Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases

Autor: Sara Bassoli, Giovanni Pellacani, A. Losi, Joseph Malvehy, Federica Arginelli, J. Łudzik, Alexander Witkowski, Francesca Farnetani, Alice Casari, Marco Manfredini, N. De Carvalho, B. De Pace, Elisa Benati, Camilla Reggiani
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Genetics and Molecular Biology (all)
Pathology
Skin Neoplasms
Carcinoma Cells
lcsh:Medicine
Pathology and Laboratory Medicine
Biochemistry
Geographical locations
030207 dermatology & venereal diseases
Computer-Assisted
0302 clinical medicine
Medicine and Health Sciences
lcsh:Science
Cultured Tumor Cells
Microscopy
education.field_of_study
Multidisciplinary
Microscopy
Confocal
Squamous Cell Carcinomas
Telemedicine
Europe
Oncology
Italy
Confocal
030220 oncology & carcinogenesis
Radiology
Biological Cultures
Research Article
Reflectance confocal microscopy
medicine.medical_specialty
Concordance
Population
Histopathology
Dermoscopy
Medical Services
Research and Analysis Methods
Carcinomas
Sensitivity and Specificity
03 medical and health sciences
Signs and Symptoms
Humans
Retrospective Studies
Image Interpretation
Computer-Assisted
Biochemistry
Genetics and Molecular Biology (all)
Agricultural and Biological Sciences (all)
Diagnostic Medicine
medicine
Cancer Detection and Diagnosis
Sensitivity (control systems)
European Union
education
Image Interpretation
business.industry
lcsh:R
Cancers and Neoplasms
Retrospective cohort study
Cell Cultures
Image diagnosis
Health Care
Anatomical Pathology
Lesions
lcsh:Q
Cellular Morphology
People and places
business
Zdroj: PLoS ONE, Vol 12, Iss 11, p e0187748 (2017)
PLoS ONE
ISSN: 1932-6203
Popis: Background Reflectance confocal microscopy (RCM) is an imaging device that permits non-invasive visualization of cellular morphology and has been shown to improve diagnostic accuracy of dermoscopically equivocal cutaneous lesions. The application of double reader concordance evaluation of dermoscopy-RCM image sets in retrospective settings and its potential application to telemedicine evaluation has not been tested in a large study population. Objective To improve diagnostic sensitivity of RCM image diagnosis using a double reader concordance evaluation approach; to reduce mismanagement of equivocal cutaneous lesions in retrospective consultation and telemedicine settings. Methods 1000 combined dermoscopy-RCM image sets were evaluated in blind by 10 readers with advanced training and internship in dermoscopy and RCM evaluation. We compared sensitivity and specificity of single reader evaluation versus double reader concordance evaluation as well as the effect of diagnostic confidence on lesion management in a retrospective setting. Results Single reader evaluation resulted in an overall sensitivity of 95.2% and specificity of 76.3%, with misdiagnosis of 8 melanomas, 4 basal cell carcinomas and 2 squamous cell carcinomas. Combined double reader evaluation resulted in an overall sensitivity of 98.3% and specificity of 65.5%, with misdiagnosis of 1 in-situ melanoma and 2 basal cell carcinomas. Conclusion Evaluation of dermoscopy-RCM image sets of cutaneous lesions by single reader evaluation in retrospective settings is limited by sensitivity levels that may result in potential mismanagement of malignant lesions. Double reader blind concordance evaluation may improve the sensitivity of diagnosis and management safety. The use of a second check can be implemented in telemedicine settings where expert consultation and second opinions may be required.
Databáze: OpenAIRE
Externí odkaz: