The growing incidence of skin cancer makes computer-aided diagnosis tools for this group of diseases increasingly important. The use of ultrasound has the potential to complement information from optical dermoscopy. The current work presents a fully automatic classification framework utilizing fully-automated (FA) segmentation and compares it with classification using two semi-automated (SA) segmentation methods. Ultrasound recordings were taken from a total of 310 lesions (70 melanoma, 130 basal cell carcinoma and 110 benign nevi). A support vector machine (SVM) model was trained on 62 features, with ten-fold cross-validation. Six classification tasks were considered, namely all the possible permutations of one class versus one or two remaining classes. The receiver operating characteristic (ROC) area under the curve (AUC) as well as the accuracy (ACC) were measured. The best classification was obtained for the classification of nevi from cancerous lesions (melanoma, basal cell carcinoma), with AUCs of over 90% and ACCs of over 85% obtained with all segmentation methods. Previous works have either not implemented FA ultrasound-based skin cancer classification (making diagnosis more lengthy and operator-dependent), or are unclear in their classification results. Furthermore, the current work is the first to assess the effect of implementing FA instead of SA classification, with FA classification never degrading performance (in terms of AUC or ACC) by more than 5%.

A compact handheld skin ultrasound imaging device has been developed that uses co-registered optical and ultrasound imaging to provide diagnostic information about the full skin depth. The aim of the current work is to present the preliminary clinical results of this device. Using additional photographic, dermoscopic and ultrasonic images as reference, the images from the device were assessed in terms of the detectability of the main skin layer boundaries and characteristic image features. Combined optical-ultrasonic recordings of various types of skin lesions (melanoma, basal cell carcinoma, seborrheic keratosis, dermatofibroma, naevus, dermatitis and psoriasis) were taken with the device (N = 53) and compared with images captured with a reference portable skin ultrasound imager. The investigator and two additional independent experts performed the evaluation. The detectability of skin structures was over 90% for the epidermis, the dermis and the lesions. The morphological and echogenicity information observed for the different skin lesions were found consistent with those of the reference ultrasound device and relevant ultrasound images in the literature. The presented device was able to obtain simultaneous in-vivo optical and ultrasound images of various skin lesions. This has the potential for further investigations, including the preoperative planning of skin cancer treatment.

ObjectivesA compact handheld skin ultrasound imaging device has been developed that uses co-registered optical and ultrasound imaging to provide diagnostic information about the full skin depth and lesions encountered therein. The aim of the current work is to present the first clinical results of the device. Using additional photographic, dermoscopic and ultrasonic images as reference, the images from the device are assessed in terms of the detectability of the skin layer boundaries (between the epidermis, dermis, and subcutis), and in terms of image features produced by common skin lesions.MethodsCombined optical-ultrasonic recordings of various types of common skin lesions (melanoma, basal cell carcinoma, keratosis, dermatofibroma, naevus, dermatitis, psoriasis) were taken with the device (N = 53) and compared with images from a reference portable skin ultrasound imager. The investigator and two additional independent experts evaluated and compared the images in terms of skin structure detectability and skin lesion features.ResultsSkin structure detectability was unanimously over 90 % for epidermis, dermis and lesion. Morphological and echogenicity information observed for melanoma, basal cell carcinoma, keratoses, dermatofibroma, naevi, atopic dermatitis, psoriasis were found consistent with those of the reference ultrasound device and relevant ultrasound images in the literature.ConclusionsThe presented device is able to obtain simultaneous in-vivo optical and ultrasound images of common skin lesions. This has the potential to provide relevant information in a number of settings to be investigated in the future, including preoperative planning of skin cancer treatment.