Automated detection of nonmelanoma skin cancer using digital images: a systematic review

Systematic review of approaches to detection and classification of skin cancer using artificial intelligence: Development and prospects

In recent years, there has been a significant improvement in the accuracy of the classification of pigmented skin lesions using artificial intelligence algorithms. Intelligent analysis and classification systems are significantly superior to visual diagnostic methods used by dermatologists and oncologists. However, the application of such systems in clinical practice is severely limited due to a lack of generalizability and risks of potential misclassification. Successful implementation of artificial intelligence-based tools into clinicopathological practice requires a comprehensive study of the effectiveness and performance of existing models, as well as further promising areas for potential research development. The purpose of this systematic review is to investigate and evaluate the accuracy of artificial intelligence technologies for detecting malignant forms of pigmented skin lesions. For the study, 10,589 scientific research and review articles were selected from electronic scientific publishers, of which 171 articles were included in the presented systematic review. All selected scientific articles are distributed according to the proposed neural network algorithms from machine learning to multimodal intelligent architectures and are described in the corresponding sections of the manuscript. This research aims to explore automated skin cancer recognition systems, from simple machine learning algorithms to multimodal ensemble systems based on advanced encoder-decoder models, visual transformers (ViT), and generative and spiking neural networks. In addition, as a result of the analysis, future directions of research, prospects, and potential for further development of automated neural network systems for classifying pigmented skin lesions are discussed.

A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis

Scientific research of artificial intelligence (AI) in dermatology has increased exponentially. The objective of this study was to perform a systematic review and meta-analysis to evaluate the performance of AI algorithms for skin cancer classification in comparison to clinicians with different levels of expertise. Based on PRISMA guidelines, 3 electronic databases (PubMed, Embase, and Cochrane Library) were screened for relevant articles up to August 2022. The quality of the studies was assessed using QUADAS-2. A meta-analysis of sensitivity and specificity was performed for the accuracy of AI and clinicians. Fifty-three studies were included in the systematic review, and 19 met the inclusion criteria for the meta-analysis. Considering all studies and all subgroups of clinicians, we found a sensitivity (Sn) and specificity (Sp) of 87.0% and 77.1% for AI algorithms, respectively, and a Sn of 79.78% and Sp of 73.6% for all clinicians (overall); differences were statistically significant for both Sn and Sp. The difference between AI performance (Sn 92.5%, Sp 66.5%) vs. generalists (Sn 64.6%, Sp 72.8%), was greater, when compared with expert clinicians. Performance between AI algorithms (Sn 86.3%, Sp 78.4%) vs expert dermatologists (Sn 84.2%, Sp 74.4%) was clinically comparable. Limitations of AI algorithms in clinical practice should be considered, and future studies should focus on real-world settings, and towards AI-assistance.

Detection and Classification of Melanoma Skin Cancer Using Image Processing Technique

Human skin cancer is the most common and potentially life-threatening form of cancer. Melanoma skin cancer, in particular, exhibits a high mortality rate. Early detection is crucial for effective treatment. Traditionally, melanoma is detected through painful and time-consuming biopsies. This research introduces a computer-aided detection technique for early melanoma diagnosis-sis. In this study, we propose two methods for detecting skin cancer and focus specifically on melanoma cancerous cells using image data. The first method employs convolutional neural networks, including AlexNet, LeNet, and VGG-16 models, and we integrate the model with the highest accuracy into web and mobile applications. We also investigate the relationship between model depth and performance with varying dataset sizes. The second method uses support vector machines with a default RBF kernel, using feature parameters to categorize images as benign, malignant, or normal after image processing. The SVM classifier achieved an 86.6% classification accuracy, while the CNN maintained a 91% accuracy rate after 100 compute epochs. The CNN model is deployed as a web and mobile application with the assistance of Django and Android Studio.

The accuracy of artificial intelligence used for non-melanoma skin cancer diagnoses: a meta-analysis

BACKGROUND

With rising incidence of skin cancer and relatively increased mortality rates, an improved diagnosis of such a potentially fatal disease is of vital importance. Although frequently curable, it nevertheless places a considerable burden upon healthcare systems. Among the various types of skin cancers, non-melanoma skin cancer is most prevalent. Despite such prevalence and its associated cost, scant proof concerning the diagnostic accuracy via Artificial Intelligence (AI) for non-melanoma skin cancer exists. This study meta-analyzes the diagnostic test accuracy of AI used to diagnose non-melanoma forms of skin cancer, and it identifies potential covariates that account for heterogeneity between extant studies.

METHODS

Various electronic databases (Scopus, PubMed, ScienceDirect, SpringerLink, and Dimensions) were examined to discern eligible studies beginning from March 2022. Those AI studies predictive of non-melanoma skin cancer were included. Summary estimates of sensitivity, specificity, and area under receiver operating characteristic curves were used to evaluate diagnostic accuracy. The revised Quality Assessment of Diagnostic Studies served to assess any risk of bias.

RESULTS

A literature search produced 39 eligible articles for meta-analysis. The summary sensitivity, specificity, and area under receiver operating characteristic curve of AI for diagnosing non-melanoma skin cancer was 0.78, 0.98, & 0.97, respectively. Skin cancer typology, data sources, cross validation, ensemble models, types of techniques, pre-trained models, and image augmentation became significant covariates accounting for heterogeneity in terms of both sensitivity and/or specificity.

CONCLUSIONS

Meta-analysis results revealed that AI is predictive of non-melanoma with an acceptable performance, but sensitivity may become improved. Further, ensemble models and pre-trained models are employable to improve true positive rating.

Quality, Usability, and Effectiveness of mHealth Apps and the Role of Artificial Intelligence: Current Scenario and Challenges

The use of artificial intelligence (AI) and big data in medicine has increased in recent years. Indeed, the use of AI in mobile health (mHealth) apps could considerably assist both individuals and health care professionals in the prevention and management of chronic diseases, in a person-centered manner. Nonetheless, there are several challenges that must be overcome to provide high-quality, usable, and effective mHealth apps. Here, we review the rationale and guidelines for the implementation of mHealth apps and the challenges regarding quality, usability, and user engagement and behavior change, with a special focus on the prevention and management of noncommunicable diseases. We suggest that a cocreation-based framework is the best method to address these challenges. Finally, we describe the current and future roles of AI in improving personalized medicine and provide recommendations for developing AI-based mHealth apps. We conclude that the implementation of AI and mHealth apps for routine clinical practice and remote health care will not be feasible until we overcome the main challenges regarding data privacy and security, quality assessment, and the reproducibility and uncertainty of AI results. Moreover, there is a lack of both standardized methods to measure the clinical outcomes of mHealth apps and techniques to encourage user engagement and behavior changes in the long term. We expect that in the near future, these obstacles will be overcome and that the ongoing European project, Watching the risk factors (WARIFA), will provide considerable advances in the implementation of AI-based mHealth apps for disease prevention and health promotion.

Artificial Intelligence and Cancer Control: Toward Prioritizing Justice, Equity, Diversity, and Inclusion (JEDI) in Emerging Decision Support Technologies

PURPOSE FOR REVIEW

This perspective piece has two goals: first, to describe issues related to artificial intelligence-based applications for cancer control as they may impact health inequities or disparities; and second, to report on a review of systematic reviews and meta-analyses of artificial intelligence-based tools for cancer control to ascertain the extent to which discussions of justice, equity, diversity, inclusion, or health disparities manifest in syntheses of the field's best evidence.

RECENT FINDINGS

We found that, while a significant proportion of existing syntheses of research on AI-based tools in cancer control use formal bias assessment tools, the fairness or equitability of models is not yet systematically analyzable across studies. Issues related to real-world use of AI-based tools for cancer control, such as workflow considerations, measures of usability and acceptance, or tool architecture, are more visible in the literature, but still addressed only in a minority of reviews. Artificial intelligence is poised to bring significant benefits to a wide range of applications in cancer control, but more thorough and standardized evaluations and reporting of model fairness are required to build the evidence base for AI-based tool design for cancer and to ensure that these emerging technologies promote equitable healthcare.

Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. For radiologists, it is still difficult to treat patients with advanced nonmelanoma skin cancer. Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. The risk is especially elevated among those who previously received systemic treatment or phototherapy. Systemic treatments, including biologic therapies and methotrexate (MTX), are effective in managing immune-mediated diseases; however, they may increase susceptibility to NMSC due to immunosuppression or other factors. Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. The patient treatment response improved with advent and utilization of immunotherapy and different immune-specific criteria are established to standardized evaluation criteria of clinical trials but none of them have been utilized routinely with immunotherapy. The advent of immunotherapy has also arisen new critical issues for radiologists, such as atypical response pattern, pseudo-progression, as well as immune-related adverse events that require early identification to optimize and improve patient prognosis and management. It is important for radiologists to have knowledge of the radiologic features site of the tumor, clinical stage, histological subtype, and any high-risk features to assess immunotherapy treatment response and immune-related adverse events.

New AI-algorithms on smartphones to detect skin cancer in a clinical setting-A validation study

BACKGROUND AND OBJECTIVES

The incidence of skin cancer is rising worldwide and there is medical need to optimize its early detection. This study was conducted to determine the diagnostic and risk-assessment accuracy of two new diagnosis-based neural networks (analyze and detect), which comply with the CE-criteria, in evaluating the malignant potential of various skin lesions on a smartphone. Of note, the intention of our study was to evaluate the performance of these medical products in a clinical setting for the first time.

METHODS

This was a prospective, single-center clinical study at one tertiary referral center in Graz, Austria. Patients, who were either scheduled for preventive skin examination or removal of at least one skin lesion were eligible for participation. Patients were assessed by at least two dermatologists and by the integrated algorithms on different mobile phones. The lesions to be recorded were randomly selected by the dermatologists. The diagnosis of the algorithm was stated as correct if it matched the diagnosis of the two dermatologists or the histology (if available). The histology was the reference standard, however, if both clinicians considered a lesion as being benign no histology was performed and the dermatologists were stated as reference standard.

RESULTS

A total of 238 patients with 1171 lesions (86 female; 36.13%) with an average age of 66.19 (SD = 17.05) was included. Sensitivity and specificity of the detect algorithm were 96.4% (CI 93.94-98.85) and 94.85% (CI 92.46-97.23); for the analyze algorithm a sensitivity of 95.35% (CI 93.45-97.25) and a specificity of 90.32% (CI 88.1-92.54) were achieved.

DISCUSSION

The studied neural networks succeeded analyzing the risk of skin lesions with a high diagnostic accuracy showing that they are sufficient tools in calculating the probability of a skin lesion being malignant. In conjunction with the wide spread use of smartphones this new AI approach opens the opportunity for a higher early detection rate of skin cancer with consecutive lower epidemiological burden of metastatic cancer and reducing health care costs. This neural network moreover facilitates the empowerment of patients, especially in regions with a low density of medical doctors.

REGISTRATION

Approved and registered at the ethics committee of the Medical University of Graz, Austria (Approval number: 30-199 ex 17/18).

Multi-site cross-organ calibrated deep learning (MuSClD): Automated diagnosis of non-melanoma skin cancer

Although deep learning (DL) has demonstrated impressive diagnostic performance for a variety of computational pathology tasks, this performance often markedly deteriorates on whole slide images (WSI) generated at external test sites. This phenomenon is due in part to domain shift, wherein differences in test-site pre-analytical variables (e.g., slide scanner, staining procedure) result in WSI with notably different visual presentations compared to training data. To ameliorate pre-analytic variances, approaches such as CycleGAN can be used to calibrate visual properties of images between sites, with the intent of improving DL classifier generalizability. In this work, we present a new approach termed Multi-Site Cross-Organ Calibration based Deep Learning (MuSClD) that employs WSIs of an off-target organ for calibration created at the same site as the on-target organ, based off the assumption that cross-organ slides are subjected to a common set of pre-analytical sources of variance. We demonstrate that by using an off-target organ from the test site to calibrate training data, the domain shift between training and testing data can be mitigated. Importantly, this strategy uniquely guards against potential data leakage introduced during calibration, wherein information only available in the testing data is imparted on the training data. We evaluate MuSClD in the context of the automated diagnosis of non-melanoma skin cancer (NMSC). Specifically, we evaluated MuSClD for identifying and distinguishing (a) basal cell carcinoma (BCC), (b) in-situ squamous cell carcinomas (SCC-In Situ), and (c) invasive squamous cell carcinomas (SCC-Invasive), using an Australian (training, n = 85) and a Swiss (held-out testing, n = 352) cohort. Our experiments reveal that MuSCID reduces the Wasserstein distances between sites in terms of color, contrast, and brightness metrics, without imparting noticeable artifacts to training data. The NMSC-subtyping performance is statistically improved as a result of MuSCID in terms of one-vs. rest AUC: BCC (0.92 vs 0.87, p = 0.01), SCC-In Situ (0.87 vs 0.73, p = 0.15) and SCC-Invasive (0.92 vs 0.82, p = 1e-5). Compared to baseline NMSC-subtyping with no calibration, the internal validation results of MuSClD (BCC (0.98), SCC-In Situ (0.92), and SCC-Invasive (0.97)) suggest that while domain shift indeed degrades classification performance, our on-target calibration using off-target tissue can safely compensate for pre-analytical variabilities, while improving the robustness of the model.

Artificial intelligence in Dermatopathology

INTRODUCTION

Ever evolving research in medical field has reached an exciting stage with advent of newer technologies. With the introduction of digital microscopy, pathology has transitioned to become more digitally oriented speciality. The potential of artificial intelligence (AI) in dermatopathology is to aid the diagnosis, and it requires dermatopathologists' guidance for efficient functioning of artificial intelligence.

METHOD

Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar." Articles published in English language were considered for the review.

RESULTS

Convolutional neural network, a type of deep neural network, is considered as an ideal tool in image recognition, processing, classification, and segmentation. Implementation of AI in tumor pathology is involved in the diagnosis, grading, staging, and prognostic prediction as well as in identification of genetic or pathological features. In this review, we attempt to discuss the use of AI in dermatopathology, the attitude of patients and clinicians, its challenges, limitation, and potential opportunities in future implementation.

Artificial intelligence: Its role in dermatopathology

Artificial intelligence (AI), a major frontier in the field of medical research, can potentially lead to a paradigm shift in clinical practice. A type of artificial intelligence system known as convolutional neural network points to the possible utility of deep learning in dermatopathology. Though pathology has been traditionally restricted to microscopes and glass slides, recent advancement in digital pathological imaging has led to a transition making it a potential branch for the implementation of artificial intelligence. The current application of artificial intelligence in dermatopathology is to complement the diagnosis and requires a well-trained dermatopathologist's guidance for better designing and development of deep learning algorithms. Here we review the recent advances of artificial intelligence in dermatopathology, its applications in disease diagnosis and in research, along with its limitations and future potential.

Artificial intelligence for oral cancer diagnosis: What are the possibilities?

Oral cancer could be prevented. The primary strategy is based on prevention. Most patients with oral cancer present to the hospital network with advanced staging and a low chance of cure. This condition may be related to physicians' difficulty of making an early diagnosis. With the advancement of information technology, artificial intelligence (AI) holds great promise in terms of assisting in diagnosis. Few machine learning algorithms have been developed for this purpose to date. In this paper, we will discuss the possibilities for diagnosing oral cancer using AI as a tool, as well as the implications for the population. A set of photographic images of oral lesions has been segmented, indicating not only the area of the lesion but also the class of lesion associated with it. Different neural network architectures were trained with the goal of fine segmentation (pixel by pixel), classification of image crops, and classification of whole images based on the presence or absence of a lesion. The accuracy results are acceptable, opening up possibilities not only for identifying lesions but also for classifying the pathology associated with them.

Artificial intelligence and its impact on the domains of universal health coverage, health emergencies and health promotion: An overview of systematic reviews

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An overview of systematic reviews on the application of AI including 129 studies.

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AI use is prominent in Universal Health Coverage, featuring image analysis in neoplasms.

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Half of the reviews did not evaluate validation procedures nor reporting guidelines.

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Risk of bias was only included un a third of the reviews.

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There is not sufficient evidence to transfer AI to actual healthcare delivery.

Background

Artificial intelligence is fueling a new revolution in medicine and in the healthcare sector. Despite the growing evidence on the benefits of artificial intelligence there are several aspects that limit the measure of its impact in people’s health. It is necessary to assess the current status on the application of AI towards the improvement of people’s health in the domains defined by WHO’s Thirteenth General Programme of Work (GPW13) and the European Programme of Work (EPW), to inform about trends, gaps, opportunities, and challenges.

Objective

To perform a systematic overview of systematic reviews on the application of artificial intelligence in the people’s health domains as defined in the GPW13 and provide a comprehensive and updated map on the application specialties of artificial intelligence in terms of methodologies, algorithms, data sources, outcomes, predictors, performance, and methodological quality.

Methods

A systematic search in MEDLINE, EMBASE, Cochrane and IEEEXplore was conducted between January 2015 and June 2021 to collect systematic reviews using a combination of keywords related to the domains of universal health coverage, health emergencies protection, and better health and wellbeing as defined by the WHO’s PGW13 and EPW. Eligibility criteria was based on methodological quality and the inclusion of practical implementation of artificial intelligence. Records were classified and labeled using ICD-11 categories into the domains of the GPW13. Descriptors related to the area of implementation, type of modeling, data entities, outcomes and implementation on care delivery were extracted using a structured form and methodological aspects of the included reviews studies was assessed using the AMSTAR checklist.

Results

The search strategy resulted in the screening of 815 systematic reviews from which 203 were assessed for eligibility and 129 were included in the review. The most predominant domain for artificial intelligence applications was Universal Health Coverage (N = 98) followed by Health Emergencies (N = 16) and Better Health and Wellbeing (N = 15). Neoplasms area on Universal Health Coverage was the disease area featuring most of the applications (21.7 %, N = 28). The reviews featured analytics primarily over both public and private data sources (67.44 %, N = 87). The most used type of data was medical imaging (31.8 %, N = 41) and predictors based on regions of interest and clinical data. The most prominent subdomain of Artificial Intelligence was Machine Learning (43.4 %, N = 56), in which Support Vector Machine method was predominant (20.9 %, N = 27). Regarding the purpose, the application of Artificial Intelligence I is focused on the prediction of the diseases (36.4 %, N = 47). With respect to the validation, more than a half of the reviews (54.3 %, N = 70) did not report a validation procedure and, whenever available, the main performance indicator was the accuracy (28.7 %, N = 37). According to the methodological quality assessment, a third of the reviews (34.9 %, N = 45) implemented methods for analysis the risk of bias and the overall AMSTAR score below was 5 (4.01 ± 1.93) on all the included systematic reviews.

Conclusion

Artificial intelligence is being used for disease modelling, diagnose, classification and prediction in the three domains of GPW13. However, the evidence is often limited to laboratory and the level of adoption is largely unbalanced between ICD-11 categoriesand diseases. Data availability is a determinant factor on the developmental stage of artificial intelligence applications. Most of the reviewed studies show a poor methodological quality and are at high risk of bias, which limits the reproducibility of the results and the reliability of translating these applications to real clinical scenarios. The analyzed papers show results only in laboratory and testing scenarios and not in clinical trials nor case studies, limiting the supporting evidence to transfer artificial intelligence to actual care delivery.

Clinically Inspired Skin Lesion Classification through the Detection of Dermoscopic Criteria for Basal Cell Carcinoma

Background and Objective. Skin cancer is the most common cancer worldwide. One of the most common non-melanoma tumors is basal cell carcinoma (BCC), which accounts for 75% of all skin cancers. There are many benign lesions that can be confused with these types of cancers, leading to unnecessary biopsies. In this paper, a new method to identify the different BCC dermoscopic patterns present in a skin lesion is presented. In addition, this information is applied to classify skin lesions into BCC and non-BCC. Methods. The proposed method combines the information provided by the original dermoscopic image, introduced in a convolutional neural network (CNN), with deep and handcrafted features extracted from color and texture analysis of the image. This color analysis is performed by transforming the image into a uniform color space and into a color appearance model. To demonstrate the validity of the method, a comparison between the classification obtained employing exclusively a CNN with the original image as input and the classification with additional color and texture features is presented. Furthermore, an exhaustive comparison of classification employing different color and texture measures derived from different color spaces is presented. Results. Results show that the classifier with additional color and texture features outperforms a CNN whose input is only the original image. Another important achievement is that a new color cooccurrence matrix, proposed in this paper, improves the results obtained with other texture measures. Finally, sensitivity of 0.99, specificity of 0.94 and accuracy of 0.97 are achieved when lesions are classified into BCC or non-BCC. Conclusions. To the best of our knowledge, this is the first time that a methodology to detect all the possible patterns that can be present in a BCC lesion is proposed. This detection leads to a clinically explainable classification into BCC and non-BCC lesions. In this sense, the classification of the proposed tool is based on the detection of the dermoscopic features that dermatologists employ for their diagnosis.

ANALYSIS OF SPECIFIC PARAMETERS FOR SKIN TUMOR CLASSIFICATION

During the last years, computer vision-based diagnosis systems have been widely used in several hospitals and dermatology clinics, aiming mostly at the early detection of malignant melanoma tumor, which is among the most frequent types of skin cancer, versus other types of nonmalignant cutaneous diseases. They grow in melanocytes, the cells responsible for pigmentation. This type of cancer is increasing rapidly and its related mortality rate is increasing more modestly, and inversely proportional to the tumor’s thickness. The mortality rate can be decreased by earlier detection of suspicious lesions and better prevention. In this work, we are interested in extracting all specific attributes which can be used for computer-aided diagnosis of melanoma. In the first step of the proposed work, we applied the Dull Razor [Lee T et al., Dullrazor: A software approach to hair removal from images, Cancer Control Research, British Columbia Cancer Agency, Vancouver, Canada, Vol. 21, No. 6, pp. 533–543, 1997] technique to images to reduce the influence of small structures, hairs, bubbles, light reflection. In the second step, a new fuzzy level set algorithm is proposed in order to facilitate the medical image segmentation task. It is able to directly evolve from the initial segmentation proposed that uses a spatial fuzzy clustering approach. The controlling parameters of the level set evolution are also estimated from the results of the fuzzy clustering step. This step is essential to characterize the shape of the lesion and also to locate the tumor to be analyzed. In this paper, we have also treated the necessity to extract all the specific attributes used to develop a characterization methodology that enables specialists to take the best possible diagnosis. For this purpose, our proposal relies largely on visual observation of the tumor while dealing with some characteristics as color, texture or form. The method used in this paper is called ABCD. It requires calculating four factors: Asymmetry ([Formula: see text], Border ([Formula: see text], Color ([Formula: see text], and Diversity ([Formula: see text]. Finally, these parameters are used to construct a classification module based on artificial neural network for the recognition of malignant melanoma.

Automatic discrimination of Yamamoto-Kohama classification by machine learning approach for invasive pattern of oral squamous cell carcinoma using digital microscopic images: a retrospective study

OBJECTIVE

The Yamamoto-Kohama criteria are clinically useful for determining the mode of tumor invasion, especially in Japan. However, this evaluation method is based on subjective visual findings and has led to significant differences in determinations between evaluators and facilities. In this retrospective study, we aimed to develop an automatic method of determining the mode of invasion based on the processing of digital medical images.

STUDY DESIGN

Using 101 digitized photographic images of anonymized stained specimen slides, we created a classifier that allowed clinicians to introduce feature values and subjected the cases to machine learning using a random forest approach. We then compared the Yamamoto-Kohama grades (1, 2, 3, 4C, 4D) determined by a human oral and maxillofacial surgeon with those determined using the machine learning approach.

RESULTS

The input of multiple test images into the newly created classifier yielded an overall F-measure value of 87% (grade 1, 93%; grade 2, 67%; grade 3, 89%; grade 4C, 83%; grade 4D, 94%). These results suggest that the output of the classifier was very similar to the judgments of the clinician.

CONCLUSIONS

This system may be valuable for diagnostic support to provide an accurate determination of the mode of invasion.

Skin lesion classification system using a K-nearest neighbor algorithm

One of the most critical steps in medical health is the proper diagnosis of the disease. Dermatology is one of the most volatile and challenging fields in terms of diagnosis. Dermatologists often require further testing, review of the patient's history, and other data to ensure a proper diagnosis. Therefore, finding a method that can guarantee a proper trusted diagnosis quickly is essential. Several approaches have been developed over the years to facilitate the diagnosis based on machine learning. However, the developed systems lack certain properties, such as high accuracy. This study proposes a system developed in MATLAB that can identify skin lesions and classify them as normal or benign. The classification process is effectuated by implementing the K-nearest neighbor (KNN) approach to differentiate between normal skin and malignant skin lesions that imply pathology. KNN is used because it is time efficient and promises highly accurate results. The accuracy of the system reached 98% in classifying skin lesions.

Does a Previous Segmentation Improve the Automatic Detection of Basal Cell Carcinoma Using Deep Neural Networks?

Basal Cell Carcinoma (BCC) is the most frequent skin cancer and its increasing incidence is producing a high overload in dermatology services. In this sense, it is convenient to aid physicians in detecting it soon. Thus, in this paper, we propose a tool for the detection of BCC to provide a prioritization in the teledermatology consultation. Firstly, we analyze if a previous segmentation of the lesion improves the ulterior classification of the lesion. Secondly, we analyze three deep neural networks and ensemble architectures to distinguish between BCC and nevus, and BCC and other skin lesions. The best segmentation results are obtained with a SegNet deep neural network. A 98% accuracy for distinguishing BCC from nevus and a 95% accuracy classifying BCC vs. all lesions have been obtained. The proposed algorithm outperforms the winner of the challenge ISIC 2019 in almost all the metrics. Finally, we can conclude that when deep neural networks are used to classify, a previous segmentation of the lesion does not improve the classification results. Likewise, the ensemble of different neural network configurations improves the classification performance compared with individual neural network classifiers. Regarding the segmentation step, supervised deep learning-based methods outperform unsupervised ones.

Artificial Intelligence and Melanoma: A Comprehensive Review of Clinical, Dermoscopic, and Histologic Applications

Melanoma detection, prognosis, and treatment represent challenging and complex areas of cutaneous oncology with considerable impact on patient outcomes and healthcare economics. Artificial intelligence (AI) applications in these tasks are rapidly developing. Neural networks with increasing levels of sophistication are being implemented in clinical image, dermoscopic image, and histopathologic specimen classification of pigmented lesions. These efforts hold promise of earlier and highly accurate melanoma detection, as well as reliable prognostication and prediction of therapeutic response. Herein, we provide a brief introduction to AI, discuss contemporary investigational applications of AI in melanoma, and summarize challenges encountered with AI.

Automatic detection of basal cell carcinoma by hyperspectral imaging

The purpose of this study was to test the ability of hyperspectral imaging (HSI) combined with unsupervised anomaly detectors to automatically differentiate basal cell carcinoma (BCC) from normal skin. Hyperspectral images of the face of a female patient with a BCC of the lower lip were acquired using a visible/near-infrared HSI system and two anomaly detection algorithms (Reed-Xiaoli and Reed-Xiaoli/Uniform Target hybrid anomaly detectors) were used to detect pathological tissue from normal skin. The results revealed that the receiver operating characteristic curve of the Reed-Xiaoli/Uniform Target hybrid detector was higher than that of the Reed-Xiaoli detector in the range of false positive rates between 0 and 0.8. The area under curve values were good (0.7074 and 0.8607, respectively) with Reed-Xiaoli/Uniform Target hybrid detector performing better. In conclusion, HSI combined with either of two anomaly detectors can play a promising role in the automated screening of BCC.

A Systematic Review of Artificial Intelligence Techniques in Cancer Prediction and Diagnosis

Artificial intelligence has aided in the advancement of healthcare research. The availability of open-source healthcare statistics has prompted researchers to create applications that aid cancer detection and prognosis. Deep learning and machine learning models provide a reliable, rapid, and effective solution to deal with such challenging diseases in these circumstances. PRISMA guidelines had been used to select the articles published on the web of science, EBSCO, and EMBASE between 2009 and 2021. In this study, we performed an efficient search and included the research articles that employed AI-based learning approaches for cancer prediction. A total of 185 papers are considered impactful for cancer prediction using conventional machine and deep learning-based classifications. In addition, the survey also deliberated the work done by the different researchers and highlighted the limitations of the existing literature, and performed the comparison using various parameters such as prediction rate, accuracy, sensitivity, specificity, dice score, detection rate, area undercover, precision, recall, and F1-score. Five investigations have been designed, and solutions to those were explored. Although multiple techniques recommended in the literature have achieved great prediction results, still cancer mortality has not been reduced. Thus, more extensive research to deal with the challenges in the area of cancer prediction is required.

Using Artificial Intelligence for High-Volume Identification of Silicosis and Tuberculosis: A Bio-Ethics Approach

Although Artificial Intelligence (AI) is being increasingly applied, considerable distrust about introducing "disruptive" technologies persists. Intrinsic and contextual factors influencing where and how such innovations are introduced therefore require careful scrutiny to ensure that health equity is promoted. To illustrate one such critical approach, we describe and appraise an AI application - the development of computer assisted diagnosis (CAD) to support more efficient adjudication of compensation claims from former gold miners with occupational lung disease in Southern Africa. In doing so, we apply a bio-ethical lens that considers the principles of beneficence, non-maleficence, autonomy and justice and add explicability as a core principle. We draw on the AI literature, our research on CAD validation and process efficiency, as well as apprehensions of users and stakeholders. Issues of concern included AI accuracy, biased training of AI systems, data privacy, impact on human skill development, transparency and accountability in AI use, as well as intellectual property ownership. We discuss ways in which each of these potential obstacles to successful use of CAD could be mitigated. We conclude that efforts to overcoming technical challenges in applying AI must be accompanied from the onset by attention to ensuring its ethical use.

Artificial intelligence in dermatology and healthcare: An overview

Many aspects of our life are affected by technology. One of the most discussed advancements of modern technologies is artificial intelligence. It involves computational methods which in some way mimic the human thought process. Just like other branches, the medical field also has come under the ambit of artificial intelligence. Almost every field in medicine has been touched by its effect in one way or the other. Prominent among them are medical diagnosis, medical statistics, robotics, and human biology. Medical imaging is one of the foremost specialties with artificial intelligence applications, wherein deep learning methods like artificial neural networks are commonly used. artificial intelligence application in dermatology was initially restricted to the analysis of melanoma and pigmentary skin lesions, has now expanded and covers many dermatoses. Though the applications of artificial intelligence are ever increasing, large data requirements, interpretation of data and ethical concerns are some of its limitations in the present day.

A Point-of-Care, Real-Time Artificial Intelligence System to Support Clinician Diagnosis of a Wide Range of Skin Diseases

Dermatological diagnosis remains challenging for nonspecialists because the morphologies of primary skin lesions widely vary from patient to patient. Although previous studies have used artificial intelligence (AI) to classify lesions as benign or malignant, there have not been extensive studies examining the use of AI on identifying and categorizing a primary skin lesion's morphology. In this study, we evaluate the performance of a standalone AI tool to correctly categorize a skin lesion's morphology from a test bank of images. To provide a marker of performance, we evaluate the accuracy of primary care physicians to categorize skin lesion morphology in the same test bank of images without any aids and then with the aid of a simple visual guide. The AI system achieved an accuracy of 68% in determining the single most likely morphology from the test image bank. When the AI's top prediction was broadened to its top three most likely predictions, accuracy improved to 80%. In comparison, the diagnostic accuracy of primary care physicians was 36% without any aids and 68% with the visual guide (P < 0.001). The AI was subsequently tested on an additional set of 222 heterogeneous images of varying Fitzpatrick skin types and achieved an overall accuracy of 70% in the Fitzpatrick I-III skin type group and 68% in the Fitzpatrick IV-VI skin type group (P = 0.79). An AI is a powerful tool to assist physicians in the diagnosis of skin lesions while still requiring the user to critically consider other possible diagnoses.

Classification of Dermoscopy Skin Lesion Color-Images Using Fractal-Deep Learning Features

The detection of skin diseases is becoming one of the priority tasks worldwide due to the increasing amount of skin cancer. Computer-aided diagnosis is a helpful tool to help dermatologists in the detection of these kinds of illnesses. This work proposes a computer-aided diagnosis based on 1D fractal signatures of texture-based features combining with deep-learning features using transferred learning based in Densenet-201. This proposal works with three 1D fractal signatures built per color-image. The energy, variance, and entropy of the fractal signatures are used combined with 100 features extracted from Densenet-201 to construct the features vector. Because commonly, the classes in the dataset of skin lesion images are imbalanced, we use the technique of ensemble of classifiers: K-nearest neighbors and two types of support vector machines. The computer-aided diagnosis output was determined based on the linear plurality vote. In this work, we obtained an average accuracy of 97.35%, an average precision of 91.61%, an average sensitivity of 66.45%, and an average specificity of 97.85% in the eight classes’ classification in the International Skin Imaging Collaboration (ISIC) archive-2019.

Machine Learning in Dermatology: Current Applications, Opportunities, and Limitations

Machine learning (ML) has the potential to improve the dermatologist's practice from diagnosis to personalized treatment. Recent advancements in access to large datasets (e.g., electronic medical records, image databases, omics), faster computing, and cheaper data storage have encouraged the development of ML algorithms with human-like intelligence in dermatology. This article is an overview of the basics of ML, current applications of ML, and potential limitations and considerations for further development of ML. We have identified five current areas of applications for ML in dermatology: (1) disease classification using clinical images; (2) disease classification using dermatopathology images; (3) assessment of skin diseases using mobile applications and personal monitoring devices; (4) facilitating large-scale epidemiology research; and (5) precision medicine. The purpose of this review is to provide a guide for dermatologists to help demystify the fundamentals of ML and its wide range of applications in order to better evaluate its potential opportunities and challenges.

Microscopic melanoma detection and classification: A framework of pixel-based fusion and multilevel features reduction

The numbers of diagnosed patients by melanoma are drastic and contribute more deaths annually among young peoples. An approximately 192,310 new cases of skin cancer are diagnosed in 2019, which shows the importance of automated systems for the diagnosis process. Accordingly, this article presents an automated method for skin lesions detection and recognition using pixel-based seed segmented images fusion and multilevel features reduction. The proposed method involves four key steps: (a) mean-based function is implemented and fed input to top-hat and bottom-hat filters which later fused for contrast stretching, (b) seed region growing and graph-cut method-based lesion segmentation and fused both segmented lesions through pixel-based fusion, (c) multilevel features such as histogram oriented gradient (HOG), speeded up robust features (SURF), and color are extracted and simple concatenation is performed, and (d) finally variance precise entropy-based features reduction and classification through SVM via cubic kernel function. Two different experiments are performed for the evaluation of this method. The segmentation performance is evaluated on PH2, ISBI2016, and ISIC2017 with an accuracy of 95.86, 94.79, and 94.92%, respectively. The classification performance is evaluated on PH2 and ISBI2016 dataset with an accuracy of 98.20 and 95.42%, respectively. The results of the proposed automated systems are outstanding as compared to the current techniques reported in state of art, which demonstrate the validity of the proposed method.

Characterizing Artificial Intelligence Applications in Cancer Research: A Latent Dirichlet Allocation Analysis

Background

Artificial intelligence (AI)–based therapeutics, devices, and systems are vital innovations in cancer control; particularly, they allow for diagnosis, screening, precise estimation of survival, informing therapy selection, and scaling up treatment services in a timely manner.

Objective

The aim of this study was to analyze the global trends, patterns, and development of interdisciplinary landscapes in AI and cancer research.

Methods

An exploratory factor analysis was conducted to identify research domains emerging from abstract contents. The Jaccard similarity index was utilized to identify the most frequently co-occurring terms. Latent Dirichlet Allocation was used for classifying papers into corresponding topics.

Results

From 1991 to 2018, the number of studies examining the application of AI in cancer care has grown to 3555 papers covering therapeutics, capacities, and factors associated with outcomes. Topics with the highest volume of publications include (1) machine learning, (2) comparative effectiveness evaluation of AI-assisted medical therapies, and (3) AI-based prediction. Noticeably, this classification has revealed topics examining the incremental effectiveness of AI applications, the quality of life, and functioning of patients receiving these innovations. The growing research productivity and expansion of multidisciplinary approaches are largely driven by machine learning, artificial neural networks, and AI in various clinical practices.

Conclusions

The research landscapes show that the development of AI in cancer care is focused on not only improving prediction in cancer screening and AI-assisted therapeutics but also on improving other corresponding areas such as precision and personalized medicine and patient-reported outcomes.