Basal Cell Carcinoma Diagnosis with Fusion of Deep Learning and Telangiectasia Features.

In recent years, deep learning (DL) has been used extensively and successfully to diagnose different cancers in dermoscopic images. However, most approaches lack clinical inputs supported by dermatologists that could aid in higher accuracy and explainability. To dermatologists, the presence of telangiectasia, or narrow blood vessels that typically appear serpiginous or arborizing, is a critical indicator of basal cell carcinoma (BCC). Exploiting the feature information present in telangiectasia through a combination of DL-based techniques could create a pathway for both, improving DL results as well as aiding dermatologists in BCC diagnosis. This study demonstrates a novel "fusion" technique for BCC vs non-BCC classification using ensemble learning on a combination of (a) handcrafted features from semantically segmented telangiectasia (U-Net-based) and (b) deep learning features generated from whole lesion images (EfficientNet-B5-based). This fusion method achieves a binary classification accuracy of 97.2%, with a 1.3% improvement over the corresponding DL-only model, on a holdout test set of 395 images. An increase of 3.7% in sensitivity, 1.5% in specificity, and 1.5% in precision along with an AUC of 0.99 was also achieved. Metric improvements were demonstrated in three stages: (1) the addition of handcrafted telangiectasia features to deep learning features, (2) including areas near telangiectasia (surround areas), (3) discarding the noisy lower-importance features through feature importance. Another novel approach to feature finding with weak annotations through the examination of the surrounding areas of telangiectasia is offered in this study. The experimental results show state-of-the-art accuracy and precision in the diagnosis of BCC, compared to three benchmark techniques. Further exploration of deep learning techniques for individual dermoscopy feature detection is warranted.

LAMA: Lesion-Aware Mixup Augmentation for Skin Lesion Segmentation.

Deep learning can exceed dermatologists' diagnostic accuracy in experimental image environments. However, inaccurate segmentation of images with multiple skin lesions can be seen with current methods. Thus, information present in multiple-lesion images, available to specialists, is not retrievable by machine learning. While skin lesion images generally capture a single lesion, there may be cases in which a patient's skin variation may be identified as skin lesions, leading to multiple false positive segmentations in a single image. Conversely, image segmentation methods may find only one region and may not capture multiple lesions in an image. To remedy these problems, we propose a novel and effective data augmentation technique for skin lesion segmentation in dermoscopic images with multiple lesions. The lesion-aware mixup augmentation (LAMA) method generates a synthetic multi-lesion image by mixing two or more lesion images from the training set. We used the publicly available International Skin Imaging Collaboration (ISIC) 2017 Challenge skin lesion segmentation dataset to train the deep neural network with the proposed LAMA method. As none of the previous skin lesion datasets (including ISIC 2017) has considered multiple lesions per image, we created a new multi-lesion (MuLe) segmentation dataset utilizing publicly available ISIC 2020 skin lesion images with multiple lesions per image. MuLe was used as a test set to evaluate the effectiveness of the proposed method. Our test results show that the proposed method improved the Jaccard score 8.3% from 0.687 to 0.744 and the Dice score 5% from 0.7923 to 0.8321 over a baseline model on MuLe test images. On the single-lesion ISIC 2017 test images, LAMA improved the baseline model's segmentation performance by 0.08%, raising the Jaccard score from 0.7947 to 0.8013 and the Dice score 0.6% from 0.8714 to 0.8766. The experimental results showed that LAMA improved the segmentation accuracy on both single-lesion and multi-lesion dermoscopic images. The proposed LAMA technique warrants further study.

Hybrid Topological Data Analysis and Deep Learning for Basal Cell Carcinoma Diagnosis.

A critical clinical indicator for basal cell carcinoma (BCC) is the presence of telangiectasia (narrow, arborizing blood vessels) within the skin lesions. Many skin cancer imaging processes today exploit deep learning (DL) models for diagnosis, segmentation of features, and feature analysis. To extend automated diagnosis, recent computational intelligence research has also explored the field of Topological Data Analysis (TDA), a branch of mathematics that uses topology to extract meaningful information from highly complex data. This study combines TDA and DL with ensemble learning to create a hybrid TDA-DL BCC diagnostic model. Persistence homology (a TDA technique) is implemented to extract topological features from automatically segmented telangiectasia as well as skin lesions, and DL features are generated by fine-tuning a pre-trained EfficientNet-B5 model. The final hybrid TDA-DL model achieves state-of-the-art accuracy of 97.4% and an AUC of 0.995 on a holdout test of 395 skin lesions for BCC diagnosis. This study demonstrates that telangiectasia features improve BCC diagnosis, and TDA techniques hold the potential to improve DL performance.

SharpRazor: Automatic removal of hair and ruler marks from dermoscopy images.

BACKGROUND: The removal of hair and ruler marks is critical in handcrafted image analysis of dermoscopic skin lesions. No other dermoscopic artifacts cause more problems in segmentation and structure detection. PURPOSE: The aim of the work is to detect both white and black hair, artifacts and finally inpaint correctly the image. METHOD: We introduce a new algorithm: SharpRazor, to detect hair and ruler marks and remove them from the image. Our multiple-filter approach detects hairs of varying widths within varying backgrounds, while avoiding detection of vessels and bubbles. The proposed algorithm utilizes grayscale plane modification, hair enhancement, segmentation using tri-directional gradients, and multiple filters for hair of varying widths. We develop an alternate entropy-based processing adaptive thresholding method. White or light-colored hair, and ruler marks are detected separately and added to the final hair mask. A classifier removes noise objects. Finally, a new technique of inpainting is presented, and this is utilized to remove the detected object from the lesion image. RESULTS: The proposed algorithm is tested on two datasets, and compares with seven existing methods measuring accuracy, precision, recall, dice, and Jaccard scores. SharpRazor is shown to outperform existing methods. CONCLUSION: The Shaprazor techniques show the promise to reach the purpose of removing and inpaint both dark and white hair in a wide variety of lesions.

Skin Lesion Segmentation in Dermoscopic Images with Noisy Data.

We propose a deep learning approach to segment the skin lesion in dermoscopic images. The proposed network architecture uses a pretrained EfficientNet model in the encoder and squeeze-and-excitation residual structures in the decoder. We applied this approach on the publicly available International Skin Imaging Collaboration (ISIC) 2017 Challenge skin lesion segmentation dataset. This benchmark dataset has been widely used in previous studies. We observed many inaccurate or noisy ground truth labels. To reduce noisy data, we manually sorted all ground truth labels into three categories - good, mildly noisy, and noisy labels. Furthermore, we investigated the effect of such noisy labels in training and test sets. Our test results show that the proposed method achieved Jaccard scores of 0.807 on the official ISIC 2017 test set and 0.832 on the curated ISIC 2017 test set, exhibiting better performance than previously reported methods. Furthermore, the experimental results showed that the noisy labels in the training set did not lower the segmentation performance. However, the noisy labels in the test set adversely affected the evaluation scores. We recommend that the noisy labels should be avoided in the test set in future studies for accurate evaluation of the segmentation algorithms.

Improving Automatic Melanoma Diagnosis Using Deep Learning-Based Segmentation of Irregular Networks.

Deep learning has achieved significant success in malignant melanoma diagnosis. These diagnostic models are undergoing a transition into clinical use. However, with melanoma diagnostic accuracy in the range of ninety percent, a significant minority of melanomas are missed by deep learning. Many of the melanomas missed have irregular pigment networks visible using dermoscopy. This research presents an annotated irregular network database and develops a classification pipeline that fuses deep learning image-level results with conventional hand-crafted features from irregular pigment networks. We identified and annotated 487 unique dermoscopic melanoma lesions from images in the ISIC 2019 dermoscopic dataset to create a ground-truth irregular pigment network dataset. We trained multiple transfer learned segmentation models to detect irregular networks in this training set. A separate, mutually exclusive subset of the International Skin Imaging Collaboration (ISIC) 2019 dataset with 500 melanomas and 500 benign lesions was used for training and testing deep learning models for the binary classification of melanoma versus benign. The best segmentation model, U-Net++, generated irregular network masks on the 1000-image dataset. Other classical color, texture, and shape features were calculated for the irregular network areas. We achieved an increase in the recall of melanoma versus benign of 11% and in accuracy of 2% over DL-only models using conventional classifiers in a sequential pipeline based on the cascade generalization framework, with the highest increase in recall accompanying the use of the random forest algorithm. The proposed approach facilitates leveraging the strengths of both deep learning and conventional image processing techniques to improve the accuracy of melanoma diagnosis. Further research combining deep learning with conventional image processing on automatically detected dermoscopic features is warranted.

ChimeraNet: U-Net for Hair Detection in Dermoscopic Skin Lesion Images.

Hair and ruler mark structures in dermoscopic images are an obstacle preventing accurate image segmentation and detection of critical network features. Recognition and removal of hairs from images can be challenging, especially for hairs that are thin, overlapping, faded, or of similar color as skin or overlaid on a textured lesion. This paper proposes a novel deep learning (DL) technique to detect hair and ruler marks in skin lesion images. Our proposed ChimeraNet is an encoder-decoder architecture that employs pretrained EfficientNet in the encoder and squeeze-and-excitation residual (SERes) structures in the decoder. We applied this approach at multiple image sizes and evaluated it using the publicly available HAM10000 (ISIC2018 Task 3) skin lesion dataset. Our test results show that the largest image size (448 × 448) gave the highest accuracy of 98.23 and Jaccard index of 0.65 on the HAM10000 (ISIC 2018 Task 3) skin lesion dataset, exhibiting better performance than for two well-known deep learning approaches, U-Net and ResUNet-a. We found the Dice loss function to give the best results for all measures. Further evaluated on 25 additional test images, the technique yields state-of-the-art accuracy compared to 8 previously reported classical techniques. We conclude that the proposed ChimeraNet architecture may enable improved detection of fine image structures. Further application of DL techniques to detect dermoscopy structures is warranted.

Deep Learning and Handcrafted Method Fusion: Higher Diagnostic Accuracy for Melanoma Dermoscopy Images.

This paper presents an approach that combines conventional image processing with deep learning by fusing the features from the individual techniques. We hypothesize that the two techniques, with different error profiles, are synergistic. The conventional image processing arm uses three handcrafted biologically inspired image processing modules and one clinical information module. The image processing modules detect lesion features comparable to clinical dermoscopy information-atypical pigment network, color distribution, and blood vessels. The clinical module includes information submitted to the pathologist-patient age, gender, lesion location, size, and patient history. The deep learning arm utilizes knowledge transfer via a ResNet-50 network that is repurposed to predict the probability of melanoma classification. The classification scores of each individual module from both processing arms are then ensembled utilizing logistic regression to predict an overall melanoma probability. Using cross-validated results of melanoma classification measured by area under the receiver operator characteristic curve (AUC), classification accuracy of 0.94 was obtained for the fusion technique. In comparison, the ResNet-50 deep learning based classifier alone yields an AUC of 0.87 and conventional image processing based classifier yields an AUC of 0.90. Further study of fusion of conventional image processing techniques and deep learning is warranted.