas and would lead to 451 false diagnoses for melanoma. Preliminary findings suggest CAD systems are at least as sensitive as assessment of dermoscopic images for the diagnosis of invasive melanoma and atypical intraepidermal melanocytic variants. We are unable to make summary statements about the use of CAD in unreferred populations, or its accuracy in detecting keratinocyte cancers, or its use in any setting as a diagnostic aid, because of the paucity of studies.

Authors' conclusions: In highly selected patient populations all CAD types demonstrate high sensitivity, and could prove useful as a back-up for specialist diagnosis to assist in minimising the risk of missing melanomas. However, the evidence base is currently too poor to understand whether CAD system outputs translate to different clinical decision-making in practice. Insufficient data are available on the use of CAD in community settings, or for the detection of keratinocyte cancers. The evidence base for individual systems is too limited to draw conclusions on which might be preferred for practice. Prospective comparative studies are required that evaluate the use of already evaluated CAD systems as diagnostic aids, by comparison to face-to-face dermoscopy, and in participant populations that are representative of those in which the test would be used in practice.

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Conflict of interest statement

Lavinia Ferrante di Ruffano: nothing to declare. Yemisi Takwoingi: nothing to declare. Jac Dinnes: nothing to declare. Naomi Chuchu: nothing to declare. Susan E Bayliss: nothing to declare. Clare Davenport: nothing to declare. Rubeta N Matin: "my institution received a grant for a Barco NV commercially sponsored study to evaluate digital dermoscopy in the skin cancer clinic. My institution also received Oxfordshire Health Services Research Charitable Funds for carrying out a study of feasibility of using the Skin Cancer Quality of Life Impact Tool (SCQOLIT) in non melanoma skin cancer. I have received royalties for the Oxford Handbook of Medical Dermatology (Oxford University Press). I have received payment from Public Health England for the "Be Clear on Cancer" skin cancer report. I have no conflicts of interest to declare that directly relate to the publication of this work." Kathie Godfrey: nothing to declare. Colette O'Sullivan: nothing to declare. Abha Gulati: nothing to declare. Sue Ann Chan: nothing to declare. Alana Durack: nothing to declare. Susan O'Connell: nothing to declare. Matthew D Gardiner: nothing to declare. Jeff Bamber: J Bamber has been a member of the advisory board of Michelson Diagnostics and has received payment from Cancer Research UK and the International Breast Ultrasound School and Queen Mary University of London for lectures given. He has received book royalties from John Wiley and Sons, and acknowledges funding from the Engineering and Physical Sciences Research Council, the NIHR Biomedical Research Centre and the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, and the Cancer Research UK Imaging Centre Grant to the Institute of Cancer Research. There was no involvement of grant funders or other sponsors in the study whatsoever. J Bamber is the first named inventor on a patent jointly held by his institution (The Institute of Cancer Research) and The University of Bern. The priority date was 26 July 2012. The PCT publication date was 30 January 2014. A brief description of the invention is as follows: "A method of ultrasound and photoacoustic imaging in which image clutter is reduced, thus improving image quality and penetration depth, by using a localised vibration to tag true signals so as to discriminate them from false signals which occur from sources outside of the imaged region." Jonathan J Deeks: nothing to declare. Hywel C Williams: I am director of the NIHR HTA Programme. HTA is part of the NIHR which also supports the NIHR systematic reviews programme from which this work is funded.

Figures

1
1
Sample photographs of superficial spreading melanoma (left) and nodular melanoma (right). Copyright © 2010 Dr Rubeta Matin: reproduced with permission.
2
2
Sample photographs of BCC (left) and cSCC (right). Copyright © 2012 Dr Rubeta Matin: reproduced with permission.
3
3
Examples of commercially available CAD systems using digital dermoscopy (A), electrical impedance spectroscopy (B) and multispectral imaging (C and D). Reproduced with permission of the manufacturers. Copyright © 2018 MedX Corp, Canada; DermoScanGmbH, Germany; SciBase III, Sweden: reproduced with permission.
4
4
Current clinical pathway for people with skin lesions.
5
5
PRISMA flow diagram.
6
6
Risk of bias and applicability concerns graph: review authors' judgements about each domain presented as percentages across included studies
7
7
Risk of bias and applicability concerns summary: review authors' judgements about each domain for each included study
8
8
Forest plot of different types of digital dermoscopy CAD systems (DermCAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
9
9
Summary plot of digital dermoscopy CAD systems (Derm‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
10
10
Forest plot of data for image‐based dermoscopy diagnosis and digital dermoscopy CAD systems (Derm‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
11
11
Summary plot of image‐based dermoscopy diagnosis versus digital dermoscopy CAD systems (Derm‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
12
12
Summary plot of direct comparisons between image‐based dermoscopy diagnosis versus digital dermoscopy CAD systems (Derm‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
13
13
Forest plot of different types of multi‐spectral imaging CAD (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
14
14
Summary plot of multi‐spectral imaging CAD (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
15
15
Forest plot of data for image‐based dermoscopy diagnosis and multi‐spectral imaging CAD systems (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
16
16
Summary plot of image‐based dermoscopy diagnosis versus multi‐spectral imaging CAD systems (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
17
17
Summary plot of direct comparisons between image‐based dermoscopy diagnosis versus multi‐spectral imaging CAD systems (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
18
18
Summary plot for the multi‐spectral imaging CAD system (MSI‐CAD) DBMIPS for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
19
19
Summary plot for the multi‐spectral imaging CAD system (MSI‐CAD) MelaFind for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
20
20
Forest plot of different types of multi‐spectral imaging CAD system (MSI‐CAD) for the detection of invasive melanoma alone (invasive melanoma)
21
21
Summary plot of different types of multi‐spectral imaging CAD (MSI‐CAD) for the detection of invasive melanoma alone (invasive melanoma)
22
22
Forest plot of direct comparisons between image‐based dermoscopy diagnosis versus multispectral imaging CAD systems (MSI‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
23
23
Forest plot of direct comparisons between image‐based dermoscopy diagnosis versus digital dermoscopy CAD systems (Derm‐CAD) for the detection of invasive melanoma or atypical intraepidermal melanocytic variants (invasive melanoma or atypical intraepidermal melanocytic variants)
1
1. Test
Derm‐CAD Microderm (invasive melanoma or atypical intraepidermal melanocytic variants).
2
2. Test
Derm‐CAD DBMIPS (invasive melanoma or atypical intraepidermal melanocytic variants).
3
3. Test
Derm‐CAD DBMIPS vs Dermoscopy (invasive melanoma or atypical intraepidermal melanocytic variants).
4
4. Test
Derm‐CAD DEMMIPS (invasive melanoma or atypical intraepidermal melanocytic variants).
6
6. Test
Derm‐CAD SkinView (invasive melanoma or atypical intraepidermal melanocytic variants).
7
7. Test
Derm‐CAD SkinView (Any lesion requiring excision).
8
8. Test
Derm‐CAD NevusDr (invasive melanoma or atypical intraepidermal melanocytic variants).
9
9. Test
Derm‐CAD NevusDr (Any lesion requiring excision).
10
10. Test
Derm‐CAD ImageJ (invasive melanoma or atypical intraepidermal melanocytic variants).
11
11. Test
Derm‐CAD IBAS2000 (invasive melanoma or atypical intraepidermal melanocytic variants).
12
12. Test
Derm‐CAD Nevuscreen (invasive melanoma or atypical intraepidermal melanocytic variants).
13
13. Test
Derm‐CAD SolarScan (invasive melanoma).
14
14. Test
Derm‐CAD SolarScan (invasive melanoma or atypical intraepidermal melanocytic variants).
15
15. Test
Derm‐CAD No name (invasive melanoma).
16
16. Test
Derm‐CAD No name (invasive melanoma or atypical intraepidermal melanocytic variants).
17
17. Test
Derm‐CAD No name (Any lesion requiring excision).
18
18. Test
Derm‐CAD No name (BCC).
19
19. Test
Derm‐CAD DBMIPS_UNREF (invasive melanoma or atypical intraepidermal melanocytic variants).
20
20. Test
MSI‐CAD SIAscope_UNREF (invasive melanoma).
21
21. Test
MSI‐CAD SIAscope_UNREF (invasive melanoma or atypical intraepidermal melanocytic variants).
22
22. Test
MSI‐CAD SIAscope_UNREF (Any lesion requiring excision).
23
23. Test
MSI‐CAD SpectroShade (invasive melanoma).
24
24. Test
MSI‐CAD SpectroShade (invasive melanoma or atypical intraepidermal melanocytic variants).
25
25. Test
EIS‐CAD‐Nevisense (invasive melanoma).
26
26. Test
EIS‐CAD‐Nevisense (invasive melanoma or atypical intraepidermal melanocytic variants).
27
27. Test
EIS‐CAD‐Nevisense (Any lesion requiring excision).
28
28. Test
EIS‐CAD‐Nevisense (BCC).
29
29. Test
EIS‐CAD‐Nevisense (cSCC).
30
30. Test
MSI‐CAD Melafind (invasive melanoma).
31
31. Test
MSI‐CAD Melafind (invasive melanoma or atypical intraepidermal melanocytic variants).
32
32. Test
MSI‐CAD Melafind_vs Dermoscopy (invasive melanoma or atypical intraepidermal melanocytic variants).
34
34. Test
MSI‐CAD SIAscopy (invasive melanoma).
35
35. Test
MSI‐CAD SIAscopy (invasive melanoma or atypical intraepidermal melanocytic variants).
36
36. Test
MSI‐CAD SIAscope Only_UNREF (Any lesion requiring excision).
37
37. Test
DRS‐CAD OIDRS (invasive melanoma or atypical intraepidermal melanocytic variants).
38
38. Test
DRS‐CAD OIDRS (Any + dysplastic).
39
39. Test
DRS‐CAD OIDRS (Any lesion requiring excision).
40
40. Test
MSI‐CAD TS (invasive melanoma).
41
41. Test
MSI‐CAD TS (invasive melanoma or atypical intraepidermal melanocytic variants).
42
42. Test
CAD–DRS–TS vs Dermoscopy (invasive melanoma or atypical intraepidermal melanocytic variants).
46
46. Test
PersonDERM‐DigidermDBMIPS (invasive melanoma or atypical intraepidermal melanocytic variants).
47
47. Test
ImageDERM‐DigidermDBMIPS (invasive melanoma or atypical intraepidermal melanocytic variants).
48
48. Test
ImageDERM‐DigidermDEMMIPS (invasive melanoma or atypical intraepidermal melanocytic variants).
49
49. Test
PersonDerm‐DigidermImageJ (invasive melanoma or atypical intraepidermal melanocytic variants).
50
50. Test
ImageDerm‐DigidermNevuscreen (invasive melanoma or atypical intraepidermal melanocytic variants).
51
51. Test
ImageDerm‐DigidermNR (invasive melanoma).
52
52. Test
ImageDerm‐DigidermNR (invasive melanoma or atypical intraepidermal melanocytic variants).
53
53. Test
PersonDERM‐DRS‐SpectroShade (invasive melanoma).
54
54. Test
ImageDERM‐DRSMelafind (invasive melanoma).
55
55. Test
ImageDERM‐DRSMelafind (invasive melanoma or atypical intraepidermal melanocytic variants).
56
56. Test
ImageDERM‐DRSSIA (invasive melanoma or atypical intraepidermal melanocytic variants).
57
57. Test
PersonDERM‐DRSTS (invasive melanoma or atypical intraepidermal melanocytic variants).
58
58. Test
Derm‐CAD (direct comparison only) (invasive melanoma or atypical intraepidermal melanocytic variants).
59
59. Test
Image‐based Dermoscopy (for Derm‐CAD comparison) (invasive melanoma or atypical intraepidermal melanocytic variants).
60
60. Test
In‐person based Dermoscopy ‐ Derm‐CAD studies (invasive melanoma or atypical intraepidermal melanocytic variants).
61
61. Test
MSI‐CAD (direct comparison only) (invasive melanoma or atypical intraepidermal melanocytic variants).
62
62. Test
Image‐based Dermoscopy (for MSI‐CAD comparison) (invasive melanoma or atypical intraepidermal melanocytic variants).
63
63. Test
MSI‐CAD All systems (invasive melanoma or atypical intraepidermal melanocytic variants).
64
64. Test
Derm‐CAD All systems (invasive melanoma or atypical intraepidermal melanocytic variants).
65
65. Test
Derm‐CAD MoleExpert (Any lesion requiring excision).
66
66. Test
Derm‐CAD All systems (invasive melanoma).
67
67. Test
Image‐based Dermoscopy ‐ Derm‐CAD studies (invasive melanoma).
68
68. Test
MSI‐CAD All (Melafind) (invasive melanoma or atypical intraepidermal melanocytic variants), CAD + Clinician (diagnostic aid) only.
69
69. Test
MSI‐CAD All (invasive melanoma or atypical intraepidermal melanocytic variants), CAD only.
70
70. Test
MSI‐CAD Melafind (invasive melanoma or atypical intraepidermal melanocytic variants), CAD only.
71
71. Test
Derm‐CAD All (invasive melanoma or atypical intraepidermal melanocytic variants), CAD + Clinician (diagnostic aid) only.
72
72. Test
Derm‐CAD All (invasive melanoma or atypical intraepidermal melanocytic variants), CAD only.

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References

References to studies included in this review

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Mohr 2013 {published data only}
    1. Mohr P, Birgersson U, Berking C, Henderson C, Trefzer U, Kemeny L, et al. Electrical impedance spectroscopy as a potential adjunct diagnostic tool for cutaneous melanoma. Skin Research and Technology 2013;19(2):75‐83. [PUBMED: 23350668] - PubMed
Mollersen 2015 {published data only}
    1. Mollersen K, Kirchesch H, Zortea M, Schopf TR, Hindberg K, Godtliebsen F. Computer‐aided decision support for melanoma detection applied on melanocytic and nonmelanocytic skin lesions: A comparison of two systems based on automatic analysis of dermoscopic images. BioMed Research International 2015;2015:579282. [ER4:25012302; PUBMED: 26693486] - PMC - PubMed
Monheit 2011 {published data only}
    1. Monheit G, Cognetta AB, Ferris L, Rabinovitz H, Gross K, Martini M, et al. The performance of MelaFind: a prospective multicenter study. Archives of Dermatology 2011;147(2):188‐94. [ER4:15466015; PUBMED: 20956633] - PubMed
Piccolo 2002 {published data only}
    1. Piccolo D, Ferrari A, Peris K, Diadone R, Ruggeri B, Chimenti S. Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer‐assisted diagnosis of 341 pigmented skin lesions: a comparative study. British Journal of Dermatology 2002;147(3):481‐6. [ER4:15466057; PUBMED: 12207587] - PubMed
Piccolo 2014 {published data only}
    1. Piccolo D, Crisman G, Schoinas S, Altamura D, Peris K. Computer‐automated ABCD versus dermatologists with different degrees of experience in dermoscopy. European Journal of Dermatology 2014;24(4):477‐81. [ER4:17941089; PUBMED: 24721784] - PubMed
Rubegni 2002a {published data only}
    1. Rubegni P, Cevenini G, Burroni M, Perotti R, Dell'Eva G, Sbano P, et al. Automated diagnosis of pigmented skin lesions. International Journal of Cancer 2002;101(6):576‐80. [ER4:20569489; PUBMED: 12237900] - PubMed
Seidenari 1998 {published data only}
    1. Seidenari S, Pellacani G, Pepe P. Digital videomicroscopy improves diagnostic accuracy for melanoma. Journal of the American Academy of Dermatology 1998;39(2 Pt 1):175‐81. [ER4:15466116; PUBMED: 9704824] - PubMed
Seidenari 1999 {published data only}
    1. Seidenari S, Pellacani G, Giannetti A. Digital videomicroscopy and image analysis with automatic classification for detection of thin melanomas. Melanoma Research 1999;9(2):163‐71. [ER4:17940983; PUBMED: 10380939] - PubMed
Serrao 2006 {published data only}
    1. Serrao VV, Baptista J, Paris F, Lopes LC, Fidalgo A, Ferreira A. Digital dermoscopy. Review of 652 lesions analysed by the DANAOS system. Skin Cancer 2006;21(4):185‐98. [ER4:18375096]
Sgouros 2014 {published data only}
    1. Sgouros D, Lallas A, Julian Y, Rigopoulos D, Zalaudek I, Longo C, et al. Assessment of SIAscopy in the triage of suspicious skin tumours. Skin Research and Technology 2014;20(4):440‐4. [ER4:17941094; PUBMED: 24517201] - PubMed
Stanganelli 2005 {published data only}
    1. Stanganelli I, Brucale A, Calori L, Gori R, Lovato A, Magi S, et al. Computer‐aided diagnosis of melanocytic lesions. Anticancer Research 2005;25(6C):4577‐82. [ER4:15466126; PUBMED: 16334145] - PubMed
Terstappen 2013 {published data only}
    1. Terstappen K, Suurkula M, Hallberg H, Ericson MB, Wennberg AM. Poor correlation between spectrophotometric intracutaneous analysis and histopathology in melanoma and nonmelanoma lesions [Erratum appears in J Biomed Opt. 2013 Jun;18(6):069804]. Journal of Biomedical Optics 2013;18(6):061223. [ER4:15466138; PUBMED: 23296145] - PubMed
Tomatis 2003 {published data only}
    1. Tomatis S, Bono A, Bartoli C, Carrara M, Lualdi M, Tragni G, et al. Automated melanoma detection: multispectral imaging and neural network approach for classification. Medical Physics 2003;30(2):212‐21. [ER4:18375057; PUBMED: 12607839] - PubMed
Tomatis 2005 {published data only}
    1. Tomatis S, Carrara M, Bono A, Bartoli C, Lualdi M, Tragni G, et al. Automated melanoma detection with a novel multispectral imaging system: results of a prospective study. Physics in Medicine and Biology 2005;50(8):1675‐87. [ER4:17941003; PUBMED: 15815089] - PubMed
Walter 2012 {published data only}
    1. Walter FM, Morris HC, Humphrys E, Hall PN, Prevost AT, Burrows N, et al. Effect of adding a diagnostic aid to best practice to manage suspicious pigmented lesions in primary care: randomised controlled trial. BMJ 2012;345:e4110. [ER4:15466154; PUBMED: 22763392] - PMC - PubMed
Wells 2012 {published data only}
    1. Wells R, Gutkowicz‐Krusin D, Veledar E, Toledano A, Chen SC. Comparison of diagnostic and management sensitivity to melanoma between dermatologists and MelaFind: a pilot study. Archives of Dermatology 2012;148(9):1083‐4. [ER4:15466163; PUBMED: 22986873] - PubMed
Winkelmann 2016 {published data only}
    1. Winkelmann RR, Farberg AS, Tucker N, White R, Rigel DS. Enhancement of international dermatologists' pigmented skin lesion biopsy decisions following dermoscopy with subsequent integration of multispectral digital skin lesion analysis. Journal of Clinical and Aesthetic Dermatology 2016;9(7):53‐5. [ER4:25701735; PUBMED: 27672411] - PMC - PubMed
Wollina 2007 {published data only}
    1. Wollina U, Burroni M, Torricelli R, Gilardi S, Dell'Eva G, Helm C, et al. Digital dermoscopy in clinical practise: a three‐centre analysis. Skin Research and Technology 2007;13(2):133‐42. [ER4:17941010; PUBMED: 17374053] - PubMed

References to studies excluded from this review

Abbas 2010 {published data only}
    1. Abbas Q, Garcia IF, Rashid M. Automatic skin tumour border detection for digital dermoscopy using a new digital image analysis scheme. British Journal of Biomedical Science 2010;67(4):177‐83. - PubMed
Abbas 2011a {published data only}
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Abbas 2011b {published data only}
    1. Abbas Q, Fondon I, Rashid M. Unsupervised skin lesions border detection via two‐dimensional image analysis. Computer Methods and Programs in Biomedicine 2011;104(3):e1‐15. - PubMed
Abbas 2012 {published data only}
    1. Abbas Q, Celebi ME, Fondon I. Computer‐aided pattern classification system for dermoscopy images. Skin Research and Technology 2012;18(3):278‐89. - PubMed
Abbas 2013a {published data only}
    1. Abbas Q, Garcia IF, Emre Celebi M, Ahmad W, Mushtaq Q. Unified approach for lesion border detection based on mixture modeling and local entropy thresholding. Skin Research and Technology 2013;19(3):314‐9. - PubMed
Abbas 2013b {published data only}
    1. Abbas Q, Garcia IF, Emre Celebi M, Ahmad W, Mushtaq Q. A perceptually oriented method for contrast enhancement and segmentation of dermoscopy images. Skin Research and Technology 2013;19(1):e490‐7. - PubMed
Abuzaghleh 2015 {published data only}
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Afonso 2012 {published data only}
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Alfed 2015 {published data only}
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Ali 2012 {published data only}
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Altamura 2008 {published data only}
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Andreassi 1999 {published data only}
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Armengol 2011 {published data only}
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Arroyo 2011 {published data only}
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Ballerini 2012 {published data only}
    1. Ballerini L, Fisher RB, Aldridge B, Rees J. Non‐melanoma skin lesion classification using colour image data in a hierarchical K‐NN classifier. 9th IEEE International Symposium on Biomedical Imaging (ISBI), Barcelona. 2012:358‐61. [DOI: 10.1109/ISBI.2012.6235558] - DOI
Barata 2012a {published data only}
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Barata 2012b {published data only}
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Barata 2013 {published data only}
    1. Barata C, Marques JS, Rozeira J. Evaluation of color based keypoints and features for the classification of melanomas using the bag‐of‐features model. Advances in Visual Computing. ISVC. Lecture Notes in Computer Science. Springer, Berlin, Heidelberg, 2013; Vol. 8033:40‐9. [DOI: 10.1007/978-3-642-41914-0_5] - DOI
Barata 2015a {published data only}
    1. Barata C, Celebi ME, Marques JS. Improving dermoscopy image classification using color constancy. IEEE Journal of Biomedical and Health Informatics 2015;19(3):1146‐52. - PubMed
Barata 2015b {published data only}
    1. Barata C, Emre CM, Marques JS. Melanoma detection algorithm based on feature fusion. Engineering in Medicine and Biology Society (EMBC), 37th Annual International Conference of the IEEE. 2015:2653‐6. [DOI: 10.1109/EMBC.2015.7318937; PUBMED: 26736837] - DOI - PubMed
Barata 2015c {published data only}
    1. Barata C, Emre CM, Marques JS. A clinically oriented system for melanoma diagnosis using a color representation. Engineering in Medicine and Biology Society (EMBC), 37th Annual International Conference of the IEEE. 2015:7462‐5. [DOI: 10.1109/EMBC.2015.7320117; PUBMED: 26738017] - DOI - PubMed
Binder 2000 {published data only}
    1. Binder M, Kittler H, Dreiseitl S, Ganster H, Wolff K, Pehamberger H. Computer‐aided epiluminescence microscopy of pigmented skin lesions: the value of clinical data for the classification process. Melanoma Research 2000;10(6):556‐61. - PubMed
Bjerring 2001 {published data only}
    1. Bjerring P, Obitz ER, Cotton S. In vivo spectrophotometric evaluation of the skin tumours using a new skin chromophore imaging system SIAscope. Melanoma Research 2001;11:S180.
Blum 2004b {published data only}
    1. Blum A, Hofmann‐Wellenhof R, Luedtke H, Ellwanger U, Steins A, Roehm S, et al. Value of the clinical history for different users of dermoscopy compared with results of digital image analysis. Journal of the European Academy of Dermatology and Venereology : JEADV 2004;18(6):665‐9. [ER4:15465865; PUBMED: 15482291] - PubMed
Boden 2013 {published data only}
    1. Boden I, Nystrom J, Lundskog B, Zazo V, Geladi P, Lindholm‐Sethson B, et al. Non‐invasive identification of melanoma with near‐infrared and skin impedance spectroscopy. Skin Research and Technology 2013;19(1):e473‐8. - PubMed
Bono 1999 {published data only}
    1. Bono A, Tomatis S, Bartoli C, Tragni G, Radaelli G, Maurichi A, et al. The ABCD system of melanoma detection: a spectrophotometric analysis of the Asymmetry, Border, Color, and Dimension. Cancer 1999;85(1):72‐7. - PubMed
Borlu 2008 {published data only}
    1. Borlu M, Yüksel ME. Development of an image processing system for automatic melanoma diagnosis from dermoscopic images: preliminary study. Turkish Journal of Dermatology 2008;2(4):111‐5.
Brown 2000 {published data only}
    1. Brown N. Exploration of diagnostic techniques for malignant melanoma: an integrative review. Clinical Excellence for Nurse Practitioners 2000;4(5):263‐71. - PubMed
Carrara 2007 {published data only}
    1. Carrara M, Bono A, Bartoli C, Colombo A, Lualdi M, Moglia D, et al. Multispectral imaging and artificial neural network: mimicking the management decision of the clinician facing pigmented skin lesions. Physics in Medicine and Biology 2007;52(9):2599‐613. [ER4:20756747; PUBMED: 17440255] - PubMed
Celebi 2008 {published data only}
    1. Celebi ME, Iyatomi H, Stoecker WV, Moss RH, Rabinovitz HS, Argenziano G, et al. Automatic detection of blue‐white veil and related structures in dermoscopy images. Computerized Medical Imaging and Graphics 2008;32(8):670‐7. - PMC - PubMed
Chen 2003 {published data only}
    1. Chen J, Stanley RJ, Moss RH, Stoecker W. Colour analysis of skin lesion regions for melanoma discrimination in clinical images. Skin Research and Technology 2003;9(2):94‐104. - PMC - PubMed
Cheng 2012 {published data only}
    1. Cheng B, Stanley RJ, Stoecker WV, Hinton K. Automatic telangiectasia analysis in dermoscopy images using adaptive critic design. Skin Research and Technology 2012;18(4):389‐96. - PubMed
Cheng 2013 {published data only}
    1. Cheng B, Stanley RJ, Stoecker WV, Stricklin SM, Hinton KA, Nguyen TK, et al. Analysis of clinical and dermoscopic features for basal cell carcinoma neural network classification. Skin Research and Technology 2013;19(1):e217‐22. - PMC - PubMed
Christensen 2010 {published data only}
    1. Christensen JH, Soerensen MB, Linghui Z, Chen S, Jensen MO. Pre‐diagnostic digital imaging prediction model to discriminate between malignant melanoma and benign pigmented skin lesion. Skin Research and Technology 2010;16(1):98‐108. - PubMed
Claridge 1992 {published data only}
    1. Claridge E, Hall PN, Keefe M, Allen JP. Shape analysis for classification of malignant melanoma. Journal of Biomedical Engineering 1992;14(3):229‐34. - PubMed
Cukras 2013 {published data only}
    1. Cukras AR. On the comparison of diagnosis and management of melanoma between dermatologists and MelaFind. JAMA Dermatology 2013;149(5):622‐3. - PubMed
Day 2001 {published data only}
    1. Day GR, Barbour RH. Automated skin lesion screening ‐ A new approach. Melanoma Research 2001;11(1):31‐5. - PubMed
Debeir 1999 {published data only}
    1. Debeir O, Decaestecker C, Pasteels JL, Salmon I, Kiss R, Ham P. Computer‐assisted analysis of epiluminescence microscopy images of pigmented skin lesions. Cytometry 1999;37(4):255‐66. - PubMed
Di 2010 {published data only}
    1. Leo G, Paolillo A, Sommella P, Fabbrocini G. Automatic diagnosis of melanoma: a software system based on the 7‐point check‐list. 43rd Hawaii International Conference on System Sciences (HICSS). IEEE, 2010:2319‐28. [DOI: 10.1109/HICSS.2010.76] - DOI
Ding 2015 {published data only}
    1. Ding Y, John NW, Smith L, Sun J, Smith M. Combination of 3D skin surface texture features and 2D ABCD features for improved melanoma diagnosis. Medical & Biological Engineering & Computing 2015;53(10):961‐74. - PubMed
Dreiseitl 2005 {published data only}
    1. Dreiseitl S, Binder M. Do physicians value decision support? A look at the effect of decision support systems on physician opinion. Artificial Intelligence in Medicine 2005;33(1):25‐30. - PubMed
Durg 1993 {published data only}
    1. Durg A, Stoecker WV, Cookson JP, Umbaugh SE, Moss RH. Identification of variegated coloring in skin tumors: Neural network vs. rule‐based induction methods. IEEE Engineering in Medicine and Biology Magazine 1993;12(3):71‐4.
Elbaum 2001 {published data only}
    1. Elbaum M, Kopf AW, Rabinovitz HS, Langley RG, Kamino H, Mihm MC Jr, et al. Automatic differentiation of melanoma from melanocytic nevi with multispectral digital dermoscopy: a feasibility study. Journal of the American Academy of Dermatology 2001;44(2):207‐18. - PubMed
Emery 2010 {published data only}
    1. Emery JD, Hunter J, Hall PN, Watson AJ, Moncrieff M, Walter FM. Accuracy of SIAscopy for pigmented skin lesions encountered in primary care: development and validation of a new diagnostic algorithm. BMC Dermatology 2010;10:9. - PMC - PubMed
Engin 2016 {published data only}
    1. Engin B, Kecici AS, Yilmaz S, Kutlubay Z, Serdaroglu S, Tuzun Y. Infrared imaging in diagnosis of dysplastic nevi and malignant melanoma. Turkiye Klinikleri Journal of Medical Sciences 2016;36(1):14‐21.
Ercal 1994 {published data only}
    1. Ercal F, Chawla A, Stoecker WV, Lee HC, Moss RH. Neural network diagnosis of malignant melanoma from color images. IEEE Transactions on Biomedical Engineering 1994;41(9):837‐45. - PubMed
Faal 2013 {published data only}
    1. Faal M, Miran Baygi MH, Kabir E. Improving the diagnostic accuracy of dysplastic and melanoma lesions using the decision template combination method. Skin Research and Technology 2013;19(1):e113‐22. - PubMed
Farina 2000 {published data only}
    1. Farina B, Bartoli C, Bono A, Colombo A, Lualdi M, Tragni G, et al. Multispectral imaging approach in the diagnosis of cutaneous melanoma: potentiality and limits. Physics in Medicine and Biology 2000;45(5):1243‐54. - PubMed
Ferris 2016 {published data only}
    1. Ferris LK, Satyanarayanan M. Reply to: "Computer‐aided classification of melanocytic lesions using dermoscopic images: Low reported accuracy for reader study on melanomas with low melanoma in situ to invasive melanoma ratio". Journal of the American Academy of Dermatology 2016;75(3):e121. - PubMed
Fidalgo 2003 {published data only}
    1. Fidalgo A, Caldas Lopes L, Macedo Ferreira A. Digital dermatoscopy: One‐year experience with the DANAOS system. Skin Cancer 2003;18(4):211‐8.
Fikrle 2007 {published data only}
    1. Fikrle T, Pizinger K. Digital computer analysis of dermatoscopical images of 260 melanocytic skin lesions; perimeter/area ratio for the differentiation between malignant melanomas and melanocytic nevi. Journal of the European Academy of Dermatology and Venereology 2007;21(1):48‐55. - PubMed
Fikrle 2013 {published data only}
    1. Fikrle T, Pizinger K, Szakos H, Panznerova P, Divisova B, Pavel S. Digital dermatoscopic follow‐up of 1027 melanocytic lesions in 121 patients at risk of malignant melanoma. Journal of the European Academy of Dermatology and Venereology 2013;27(2):180‐6. - PubMed
Fruhauf 2012 {published data only}
    1. Fruhauf J, Leinweber B, Fink‐Puches R, Ahlgrimm‐Siess V, Richtig E, Wolf IH, et al. Patient acceptance and diagnostic utility of automated digital image analysis of pigmented skin lesions. Journal of the European Academy of Dermatology and Venereology 2012;26(3):368‐72. - PubMed
Fueyo‐Casado 2009 {published data only}
    1. Fueyo‐Casado A, Vázquez‐López F, Sanchez‐Martin J, Garcia‐Garcia B, Pérez‐Oliva N. Evaluation of a program for the automatic dermoscopic diagnosis of melanoma in a general dermatology setting. Dermatologic Surgery 2009;35(2):257‐9; discussion 260‐2. - PubMed
Ganster 2001 {published data only}
    1. Ganster H, Pinz P, Rohrer R, Wildling E, Binder M, Kittler H. Automated melanoma recognition. IEEE Transactions on Medical Imaging 2001;20(3):233‐9. - PubMed
García 2014 {published data only}
    1. García Arroyo JL, García Zapirain B. Detection of pigment network in dermoscopy images using supervised machine learning and structural analysis. Computers in Biology and Medicine 2014;44:144‐57. - PubMed
Garcia‐Uribe 2004 {published data only}
    1. Garcia‐Uribe A, Kehtarnavaz N, Marquez G, Prieto V, Duvic M, Wang LV. Skin cancer detection by spectroscopic oblique‐incidence reflectometry: classification and physiological origins. Applied Optics 2004;43(13):2643‐50. - PubMed
Garcia‐Uribe 2010 {published data only}
    1. Garcia‐Uribe A, Zou J, Chang TH, Duvic M, Prieto V, Wang LV. Oblique‐incidence spatially resolved diffuse reflectance spectroscopic diagnosis of skin cancer. SPIE. Optical Diagnostics and Sensing X: Toward Point‐of‐Care Diagnostics. 26 February 2010; Vol. 7572:75720L. [DOI: 10.1117/12.842781] - DOI
Garnavi 2012 {published data only}
    1. Garnavi R, Aldeen M, Bailey J. Computer‐aided diagnosis of melanoma using border and wavelet‐based texture analysis. IEEE Transactions on Information Technology in Biomedicine 2012;16(6):1239‐52. - PubMed
Gerger 2003 {published data only}
    1. Gerger A, Pompl R, Smolle J, Stolz W. Automated epiluminescence microscopy‐‐tissue counter analysis using CART and 1‐NN in the diagnosis of melanoma. Skin Research and Technology 2003;9(2):105‐10. [ER4:15465930; PUBMED: 12709127] - PubMed
Glotsos 2015 {published data only}
    1. Glotsos D, Kostopoulos S, Lalissidou S, Sidiropoulos K, Asvestas P, Konstandinou C, et al. Design of a decision support system, trained on GPU, for assisting melanoma diagnosis in dermatoscopy images. 4th International Conference on Mathematical Modeling in Physical Sciences. 2015:012079. [DOI: 10.1088/1742-6596/633/1/012079] - DOI
Gniadecka 2004 {published data only}
    1. Gniadecka M, Philipsen PA, Sigurdsson S, Wessel S, Nielsen OF, Christensen DH, et al. Melanoma diagnosis by Raman spectroscopy and neural networks: structure alterations in proteins and lipids in intact cancer tissue. Journal of Investigative Dermatology 2004;122(2):443‐9. - PubMed
Govindan 2007 {published data only}
    1. Govindan K, Smith J, Knowles L, Harvey A, Townsend P, Kenealy J. Assessment of nurse‐led screening of pigmented lesions using SIAscope. Journal of Plastic, Reconstructive & Aesthetic Surgery 2007;60(6):639‐45. - PubMed
Green 1991 {published data only}
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Green 1994 {published data only}
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Guerra‐Rosas 2015 {published data only}
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Guillod 1996 {published data only}
    1. Guillod JF, Schmid Ph, Fischer S, Salomon D, Saurat JH. Detection and classification of pigmented skin lesions by dermatoscopic digital image processing. Dermatology 1996;193(2):169.
Gutkowicz‐Krusin 2000 {published data only}
    1. Gutkowicz‐Krusin D, Elbaum M, Jacobs A, Keem S, Kopf AW, Kamino H, et al. Precision of automatic measurements of pigmented skin lesion parameters with a MelaFind(™) multispectral digital dermatoscope. Melanoma Research 2000;10(6):563‐70. - PubMed
Hacioglu 2013 {published data only}
    1. Hacioglu S, Saricaoglu H, Baskan EB, Uner SI, Aydogan K, Tunali S. The value of spectrophotometric intracutaneous analysis in the noninvasive diagnosis of nonmelanoma skin cancers. Clinical and Experimental Dermatology 2013;38(5):464‐9. - PubMed
Haenssle 2004 {published data only}
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Haenssle 2010 {published data only}
    1. Haenssle HA, Korpas B, Hansen‐Hagge C, Buhl T, Kaune KM, Johnsen S, et al. Selection of patients for long‐term surveillance with digital dermoscopy by assessment of melanoma risk factors. Archives of Dermatology 2010;146(3):257‐64. - PubMed
Haniffa 2007 {published data only}
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Hintz‐Madsen 2001 {published data only}
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Hoffmann 2003 {published data only}
    1. Hoffmann K, Gambichler T, Rick A, Kreutz M, Anschuetz M, Grunendick T, et al. Diagnostic and neural analysis of skin cancer (DANAOS). A multicentre study for collection and computer‐assisted analysis of data from pigmented skin lesions using digital dermoscopy. British Journal of Dermatology 2003;149(4):801‐9. - PubMed
Horsch 1997 {published data only}
    1. Horsch A, Stolz W, Neiss A, Abmayr W, Pompl R, Bernklau A, et al. Improving early recognition of malignant melanomas by digital image analysis in dermatoscopy. Studies in Health Technology and Informatics 1997;43(Pt B):531‐5. - PubMed
Huang 1996 {published data only}
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Ikuma 2013 {published data only}
    1. Ikuma Y, Iyatomi H. Production of the grounds for melanoma classification using adaptive fuzzy inference neural network. IEEE International Conference on Systems, Man, and Cybernetics (SMC). 2013:2570‐5. [DOI: 10.1109/SMC.2013.439] - DOI
Isasi 2011 {published data only}
    1. Isasi AG, Zapirain BG, Zorrilla AM. Melanomas non‐invasive diagnosis application based on the ABCD rule and pattern recognition image processing algorithms. Computers in Biology and Medicine 2011;41(9):742‐55. - PubMed
Iyatomi 2006 {published data only}
    1. Iyatomi H, Oka H, Saito M, Miyake A, Kimoto M, Yamagami J, et al. Quantitative assessment of tumour extraction from dermoscopy images and evaluation of computer‐based extraction methods for an automatic melanoma diagnostic system. Melanoma Research 2006;16(2):183‐90. - PubMed
Iyatomi 2008a {published data only}
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Iyatomi 2008b {published data only}
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Iyatomi 2008c {published data only}
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Iyatomi 2010b {published data only}
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