Early detection of melanoma

Early detection of melanoma utilising 3D body imaging technology

Melanoma is the most severe type of skin cancer. Developing from epidermal melanocytes or pigment-producing cells in the skin, melanoma usually occurs on parts of the body that have been overexposed to the sun. Early detection and recognition of melanoma is critical for successful treatment.

This project developed an innovative clinical workflow, utilising a 3D total body imaging system, linked to electronic medical records. These records will subsequently be integrated into telehealth networks to improve patient access and equity to healthcare. This novel approach will in turn facilitate the more accurate screening and earlier diagnosis of skin cancers and lesions in high-risk patients.

Outcomes from this study formed the foundations of the Australian Cancer Research Foundation (ACRF) Australia Centre of Excellence in Melanoma Imaging and Diagnosis (ACEMID) Study, which commenced in Brisbane in February 2021. The ACEMID Study will see the establishment of a network of 15 3D total body skin imaging systems, and the development of specialised technology infrastructure to form a multi-disciplinary, multi-site centre of excellence across three Australian states for melanoma and skin cancer detection.

Outcomes

• A comparison study that assessed the diagnostic agreement and clinical decision-making between tele-derm and face-to-face dermatology assessment was completed. This comparison study involved a sample of 41 participants.
• A high-risk melanoma clinic was established within the dermatology department at Princess Alexandra Hospital (PAH), utilising the workflow established in this study. The clinic operates one session per week and sees four to five high-risk patients. Patients are seen by registrars under the supervision of consultant dermatologists, thus contributing to another key project objective, to train the next generation of dermatologists. Since opening, the clinic has seen almost 400 patients.
• A consumer framework was developed and takes into consideration privacy and data handling requirements and protecting patient data.
• Development of bespoke web-based software tools to improve the efficiency of labelling images for machine learning applications. This includes labelling of “ugly duckling” lesions (moles that look obviously different from other moles on an individual and should raise suspicion for melanomas) from patient image sets, and a multi-lesion labelling tool.
• Design of Dermatologist Report – working with the industry partner Canfield Scientific, the teams have created a dermatologist report for documenting lesions of concern. This will be used as a standardised report for the review of pigmented skin and lesions in skin cancer screening, and to communicate between patient clinicians.

Next steps

• Working under the ACRF ACEMID Cohort Study, the project team received other funding to establish a familial melanoma research clinic over three years. Recruitment began at the PAH site in February 2021, with the first participant visit conducted later that same month.
• The PAH site is currently staffed by two part-time melanographers and six part-time clinicians. A total of 832 participants have been recruited for an NHMRC funded Melanoma Cohort Study to date, with 752 completing baseline study visits.
• A second ACEMID site opened at Herston Imaging Research Facility (HIRF) at the RBWH in August 2022. A total of 187 patients have been recruited, and 93 have completed baseline study visits.
• Across Queensland, new ACEMID sites will be opening at Sunshine Coast University Hospital, Cairns, and Mt Isa in 2023, which will further utilise and develop teledermatology networks.

Project investigators

Project leaders engage with and draw on the expertise of partners within universities, research institutes, and hospital and health services around Queensland.

• Professor H. Peter Soyer, Chair in Dermatology, The University of Queensland (Lead)
• Dr Brigid Betz-Stablein, Post Doctorial Research Fellow, The University of Queensland (Biostatistician)
• Associate Professor Liam Caffery, Telehealth and Director of Telehealth Technology, The University of Queensland
• Dr Aideen McInerney-Leo, Senior Research Fellow, The University of Queensland