
Low-cost, non-invasive melanoma detector wins award - ductionist
https://jamesdysonaward.org/news/skan-james-dyson-award-2017-international-winner/
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dreadmocks
The creators are from McMaster* University in Canada, their names are Rotimi
Fadiya, Prateek Mathur, Michael Takla and Shivad Bhavsar. Really wish they got
the credit in the article.

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epmaybe
questions I have from a clinical perspective: Today, we see skin lesions that
look like melanoma and apply the ABCDE acronym for diagnosis:

Asymmetry

Border irregularity

Color (all the same or not)

Diameter greater than 6 mm

Evolving size, shape or color (over time)

Now, based on this, we would then probably biopsy the lesion (any
dermatologists lurking on HN wish to chime in?) and send to pathology to
interpret.

Will this method beat out the clinical diagnosis in terms of sensitivity
(number of false negatives, which is what I would care more about) and
specificity (number of false positives), such that we could biopsy more of the
patients that we missed before? Additionally, would we see these changes
earlier with this software and hardware?

Cool idea, nonetheless. I'd be more than happy to set up some sort of clinical
study looking at this technique though if there are enough tools out there to
implement this myself.

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karmajunkie
Not a dermatologist but I've following melanoma research for several years now
thanks to my wife's diagnosis.

What's exciting about this one to me is that if the detection mechanism is
truly sound, this is a great leap over the ABCD(E) criteria which have been
the clinician's main tool, and which has a high false negative for one of the
deadliest forms of melanoma, nodular melanoma. This often does not present
with varigated coloration and because it tends to invade tissue rather that
spread superficially its morphological characteristics aren't as apparent
until its more developed, greatly increasing the risk of metastases. This was
the case with my wife's primary, which her dermatologist _almost_ didn't send
out for a pathological workup, and had been missed by a couple of different
doctors thanks to its atypical presentation.

All of which is not to say that ABCDE isn't a valuable rule of thumb, but its
always struck me as somewhat subjective, which I guess is tempered with the
experience of the physician but also does have the false negative problem,
even with specialists.

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epmaybe
Best of luck to you and your wife.

ABCDE is awful, don't get me wrong. I've always felt it was like holding your
finger out to see what the wind direction is like. It has a horrible
sensitivity (50%-90% depending on the type, I'd err on the side of lower). But
if this technique also only has a 50% sensitivity, that is what would bother
me. Hopefully the sensors they are using are sensitive enough to detect these
temperature changes well.

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robocat
> [ABCDE] has a horrible sensitivity (50%-90% depending on the type). But if
> this technique also only has a 50% sensitivity...

If the sensitivity of the two techniques are not correlated, a 50% improvement
on top of ABCDE would be fantastic.

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lovemenot
Then call it ABCDEF (Frigid cells warm quicker)

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alasdair_
I've seen multiple attempts to get melanoma detectors past the FDA. The last
attempt cost millions of dollars on appeals and still ultimately failed.

Hopefully thia one will do better.

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taneq
It seems to me that the FDA should allow the best available option through
even if it's not very effective, as long as it's safe and no false claims are
made. This would at least allow companies to bootstrap and iterate if their
approach works at all.

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jhayward
I believe FDA criteria is it has to be as good or better than the best
available technique, which AFAIK is a detailed exam by a trained
dermatologist, possibly using several tools like light sources, magnification,
etc.

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dharma1
Could you do this with looking at post-cooling images from something like FLIR
One? [http://www.flir.com/flirone/](http://www.flir.com/flirone/)

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giarc
Perhaps, but from the video it appears they have some software that helps with
diagnoses as well. Something the Flir camera wouldn't have (at least not
specific to skin cancer).

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dharma1
Not trying to belittle the project, it's very cool - just might make sense to
use existing commodity hardware. Yes the software would be crucial - FLIR One
+ Android/iOS software for analysis would be a quick route to market

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known
I think a proper blood test for proteins should detect cancer e.g.
[https://en.wikipedia.org/wiki/Alpha-
fetoprotein](https://en.wikipedia.org/wiki/Alpha-fetoprotein) test to detect
liver cancer

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amelius
Did they invent some new mechanism to detect melanomas? Or did they just
automate existing methods?

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karmajunkie
This is a novel method—existing patents I've seen on melanoma scanners
generally fall into the category of 3D imaging and computer vision to automate
what a clinician does to various degrees.

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pbhjpbhj
So is it basically that the specific heat capacity of the material in the top
layers of the skin is altered when there's melanoma present, so when it's
cooled one can observe that this part warms more slowly (?) than the
surrounding tissue (because of density?).

It seems likely to me that there would be a difference in
reflectivity/transmittivity too that could be detected by using a strong light
source that could penetrate the exterior dermal layers. Presumably active
scanning like MRI (or microwave heating - probably too risky) would show the
differences well too?

Would be interesting to read about the range of methods that have been tested
(conductivity using surface contact probes would seem another obvious
method?).

The benefit, as it appears, of the current method is probably simplicity but
it doesn't appear to scale to scanning the full surface readily.

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tylerhou
The article says that cancer cells have a “higher metabolic rate” which I
understood to mean that they use more energy and thus generate more heat.

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mwdalrymple
My wife works at McMaster. Lots of great research happening there.

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neves
Can you give some examples?

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themihai
Regardless of the usefulness of the device $40K award doesn't seem a lot,
especially for a company like Dayson.

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themihai
I wonder why the down-votes? For a company with hundreds of millions if not
billions stashed in tax heavens and a founder who's worth £2.5bn to give a
$40k award a year seems like an insult to me. It's not bad but still...even
McDonalds had better campaigns as far as social responsibility is concerned.

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_joel
Let's not forget he was a proponent of Brexit

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foreigner
I read this headline as "Mellodrama Detector" X-D

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ransom1538
[deleted]

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euroclydon
Wait, they’re a scam, but you think there should be more of them?

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karmajunkie
GP is a little jaded IMHO (but perhaps with some reason, if family members
have dealt with melanoma—my experience has been different) but essentially
spot on WRT to the supply and demand. The medical profession is protectionist
to the extreme. Basic economic forces should see the supply of medical schools
(and doctors that graduate from them) increasing, but the AMA keeps a tight
lid on that, and specialization boards further distort the market.

