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MELANOMA SCREENING,
DIAGNOSIS, AND PREVENTION, OR
WILL ARTIFICIAL INTELLIGENCE
PUT ME OUT OF A JOB?
HTTP://MDACC.PARTICIPO...
■ No conflicts
http://mdacc.participoll.com/
What is your relationship to melanoma?
■ A: I have not had melanoma and I don’t
know anyone who has
■ B: I have not had me...
If you have been diagnosed with
melanoma, who found your melanoma?
■ A: I did
■ B: family/friend
■ C: a physician/provider...
If your melanoma was found by a
physician, what kind?
■ A: primary care provider
■ B: dermatologist
■ C: surgeon
■ D: othe...
If you found your melanoma, when you
showed it to a doctor, what did he/she say?
■ A: yep, that’s a melanoma
■ B: that loo...
Melanoma Prevention
■ Primary
– Let’s keep it from
happening in the
first place
■ Secondary
– When it happens
let’s diagno...
Seeing
it
Diagnosing
it
Access to
care
Melanoma Secondary Prevention
Seeing
it
Diagnosing
it
Access to
care
Melanoma Secondary Prevention
Seeing
it
Diagnosing
it
Access to
care
Melanoma Secondary Prevention
Superficial spreading melanoma, Breslow depth 0.7 mm
Melanoma in situ
Melanoma in situ
Seeing
it
Diagnosing
it
Access to
care
Melanoma Secondary Prevention
Ugly duckling
Ugly Duckling
Ugly Duckling
Clinically subtle melanoma
Diagnostic technologies
■ Reflectance confocal
microscopy
■ Optical coherence tomography
■ High frequency ultrasound
■ Tap...
Dermoscopy
Lancet Oncol 2002;3(3):159-65; PMID 11902502
Dermoscopy
■ Pigmented basal
cell carcinoma
– Vessels: crisp,
arborizing
– Pigment:
blue/grey ovoid
nests
– ulceration
■ M...
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
0A B
0A B
Which one is the melanoma?
A B
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
0A B
0A B
Which one is the melanoma?
A B
0A B
Which one is the melanoma?
A B
Automated dermoscopic analysis
MelaFind
 Automated multispectral
dermoscopy analysis
 FDA approved
 Expensive
 Sensiti...
0A B
Have you heard about this?
A: yes
B: no
Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
http://mdacc.participoll....
Artificial Intelligence and Image
Recognition
■ Feature extraction + Classification
■ Deep Convolutional Neural Network
– ...
https://medium.com/@ageitgey/machine-learning-is-fun-part-3-deep-learning-and-convolutional-neural-networks-f40359318721
h...
Classification
https://devblogs.nvidia.com/parallelforall/deep-learning-nutshell-core-concepts/
Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
Essential Next Steps
■ Validation
■ Validation
■ Validation
Take Home Points
■ Primary Prevention: UV protection
■ Secondary Prevention: Patient Access, Seeing it, Diagnostic Accurac...
Melanoma Screening, Diagnosis, and Prevention – Kelly C. Nelson, MD
Melanoma Screening, Diagnosis, and Prevention – Kelly C. Nelson, MD
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Melanoma Screening, Diagnosis, and Prevention – Kelly C. Nelson, MD

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Kelly Nelson, MD, PhD, provides an update on melanoma screening, diagnosis and prevention at the 2017 MD Anderson Melanoma Patient Symposium held in Austin, TX on May 6, 2017.

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Melanoma Screening, Diagnosis, and Prevention – Kelly C. Nelson, MD

  1. 1. MELANOMA SCREENING, DIAGNOSIS, AND PREVENTION, OR WILL ARTIFICIAL INTELLIGENCE PUT ME OUT OF A JOB? HTTP://MDACC.PARTICIPOLL.COM/ Kelly Nelson, MD FAAD Associate Professor Department of Dermatology MD Anderson Cancer Center
  2. 2. ■ No conflicts http://mdacc.participoll.com/
  3. 3. What is your relationship to melanoma? ■ A: I have not had melanoma and I don’t know anyone who has ■ B: I have not had melanoma, but I know someone who has ■ C: I have been diagnosed with melanoma, but it was not in my lymph nodes (stage 0-II) ■ D: I have been diagnosed with melanoma, and it was only in my lymph nodes (stage III) ■ E: I have been diagnosed with melanoma that has spread elsewhere in my body (stage IV) 0A B C D E http://mdacc.participoll.com/
  4. 4. If you have been diagnosed with melanoma, who found your melanoma? ■ A: I did ■ B: family/friend ■ C: a physician/provider 0A B C http://mdacc.participoll.com/
  5. 5. If your melanoma was found by a physician, what kind? ■ A: primary care provider ■ B: dermatologist ■ C: surgeon ■ D: other specialist 0A B C D http://mdacc.participoll.com/
  6. 6. If you found your melanoma, when you showed it to a doctor, what did he/she say? ■ A: yep, that’s a melanoma ■ B: that looks kinda funny, let’s take that off ■ C: that spot is fine, you don’t need to be worried 0A B C http://mdacc.participoll.com/
  7. 7. Melanoma Prevention ■ Primary – Let’s keep it from happening in the first place ■ Secondary – When it happens let’s diagnose it as early as possible
  8. 8. Seeing it Diagnosing it Access to care Melanoma Secondary Prevention
  9. 9. Seeing it Diagnosing it Access to care Melanoma Secondary Prevention
  10. 10. Seeing it Diagnosing it Access to care Melanoma Secondary Prevention
  11. 11. Superficial spreading melanoma, Breslow depth 0.7 mm
  12. 12. Melanoma in situ
  13. 13. Melanoma in situ
  14. 14. Seeing it Diagnosing it Access to care Melanoma Secondary Prevention
  15. 15. Ugly duckling Ugly Duckling
  16. 16. Ugly Duckling
  17. 17. Clinically subtle melanoma
  18. 18. Diagnostic technologies ■ Reflectance confocal microscopy ■ Optical coherence tomography ■ High frequency ultrasound ■ Tape stripping ■ Spectroscopy ■ Expensive ■ Bulky machines ■ Challenging image acquisition ■ True predictive capacity
  19. 19. Dermoscopy Lancet Oncol 2002;3(3):159-65; PMID 11902502
  20. 20. Dermoscopy ■ Pigmented basal cell carcinoma – Vessels: crisp, arborizing – Pigment: blue/grey ovoid nests – ulceration ■ Melanoma – Vessels: disorganized – Pigment: light brown homogenous, reticular pattern, globules http://mdacc.participoll.com/
  21. 21. Which one is the melanoma? A B 0A B
  22. 22. Which one is the melanoma? A B 0A B
  23. 23. Which one is the melanoma? A B 0A B
  24. 24. 0A B Which one is the melanoma? A B
  25. 25. Which one is the melanoma? A B 0A B
  26. 26. Which one is the melanoma? A B 0A B
  27. 27. Which one is the melanoma? A B 0A B
  28. 28. Which one is the melanoma? A B 0A B
  29. 29. 0A B Which one is the melanoma? A B
  30. 30. 0A B Which one is the melanoma? A B
  31. 31. Automated dermoscopic analysis MelaFind  Automated multispectral dermoscopy analysis  FDA approved  Expensive  Sensitivity: 98.4%  Specificity: 9.9% Arch Dermatol 2011;147:188. PMID 20956633
  32. 32. 0A B Have you heard about this? A: yes B: no Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445 http://mdacc.participoll.com/
  33. 33. Artificial Intelligence and Image Recognition ■ Feature extraction + Classification ■ Deep Convolutional Neural Network – Overlapping data intake fields – Convolutional processing – Deep learning ■ GoogleNet Inception v3 CNN architecture
  34. 34. https://medium.com/@ageitgey/machine-learning-is-fun-part-3-deep-learning-and-convolutional-neural-networks-f40359318721 http://cs.nyu.edu/~fergus/tutorials/deep_learning_cvpr12/ Feature extraction
  35. 35. Classification https://devblogs.nvidia.com/parallelforall/deep-learning-nutshell-core-concepts/
  36. 36. Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
  37. 37. Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
  38. 38. Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
  39. 39. Nature. 2017 Feb 2;542(7639):115-118; PMID 28117445
  40. 40. Essential Next Steps ■ Validation ■ Validation ■ Validation
  41. 41. Take Home Points ■ Primary Prevention: UV protection ■ Secondary Prevention: Patient Access, Seeing it, Diagnostic Accuracy ■ Ideal Diagnostic Technology: Portable, Cheap, Accurate ■ Validation is essential

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