Border cut-off in dermoscopic images of melanocytic lesions: computer evaluation and comparison with clinical assessment

The description of the border appears to be an important feature for clinical judgement in dermatoscopy, but it is subjective and can lead to different results depending on the examiners’ experience. In order to provide mathematical descriptors for border regularity and to increase the reproducibility of clinical judgement, a method to quantify border characteristics and to automatically reproduce the B (Border) parameters of the ABCD rule was developed. 331 images of pigmented skin lesions, 113 referring to melanomas and 218 to melanocytic naevi, acquired by a digital videomicroscope with a 20× magnification were studied. Clinical evaluation: for the evaluation of border cut-off, a score ranging to 0 from 8 was attributed to each lesion on the basis of the number of segments with an abrupt edge interruption of the pigmentation. Computer elaboration: after automatic border detection, the skin lesion gradient, defined as the change in lightness values along a 30 pixel long segment centred on the lesion border, expressed as the slope of the curve, was calculated along a 30 pixel segment. Minimum and maximum values and the standard deviation were calculated for the description of border regularity. In order to compare clinical and computer evaluation, the lesion border was divided into 8 segments and a threshold for abrupt border cut-off was set on a visual basis. Melanomas presented more abrupt and inhomogeneous margins in respect of melanocytic naevi. A good correlation between clinical evaluation and computer elaboration was found for the number of borders with an abrupt cut-off (rho = 0.834; P < 0.001). Computerized image analysis appears to be able to numerically describe pigmented skin lesions and to reproduce some aspects of the clinical evaluation. Enabling an objective and reproducible description, it could represent a useful support to clinical diagnosis.