{Reference Type}: Journal Article
{Title}: Convolutional neural network assistance significantly improves dermatologists' diagnosis of cutaneous tumours using clinical images.
{Author}: Ba W;Wu H;Chen WW;Wang SH;Zhang ZY;Wei XJ;Wang WJ;Yang L;Zhou DM;Zhuang YX;Zhong Q;Song ZG;Li CX;
{Journal}: Eur J Cancer
{Volume}: 169
{Issue}: 0
{Year}: 07 2022
{Factor}: 10.002
{DOI}: 10.1016/j.ejca.2022.04.015
{Abstract}: Convolutional neural networks (CNNs) have demonstrated expert-level performance in cutaneous tumour classification using clinical images, but most previous studies have focused on dermatologist-versus-CNN comparisons rather than their combination. The objective of our study was to evaluate the potential impact of CNN assistance on dermatologists for clinical image interpretation.<BR>A multi-class CNN was trained and validated using a dataset of 25,773 clinical images comprising 10 categories of cutaneous tumours. The CNN's performance was tested on an independent dataset of 2107 images. A total of 400 images (40 per category) were randomly selected from the test dataset. A fully crossed, self-control, multi-reader multi-case (MRMC) study was conducted to compare the performance of 18 board-certified dermatologists (experience: 13/18 ≤ 10 years; 5/18＞10 years) in interpreting the 400 clinical images with or without CNN assistance.<BR>The CNN achieved an overall accuracy of 78.45% and kappa of 0.73 in the classification of 10 types of cutaneous tumours on 2107 images. CNN-assisted dermatologists achieved a higher accuracy (76.60% vs. 62.78%, P < 0.001) and kappa (0.74 vs. 0.59, P < 0.001) than unassisted dermatologists in interpreting the 400 clinical images. Dermatologists with less experience benefited more from CNN assistance. At the binary classification level (malignant or benign), the sensitivity (89.56% vs. 83.21%, P < 0.001) and specificity (87.90% vs. 80.92%, P < 0.001) of dermatologists with CNN assistance were also significantly improved than those without.<BR>CNN assistance improved dermatologist accuracy in interpreting cutaneous tumours and could further boost the acceptance of this new technique.