"Solarscan" differentiates melanoma from benign lesions

An automated dermoscopy image analysis instrument (SolarScan; Polartechnics Ltd) is accurate enough to serve as an "expert second opinion" in differentiating primary melanoma from benign melanocytic lesions, a multinational research team reports.

Dr. Scott W. Menzies from the University of Sydney in Australia and colleagues compared clinician diagnosis with that obtained with the SolarScan. They used a training set of 260 melanomas and 1239 benign melanocytic lesions that had been characterized histologically, and a test set of 122 melanoma and 596 benign melanocytic lesions. Data were collected from nine centers on three continents.According to the report in the November issue of the Archives of Dermatology, the training set exhibited a sensitivity for melanoma of 90% and specificity of 64%. Results in the test set were similar, with 91% sensitivity and 68% specificity."SolarScan had a sensitivity comparable with that of dermoscopy experts, dermatologists, and trainee dermatologists, and had a substantial superior sensitivity compared with general practitioners," Dr. Menzies' group reports. The automated instrument also had higher specificity than all four clinical groups.The authors note that the instrument demonstrated poor discrimination when analyzing nonmelanocytic-pigmented lesions such as seborrheic keratoses and hemangiomas."Because such instrumentation will never achieve 100% diagnostic accuracy, and because the gold standard of histopathologic diagnosis suffers from significant interobserver discordance, the absolute computer diagnosis will likely never be used as an absolute clinical diagnosis," the authors conclude."Rather, it is more likely to be used as...an auxiliary for clinical decision making."In a related editorial, Dr. Pietro Rubegni, from Universita degli Studi di Siena in Italy and his associates suggest that automated digital dermoscopy only be used by expert clinicians who can judge which pigmented skin lesions require such analysis."It is...through continuous interaction among dermatologists, directing the development of software, and the digital dermoscopy analyzer that the maximum utility of these instruments can be obtained in research, teaching, and, perhaps in the future, assisting diagnoses," they add.(Source: Arch Dermatol 2005;141:1388-1396,1444-1446: Reuters Health: Oncolink: December 2005.)