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Published on: July 11, 2025
Computer-aided classification of suspicious pigmented lesions using wide-field images
Judith S Birkenfeld1, Jason M Tucker-Schwartz2, Luis R Soenksen3
1Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA; Brigham and Women's Hospital - Harvard Medical School, 75 Francis St, Boston, MA 02115, United States; Massachusetts General Hospital - Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States.
Background And Objective:
Early identification of melanoma is conducted through whole-body visual examinations to detect suspicious pigmented lesions, a situation that fluctuates in accuracy depending on the experience and time of the examiner. Computer-aided diagnosis tools for skin lesions are typically trained using pre-selected single-lesion images, taken under controlled conditions, which limits their use in wide-field scenes. Here, we propose a computer-aided classifier system with such input conditions to aid in the rapid identification of suspicious pigmented lesions at the primary care level.
Methods:
133 patients with a multitude of skin lesions were recruited for this study. All lesions were examined by a board-certified dermatologist and classified into "suspicious" and "non-suspicious". A new clinical database was acquired and created by taking Wide-Field images of all major body parts with a consumer-grade camera under natural illumination condition and with a consistent source of image variability. 3-8 images were acquired per patient on different sites of the body, and a total of 1759 pigmented lesions were extracted. A machine learning classifier was optimized and build into a computer aided classification system to binary classify each lesion using a suspiciousness score.
Results:
In a testing set, our computer-aided classification system achieved a sensitivity of 100% for suspicious pigmented lesions that were later confirmed by dermoscopy examination ("SPL_A") and 83.2% for suspicious pigmented lesions that were not confirmed after examination ("SPL_B"). Sensitivity for non-suspicious lesions was 72.1%, and accuracy was 75.9%. With these results we defined a suspiciousness score that is aligned with common macro-screening (naked eye) practices.
Conclusions:
This work demonstrates that wide-field photography combined with computer-aided classification systems can distinguish suspicious from non-suspicious pigmented lesions, and might be effective to assess the severity of a suspicious pigmented lesions. We believe this approach could be useful to support skin screenings at a population-level.

