Development of a new program for image analysis of digital videomicroscopic images of pigmented skin lesions

Although an improvement of the diagnostic accuracy of pigmented skin lesions (PSL) has been achieved by the epiluminescence technique (ELM), the interpretation of ELM criteria is often confusing, especially for inexperienced observers. To enhance the reproducibility and accuracy of clinical judgement and the training of inexperienced operators, programs for PSL image analysis and algorithms for automatic diagnosis have been developed. The aim of our study was to develop a new program for PSL image analysis, able to describe different aspects of PSLs and to test its descriptive capability on PSL acquired by means of a digital videomicroscope (VMS 110A, Scalar Mitsubishi, Japan) using 20-fold magnification. After automatic border identification and baricentre determination, some geometric parameters, describing shape characteristics of the lesion, were calculated. A mathematical description of the border cut-off was obtained. The texture of the lesion was calculated applying the co-occurrence matrix at different image resolutions. Dark areas and colour areas, referring to selected colour groups, were obtained and their aspect and distribution were mathematically defined and calculated. 281 common nevi and 117 melanomas were numerically described by our program and the capability of the mathematical parameters to distinguish between benign and malignant lesion was tested by means of discriminant analysis. Significant differences were observed for most parameters between different PSL populations. The automatic classification enabled the distinction between melanomas and nevi with a 100% sensitivity and a 82.9% specificity.