Comparison between computer elaboration and clinical assessment of asymmetry and border cut-off in melanoma images

Abstract: Clinical evaluation of pigmented skin lesion images is subjective and can lead to different results depending on the examiner’s experience, also applying semiquantitative methods such as the ABCD rule for dermatoscopy. In order to increase the reproducibility of clinical judgement, a method to automatically reproduce the A (Asymmetry) and the B (Border) parameters of the ABCD rule was developed. One hundred and fourteen images of melanomas acquired by a digital videomicroscope with a 20x magnification were studied.Clinical evaluation: a clinical judgement of asymmetry of the shape and pigment distribution along 2 axes were performed by 0–2 scoring system. For the evaluation of the border cut-off, a score ranging to 0 from 8 was attributed to each lesion on the basis of the number of segments with an abrupt edge interruption of the pigmentation. Computer elaboration: after automatic border detection, major and minor axes were obtained and ‘shape asymmetry’ on each axis was calculated considering the proportion of overlapping pixels. A correspondence lower than 90% was selected as the threshold for asymmetry. The ‘pigment distribution asymmetry’ on each axis was calculated comparing the portion of the dark area, obtained by the median cut algorithm, in the two halves of the lesion. A correspondence lower than 80% was considered as the threshold for asymmetry. In order to numerically describe the gradient at the border, the lesion border was divided into 8 segments and the change in lightness values along a 30 pixel long segment centered on the lesion border, expressed as the slope of the curve, was considered. Threshold for abrupt border cut-off was set by a slope greater than 3.609Results: a good correlation between clinical evaluation and computer elaboration was found for shape asymmetry (rho=0.698;p<0.001), pigment distribution asymmetry (rho=0.428;p<0.001) and number of borders with an abrupt cut-off (rho=0.834;p<0.001).

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