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

TL;DR

This study compares two computer-aided decision support systems for skin cancer detection, demonstrating that one system can effectively identify both melanoma and nonmelanoma skin cancers with comparable sensitivity to existing solutions.

Contribution

The paper evaluates and compares the performance of two CDSSs, including a new system capable of detecting multiple skin cancer types, highlighting its potential for broader clinical application.

Findings

ND detects NMSC with 100% sensitivity at 95% melanoma sensitivity

ND and ME have similar melanoma sensitivity levels

ND can identify NMSC without reducing melanoma detection performance

Abstract

Commercially available clinical decision support systems (CDSSs) for skin cancer have been designed for the detection of melanoma only. Correct use of the systems requires expert knowledge, hampering their utility for nonexperts. Furthermore, there are no systems to detect other common skin cancer types, that is, nonmelanoma skin cancer (NMSC). As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts. Nevus Doctor (ND) is a CDSS being developed by the authors. We here investigate ND's ability to detect both melanoma and NMSC and the opportunities for improvement. An independent test set of dermoscopic images of 870 skin lesions, including 44 melanomas and 101 NMSCs, were analysed by ND. Its sensitivity to melanoma and NMSC was compared to that of Mole Expert (ME), a commercially available CDSS, using the same set of lesions. ND and ME had similar sensitivity to melanoma. For ND at 95 percent melanoma sensitivity, the NMSC sensitivity was 100 percent, and the specificity was 12 percent. The melanomas misclassified by ND at 95 percent sensitivity were correctly classified by ME, and vice versa. ND is able to detect NMSC without sacrificing melanoma sensitivity.