The performance of SolarScan: an automated dermoscopy image analysis instrument for the diagnosis of primary melanoma.
OBJECTIVE
To describe the diagnostic performance of SolarScan (Polartechnics Ltd, Sydney, Australia), an automated instrument for the diagnosis of primary melanoma.


METHODS
Images from a data set of 2430 lesions (382 were melanomas; median Breslow thickness, 0.36 mm) were divided into a training set and an independent test set at a ratio of approximately 2:1. A diagnostic algorithm (absolute diagnosis of melanoma vs benign lesion and estimated probability of melanoma) was developed and its performance described on the test set. High-quality clinical and dermoscopy images with a detailed patient history for 78 lesions (13 of which were melanomas) from the test set were given to various clinicians to compare their diagnostic accuracy with that of SolarScan.


METHODS
Seven specialist referral centers and 2 general practice skin cancer clinics from 3 continents. Comparison between clinician diagnosis and SolarScan diagnosis was by 3 dermoscopy experts, 4 dermatologists, 3 trainee dermatologists, and 3 general practitioners.


METHODS
Images of the melanocytic lesions were obtained from patients who required either excision or digital monitoring to exclude malignancy.


METHODS
Sensitivity, specificity, the area under the receiver operator characteristic curve, median probability for the diagnosis of melanoma, a direct comparison of SolarScan with diagnoses performed by humans, and interinstrument and intrainstrument reproducibility.


RESULTS
The melanocytic-only diagnostic model was highly reproducible in the test set and gave a sensitivity of 91% (95% confidence interval [CI], 86%-96%) and specificity of 68% (95% CI, 64%-72%) for melanoma. SolarScan had comparable or superior sensitivity and specificity (85% vs 65%) compared with those of experts (90% vs 59%), dermatologists (81% vs 60%), trainees (85% vs 36%; P =.06), and general practitioners (62% vs 63%). The intraclass correlation coefficient of intrainstrument repeatability was 0.86 (95% CI, 0.83-0.88), indicating an excellent repeatability. There was no significant interinstrument variation (P = .80).


CONCLUSIONS
SolarScan is a robust diagnostic instrument for pigmented or partially pigmented melanocytic lesions of the skin. Preliminary data suggest that its performance is comparable or superior to that of a range of clinician groups. However, these findings should be confirmed in a formal clinical trial.
Menzies
Scott W
SW
Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. scott.menzies@email.cs.nsw.gov.au
Bischof
Leanne
L
Talbot
Hugues
H
Gutenev
Alex
A
Avramidis
Michelle
M
Wong
Livian
L
Lo
Sing Kai
SK
Mackellar
Geoffrey
G
Skladnev
Victor
V
McCarthy
William
W
Kelly
John
J
Cranney
Brad
B
Lye
Peter
P
Rabinovitz
Harold
H
Oliviero
Margaret
M
Blum
Andreas
A
Varol
Alexandra
A
Virol
Alexandra
A
De'Ambrosis
Brian
B
McCleod
Roderick
R
Koga
Hiroshi
H
Grin
Caron
C
Braun
Ralph
R
Johr
Robert
R
D000465:Algorithms; D001315:Australia; D046169:Dermoscopy / Q000379:methods*; D005431:Florida; D005858:Germany; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008499:Medical Records; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology