Histologic Screening of Malignant Melanoma, Spitz, Dermal and Junctional Melanocytic Nevi Using a Deep Learning Model

Am J Dermatopathol. 2022 Sep 1;44(9):650-657. doi: 10.1097/DAD.0000000000002232. Epub 2022 Jul 19.


Objective: The integration of an artificial intelligence tool into pathologists' workflow may lead to a more accurate and timely diagnosis of melanocytic lesions, directly patient care. The objective of this study was to create and evaluate the performance of such a model in achieving clinical-grade diagnoses of Spitz nevi, dermal and junctional melanocytic nevi, and melanomas.

Methods: We created a beginner-level training environment by teaching our algorithm to perform cytologic inferences on 136,216 manually annotated tiles of hematoxylin and eosin-stained slides consisting of unequivocal melanocytic nevi, Spitz nevi, and invasive melanoma cases. We sequentially trained and tested our network to provide a final diagnosis-classification on 39 cases in total. Positive predictive value (precision) and sensitivity (recall) were used to measure our performance.

Results: The tile-classification algorithm predicted the 136,216 irrelevant, melanoma, melanocytic nevi, and Spitz nevi tiles at sensitivities of 96%, 93%, 94% and 73%, respectively. The final trained model was able to correctly classify and predict the correct diagnosis in 85.7% of unseen cases (n = 28), reporting at or near screening-level performances for precision and recall of melanoma (76.2%, 100.0%), melanocytic nevi (100.0%, 75.0%), and Spitz nevi (100.0%, 75.0%).

Conclusions: Our pilot study proves that convolutional networks trained on cellular morphology to classify melanocytic proliferations can be used as a powerful tool to assist pathologists in screening for melanoma versus other benign lesions.

MeSH terms

  • Artificial Intelligence
  • Deep Learning*
  • Diagnosis, Differential
  • Humans
  • Melanoma* / diagnosis
  • Melanoma* / pathology
  • Nevus, Epithelioid and Spindle Cell* / diagnosis
  • Nevus, Pigmented* / pathology
  • Pilot Projects
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / pathology

Supplementary concepts

  • Melanoma, Cutaneous Malignant