Timo Buhl, MD, Christian Hansen-Hagge, MD, Bianca Korpas, Kjell M

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Presentation transcript:

Integrating static and dynamic features of melanoma: The DynaMel algorithm Timo Buhl, MD, Christian Hansen-Hagge, MD, Bianca Korpas, Kjell M. Kaune, MD, Ellen Haas, MD, Albert Rosenberger, MD, Michael P. Schön, MD, Steffen Emmert, MD, Holger A. Haenssle, MD Journal of the American Academy of Dermatology Volume 66, Issue 1, Pages 27-36 (January 2012) DOI: 10.1016/j.jaad.2010.09.731 Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Area under curve (AUC) of receiver operating characteristic (ROC) and Brier scores. Of 25 analyzed models, selection of those with best diagnostic performance is depicted. AUC of ROC and Brier scores help to assess predictive accuracy of models for melanoma diagnosis. Models with best predictive accuracy shown in upper left corner. 1, Seven-point checklist (reference model); 2, DynaMel algorithm; 3, 7-point checklist plus focal or multifocal enlargement plus focal change in pigmentation (2 and 3 represent two best models combining 7-point checklist and dynamic criteria); 4, focal or multifocal enlargement; 5, six combinations of two dynamic criteria (eg, architectural change plus focal/multifocal enlargement) (4 and 5 represent two best models of dynamic criteria only); 6, new weighting of 7-point checklist plus dynamic criteria; 7, new weighting of 7-point checklist criteria alone (6 and 7 represent models with data set optimized weighting of 7-point checklist criteria enriched or not enriched by information about dynamic criteria). Journal of the American Academy of Dermatology 2012 66, 27-36DOI: (10.1016/j.jaad.2010.09.731) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Baseline images (left): 7-point checklist score is 0 points for all. A, Follow-up image at 6 months: focal increase in pigmentation and new irregular dots; DynaMel score: 4 points (7-point checklist score: 1 point; architectural change [new dots]: 2 points; focal increase in pigmentation: 1 point), dysplastic compound nevus. B, Follow-up image at 11 months: focal increase in pigmentation and new irregular dots; DynaMel score: 4 points (7-point checklist score: 1 point; architectural change [new dots]: 2 points; focal increase in pigmentation: 1 point), invasive melanoma (0.9 mm). C, Follow-up image at 12 months: asymmetric multifocal enlargement, new irregular dots, and new irregular streaks; DynaMel score: 6 points (7-point checklist score: 2 points; architectural change [new irregular dots]: 2 points; architectural change [new irregular streaks]: 2 points), invasive melanoma (0.34 mm). D, Follow-up image at 7 months: focal increase in pigmentation and new prominent pigment network; DynaMel score: 5 points (7-point checklist score: 2 points; architectural change [new prominent pigment network]: 2 points; focal increase in pigmentation: 1 point), invasive melanoma (0.25 mm). E, Follow-up image at 10 months: overall hypopigmentation associated with new regression patterns; DynaMel score: 4 points (7-point checklist score: 1 point; architectural change [new regression pattern]: 2 points; overall decrease in pigmentation: 1 point), invasive melanoma (0.5 mm). Journal of the American Academy of Dermatology 2012 66, 27-36DOI: (10.1016/j.jaad.2010.09.731) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Decision tree for DynaMel algorithm. Lesions with signs of atypia were defined to score 2, 1, or 0 points by 7-point checklist. Lesions scoring 0 points were required to present clinical or dermatoscopic criteria of atypia not included in 7-point checklist (eg, asymmetry in shape, irregular margin, color variegation) to initiate digital dermatoscopy follow-up. Journal of the American Academy of Dermatology 2012 66, 27-36DOI: (10.1016/j.jaad.2010.09.731) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions