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12 March 2008 Existence and perception of textural information predictive of atypical nevi: preliminary insights
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Texture is known to predict atypicality in pigmented skin lesions. This paper describes an experiment that was conducted to determine 1) if this textural information is present in the center of skin lesions, and 2) how color affects the perception of this information. Images of pigmented skin lesions from three categories were shown to subjects in such a way that only textural information could be perceived; other factors known to predict atypicality were removed or held constant. These images were shown in both color and grayscale. Each subject assigned a score of atypicality to each image. The experiment was conducted on 5 subjects of varying backgrounds, including one expert. Each subject's accuracy under each modality was measured by calculating the volume under a 3-way ROC surface. The modalities were compared using the Dorfman-Berbaum-Metz (DBM) method of ROC analysis, giving a p-value of 0.8611. Therefore the null hypothesis that there is no difference between the predictive power of the modalities cannot be rejected. Also, a two one-sided test of equivalence (TOST) was performed giving a p-value pair of < 0.01; strong evidence that the textural information is independent of color. Additionally, the subjects' accuracies were compared to a set of random readers using the DBM and TOST methods. This was done for accuracies under the color modality, the grayscale modality and both modalities simultaneously. The results (all p-values < 0.001) confirm the existence of textural information predictive of atypia in the center of pigmented skin lesions.
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Paul Wighton, Tim K. Lee, David McLean M.D., Harvey Lui M.D., and M. Stella Atkins "Existence and perception of textural information predictive of atypical nevi: preliminary insights", Proc. SPIE 6917, Medical Imaging 2008: Image Perception, Observer Performance, and Technology Assessment, 69170J (12 March 2008);

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