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Eur J Cancer. 2019 Aug 8;119:30-34. doi: 10.1016/j.ejca.2019.07.009. [Epub ahead of print]

Prediction of melanoma evolution in melanocytic nevi via artificial intelligence: A call for prospective data.

Author information

1
Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
2
Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.
3
Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany.
4
Department of Dermatology, University Hospital Kiel, University of Kiel, Kiel, Germany.
5
Department of Dermatology, University Hospital Munich (LMU), Munich, Germany.
6
Department of Dermatology, University Hospital Erlangen, University of Erlangen, Erlangen, Germany.
7
Department of Dermatology, University Hospital Würzburg, University of Würzburg, Germany.
8
Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
9
National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
10
Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120 Heidelberg, Germany. Electronic address: titus.brinker@nct-heidelberg.de.

Abstract

Recent research revealed the superiority of artificial intelligence over dermatologists to diagnose melanoma from images. However, 30-50% of all melanomas and more than half of those in young patients evolve from initially benign lesions. Despite its high relevance for melanoma screening, neither clinicians nor computers are yet able to reliably predict a nevus' oncologic transformation. The cause of this lies in the static nature of lesion presentation in the current standard of care, both for clinicians and algorithms. The status quo makes it difficult to train algorithms (and clinicians) to precisely assess the likelihood of a benign skin lesion to transform into melanoma. In addition, it inhibits the precision of current algorithms since 'evolution' image features may not be part of their decision. The current literature reveals certain types of melanocytic nevi (i.e. 'spitzoid' or 'dysplastic' nevi) and criteria (i.e. visible vasculature) that, in general, appear to have a higher chance to transform into melanoma. However, owing to the cumulative nature of oncogenic mutations in melanoma, a more fine-grained early morphologic footprint is likely to be detectable by an algorithm. In this perspective article, the concept of melanoma prediction is further explored by the discussion of the evolution of melanoma, the concept for training of such a nevi classifier and the implications of early melanoma prediction for clinical practice. In conclusion, the authors believe that artificial intelligence trained on prospective image data could be transformative for skin cancer diagnostics by (a) predicting melanoma before it occurs (i.e. pre-in situ) and (b) further enhancing the accuracy of current melanoma classifiers. Necessary prospective images for this research are obtained via free mole-monitoring mobile apps.

KEYWORDS:

Artificial intelligence; Deep learning; Melanoma; Prediction; Skin cancer

PMID:
31401471
DOI:
10.1016/j.ejca.2019.07.009
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