CLASSIFICATION OF BASAL CELL CARCINOMA IN EX VIVO CONFOCAL MICROSCOPY IMAGES FROM FRESHLY EXCISED TISSUES USING A DEEP LEARNING ALGORITHM.

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Abstract

Ex vivo confocal microscopy (EVCM) generates digitally colored purple-pink images similar to H&E, without time-consuming tissue processing. It can be used during Mohs surgery for rapid detection of basal cell carcinoma (BCC); however, reading EVCM images requires specialized training. An automated approach using a Deep Learning algorithm to BCC detection in EVCM images can aid in diagnosis. 40 BCCs and 28 negative (“not-BCC”) samples were collected at Memorial Sloan Kettering Cancer Center to create three training datasets: 1) EVCM image dataset (663 images), 2) H&E image dataset (516 images), and 3) a combination of the two datasets. 7 BCCs and 4 negative samples were collected to create a EVCM test dataset (107 images). The model trained with the EVCM dataset achieved 92% diagnostic accuracy, similar to the H&E model (93%). The area under ROC was 0.94, 0.95, and 0.94 for EVCM, H&E, and combination trained models, respectively. We developed an algorithm for automatic BCC detection in EVCM images (comparable accuracy to dermatologists). This approach could be used to assist with BCC detection during Mohs surgery. Furthermore, we found that a model trained with only H&E images (which are more available than EVCM images) can accurately detect BCC in EVCM images.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.