Clinical Melanoma Diagnosis with Artificial Intelligence: Insights from a Prospective Multicenter Study
CoRR(2024)
摘要
Early detection of melanoma, a potentially lethal type of skin cancer with
high prevalence worldwide, improves patient prognosis. In retrospective
studies, artificial intelligence (AI) has proven to be helpful for enhancing
melanoma detection. However, there are few prospective studies confirming these
promising results. Existing studies are limited by low sample sizes, too
homogenous datasets, or lack of inclusion of rare melanoma subtypes, preventing
a fair and thorough evaluation of AI and its generalizability, a crucial aspect
for its application in the clinical setting. Therefore, we assessed 'All Data
are Ext' (ADAE), an established open-source ensemble algorithm for detecting
melanomas, by comparing its diagnostic accuracy to that of dermatologists on a
prospectively collected, external, heterogeneous test set comprising eight
distinct hospitals, four different camera setups, rare melanoma subtypes, and
special anatomical sites. We advanced the algorithm with real test-time
augmentation (R-TTA, i.e. providing real photographs of lesions taken from
multiple angles and averaging the predictions), and evaluated its
generalization capabilities. Overall, the AI showed higher balanced accuracy
than dermatologists (0.798, 95
95
0.900- 0.942 vs. 0.734, 95
specificity (0.673, 95
As the algorithm exhibited a significant performance advantage on our
heterogeneous dataset exclusively comprising melanoma-suspicious lesions, AI
may offer the potential to support dermatologists particularly in diagnosing
challenging cases.
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