According to an EADV press release, the AI software demonstrated a “100% (59/59 cases identified) sensitivity for detecting melanoma—the most serious form of skin cancer.” The AI software also “correctly detected 99.5% (189/190) of all skin cancers and 92.5% (541/585) of pre-cancerous lesions.”
“Of the basal cell carcinoma cases, a single case was missed out of 190, which was later identified at a second read by a dermatologist ‘safety net.’ This further demonstrates the need to have appropriate clinical oversight of the AI,” the press release noted.
AI is being utilized more frequently within the healthcare industry to diagnose and treat a plethora of illnesses. This recent study performed by scientists in the United Kingdom demonstrates that new AI models can be used to accurately diagnose some skin cancers, but that “AI should not be used as a standalone detection tool without the support of a consultant dermatologist,” the press release noted.
“The role of AI in dermatology and the most appropriate pathway are debated,” said Kashini Andrew, MBBS, MSc (above), Specialist Registrar at University Hospitals Birmingham NHS Foundation Trust. “Further research with appropriate clinical oversight may allow the deployment of AI as a triage tool. However, any pathway must demonstrate cost-effectiveness, and AI is currently not a stand-alone tool in dermatology. Our data shows the great promise of AI in future provision of healthcare.” Clinical laboratories and dermatopathologists in the United States will want to watch the further development of this AI application. (Photo copyright: LinkedIn.)
How the NHS Scientists Conducted Their Study
Researchers tested their algorithm for almost three years to determine its ability to detect cancerous and pre-cancerous growths. A group of dermatologists and medical photographers entered patient information into their algorithm and trained it how to detect abnormalities. The collected data came from 22,356 patients with suspected skin cancers and included photos of known cancers.
The scientists then repeatedly recalibrated the software to ensure it could distinguish between non-cancerous lesions and potential cancers or malignancies. Dermatologists then reviewed the final data from the algorithm and compared it to diagnoses from health professionals.
“This study has demonstrated how AI is rapidly improving and learning, with the high accuracy directly attributable to improvements in AI training techniques and the quality of data used to train the AI,” said Kashini Andrew, MBBS, MSc, Specialist Registrar at University Hospitals Birmingham NHS Foundation Trust, and co-author of the study, in EADV press release.
Freeing Up Physician Time
The EADV Congress where the NHS researchers presented their findings took place in October in Berlin. The first model of their AI software was tested in 2021 and that version was able to detect:
85.9% (195 out of 227) of melanoma cases,
83.8% (903 out of 1078) of all skin cancers, and
54.1% (496 out of 917) of pre-cancerous lesions.
After fine-tuning, the latest version of the algorithm was even more promising, with results that included the detection of:
100% (59 out of 59) cases of melanoma,
99.5% (189 out of 190) of all skin cancers, and
92.5% (541 out of 585) pre-cancerous lesions.
“The latest version of the software has saved over 1,000 face-to-face consultations in the secondary care setting between April 2022 and January 2023, freeing up more time for patients that need urgent attention,” Andrew said in the press release.
Still, the researchers admit that AI should not be used as the only detection method for skin cancers.
“We would like to stress that AI should not be used as a standalone tool in skin cancer detection and that AI is not a substitute for consultant dermatologists,” stated Irshad Zaki, B Med Sci (Hons), Consultant Dermatologist at University Hospitals Birmingham NHS Foundation Trust and one of the authors of the study, in the press release.
“The role of AI in dermatology and the most appropriate pathway are debated. Further research with appropriate clinical oversight may allow the deployment of AI as a triage tool,” said Andrew in the press release. “However, any pathway must demonstrate cost-effectiveness, and AI is currently not a stand-alone tool in dermatology. Our data shows the great promise of AI in future provision of healthcare.”
Two People in the US Die of Skin Cancer Every Hour
According to the Skin Cancer Foundation, skin cancer is the most common cancer in the United States as well as the rest of the world. More people in the US are diagnosed with skin cancer every year than all other cancers combined.
When detected early, the five-year survival rate for melanoma is 99%, but more than two people in the US die of skin cancer every hour. At least one in five Americans will develop skin cancer by the age of 70 and more than 9,500 people are diagnosed with the disease every day in the US.
The annual cost of treating skin cancers in the United States is estimated at $8.1 billion annually, with approximately $3.3 billion of that amount being for melanoma and the remaining $4.8 billion for non-melanoma skin cancers.
More research is needed before University Hospitals Birmingham’s new AI model can be used clinically in the diagnoses of skin cancers. However, its level of accuracy is unprecedented in AI diagnostics. This is a noteworthy step forward in the field of AI for diagnostic purposes that can be used by clinical laboratories and dermatopathologists.
Computer-aided diagnostic system combines optical dermatoscopy, spectrophotometry and high-frequency ultrasound imaging techniques to differentiate malignant lesions from benign moles
Detecting skin cancer via the use of skin biopsies is the bread and butter of many dermatopathology practices. But new technologies that can instantly detect and distinguish different types of skin malignancies may result in a reduced flow of skin biopsies to dermatopathologists in the not-too-distant future.
The new technique achieved a more accurate method of differentiating melanoma from benign lesions, according to the researchers.
“The novelty of our method is that it combines diagnostic information obtained from different non-invasive imaging technologies such as optical spectrophotometry and [high-frequency] ultrasound. Based on the results of our research, we can confirm that the developed automated system can complement the non-invasive diagnostic methods currently applied in the medical practice by efficiently differentiating melanoma from a melanocytic mole,” said Renaldas Raišutis, PhD, coauthor of the study, in a KTU news release.
“An efficient diagnosis of an early-stage malignant skin tumor could save critical time, more patients could be examined, and more of them could be saved,” Raišutis said in the news release. He added that the CADx-based diagnostic system is aimed at medical professionals but at a price that makes it affordable for smaller medical institutions. The Lithuanian team also is working to design a system that could be marketed for home use.
New Non-invasive Optical Technology May Reduce Demand for Skin Biopsies
A systematic review article published in Frontiers in Medicine Dermatology compared current diagnostic techniques for melanoma. It noted, “The current gold standard for melanoma diagnosis is the administration of dermoscopy, followed by a biopsy and subsequent histopathological analysis of the excised tissue. To minimize the risk of misdiagnosis of true melanomas, a significant number of dermoscopically ambiguous lesions are biopsied [increasing] the overall diagnostic costs and time to obtain the final diagnosis.”
But continuing technological innovations may be setting the stage for a reduction in the number of skin biopsies performed each year. In addition to the novel diagnostic method announced by the Lithuanian researchers, an Israeli scientist has created an innovative optical technology that can instantly and non-invasively detect and distinguish between three primary skin cancers:
“We figured that with the help of devices that can identify these colors, healthy skin and each of the benign and malignant lesions would have different ‘colors,’ which would enable us to identify melanoma,” Katzir said in an Israel 21c news article.
“Melanoma is a life-threatening cancer, so it is very important to diagnose it early on, when it is still superficial,” Katzir told Israel 21c, adding that the new technology has the potential to cause “dramatic change” in the field of diagnosing and treating skin cancer, “and perhaps other types of cancer as well.”
As advancements in the non-invasive diagnosis of skin cancers continue, dermatopathologists—and in fact all anatomic and histopathology practices—should prepare for the financial impact this change may have on their clinical practices as demand for skin biopsies decreases.
This diagnostic instrument would be preferred by patients and physicians alike because it is noninvasive and provides immediate results
Dermapathologists will be interested to learn about a new handheld, point-of-care (POC) device that images melanoma tumors and enables the in vivo diagnosis of melanoma.
Because this diagnostic technology is noninvasive and provides immediate results, it is likely to be preferred by patients and doctors alike and could thus substantially reduce the volume of skin biopsies referred to dermapathologists and pathology laboratories. (more…)