Turbo Mohs for Basal Cell Carcinoma Skin Cancer

Comparative Medicine - OneHealth and Comparative Medicine Poster SessionMohs skin cancer surgery is also known as microscopically-controlled surgery because at each stage in the Mohs procedure, a new layer of tissue is obtained surgically and frozen sections made, allowing a microscopic reading of the tissue margins. The Mohs technique, sometimes requiring 3 or more hours because of the pathology determinations, is repeated until the final surgical margins are clear, allowing an overall cure rate exceeding ~97%. Mohs surgery, although more costly than traditional excisional surgery or simple curettage, is often advocated for patients because of the high rate of cure and because it is said to be tissue sparing, requiring no wider margins than the minimal margins needed for tumor clearance. A novel optical technique which would allow skin cancer margin determination is an important goal of the dermatology image research community, because such a technique would eliminate the lengthy and expensive intervening pathology steps, greatly reducing clinic time spent on the procedure, yielding a similar cure rate at a much lower cost. An Italian research group has reported a cure rate for excisional surgery exceeding 98%. Using a tissue optic phenomenon in dermoscopy called “semitranslucency.” Dermoscopic semistranslucency, first described by researchers at S&A and colleagues, has been used in one clinic to determine successful extirpation using curettage. We have confirmed that semitranslucency yields good indication of whether any skin cancer remains. This report describes the use of semitranslucency and the distinction of semitranslucency from two competing structures: white chrysalis structures and sparkling orange structures, visible with cross-polarized light. Plans to further optimize the cross-polarized light source are presented

Approximate Lesion Localization in Dermoscopy Images

Background: Dermoscopy is one of the major imaging modalities used in the diagnosis of melanoma and other pigmented skin lesions. Due to the difficulty and subjectivity of human interpretation, automated analysis of dermoscopy images has become an important research area. Border detection is often the first step in this analysis. Methods: In this article, we present an approximate lesion localization method that serves as a preprocessing step for detecting borders in dermoscopy images. In this method, first the black frame around the image is removed using an iterative algorithm. The approximate location of the lesion is then determined using an ensemble of thresholding algorithms. Results: The method is tested on a set of 428 dermoscopy images. The localization error is quantified by a metric that uses dermatologist determined borders as the ground truth. Conclusion: The results demonstrate that the method presented here achieves both fast and accurate localization of lesions in dermoscopy images

Detection of Solid Pigment in Dermatoscopy Images using Texture Analysis

Background/aims: Epiluminescence microscopy (ELM), also known as dermoscopy or dermatoscopy, is a non-invasive, in vivo technique, that permits visualization of features of pigmented melanocytic neoplasms that are not discernable by examination with the naked eye. ELM offers a completely new range of visual features. One such feature is the solid pigment, also called the blotchy pigment or dark structureless area. Our goal was to automatically detect this feature and determine whether its presence is useful in distinguishing benign from malignant pigmented lesions. Methods: Here, a texture-based algorithm is developed for the detection of solid pigment. The factors d and a used in calculating neighboring gray level dependence matrix (NGLDM) numbers were chosen as optimum by experimentation. The algorithms are tested on a set of 37 images. A new index is presented for separation of benign and malignant lesions, based on the presence of solid pigment in the periphery. Results: The NGLDM large number emphasis N2 was satisfactory for the detection of the solid pigment. Nine lesions had solid pigment detected, and among our 37 lesions, no melanoma lacked solid pigment. The index for separation of benign and malignant lesions was applied to the nine lesions. We were able to separate the benign lesions with solid pigment from the malignant lesions with the exception of only one lesion, a Spitz nevus that mimicked a malignant melanoma. Conclusion: Texture methods may be useful in detecting important dermatoscopy features in digitized images and a new index may be useful in separating benign from malignant lesions. Testing on a larger set of lesions is needed before further conclusions can be made

Neural Networks Skin Tumor Diagnostic System

In this study, a malignant melanoma diagnostic system is designed using a straightforward neural network with the back-propagation learning algorithm. Eleven features are automatically extracted from skin tumor images. The correct diagnostic rate of this system is better than the average rate of 16 dermatologists who based their diagnosis with only the slide images

A Novel Morphological Operator to Calculate Euler Number

This paper introduces a novel morphological operator to calculate the Euler number for binary images. The operator is based on the condition of eight-connectedness for foreground and four-connectedness for background. It is significantly faster than the previous operators. The morphological operations used in border detection are discusse

Border Detection on Digitized Skin Tumor Images

A radial search technique is presented for detecting skin tumor borders in clinical dermatology images. First, it includes two rounds of radial search based on the same tumor center. The first-round search is independent, and the second-round search is knowledge-based tracking. Then a rescan with a new center is used to solve the blind-spot problem. The algorithm is tested on model images with excellent performance, and on 300 real clinical images with a satisfactory resul

Automatic Color Segmentation of Images with Application to Detection of Variegated Coloring in Skin Tumors

A description is given of a computer vision system, developed to serve as the front-end of a medical expert system, that automates visual feature identification for skin tumor evaluation. The general approach is to create different software modules that detect the presence or absence of critical features. Image analysis with artificial intelligence (AI) techniques, such as the use of heuristics incorporated into image processing algorithms, is the primary approach. On a broad scale, this research addressed the problem of segmentation of a digital image based on color information. The algorithm that was developed to segment the image strictly on the basis of color information was shown to be a useful aid in the identification of tumor border, ulcer, and other features of interest. As a specific application example, the method was applied to 200 digitized skin tumor images to identify the feature called variegated coloring. Extensive background information is provided, and the development of the algorithm is described

Applying Artificial Intelligence to the Identification of Variegated Coloring in Skin Tumors

The importance of color information for the automatic diagnosis of skin tumors by computer vision is demonstrated. The utility of the relative color concept is proved by the results in identifying variegated coloring. A feature file paradigm is shown to provide an effective methodology for the independent development of software modules for expert system/computer vision research. An automatic induction tool is used effectively to generate rules for identifying variegated coloring. Variegated coloring can be identified at rates as high as 92% when using the automatic induction technique in conjunction with the color segmentation metho

Detection of Skin Tumor Boundaries in Color Images

A simple and yet effective method for finding the borders of tumors is presented as an initial step towards the diagnosis of skin tumors from their color images. The method makes use of an adaptive color metric from the red, green, and blue planes that contains information for discriminating the tumor from the background. Using this suitable coordinate transformation, the image is segmented. The tumor portion is then extracted from the segmented image and borders are drawn. Experimental results that verify the effectiveness of this approach are give

Neural Network Diagnosis of Malignant Melanoma from Color Images

Malignant melanoma is the deadliest form of all skin cancers. Approximately 32,000 new cases of malignant melanoma were diagnosed in 1991, with approximately 80 percent of patients expected to survive five years [1]. Fortunately, if detected early, even malignant melanoma may be treated successfully. Thus, in recent years, there has been a rising interest in the automated detection and diagnosis of skin cancer, particularly malignant melanoma [2]. In this paper, we present a novel neural network approach for the automated separation of melanoma from three other benign categories of tumors which exhibit melanoma-like characteristics. Our approach is based on devising new and discriminant features which are used as inputs to an artificial neural network for classification of tumor images as malignant or benign. We have obtained promising results using our method on real skin cancer images