ReportThe CASH (color, architecture, symmetry, and homogeneity) algorithm for dermoscopy
Section snippets
Methods
Most dermoscopic algorithms begin with a two-step procedure. In step one, the PLS are classified as melanocytic or nonmelanocytic. Accordingly, only melanocytic neoplasms were included in this study set.
For this study, the digital dermoscopic images of melanocytic neoplasms were selected from the following databases: (1) New York University Department of Dermatology Pigmented Lesion Clinic; (2) Consensus Net Meeting (with the permission of Drs Argenziano and Soyer); (3) Consortium of
Results
A total of 325 melanocytic neoplasms were studied. Included in the data set were 131 MMs, 70 DN, and 124 MN (Table I). The mean TCS for the 3 populations of melanocytic neoplasms were as follows: MM 12.28 (SD 2.47); DN 7.62 (SD 2.49); and MN 5.24 (SD 2.47). The mean TCS for MM was significantly greater than for DN (P < .001) and for MN (P < .0001) (Fig 3). Combining the TCS for DN and MN gave a mean TCS of 7.62 (SD 2.67), which was significantly different from the MM mean TCS of 12.28 (P <
Discussion
This cross-sectional pilot study demonstrates that the CASH algorithm can distinguish benign from malignant melanocytic neoplasms with a level of sensitivity, specificity, and diagnostic accuracy comparable with other verified dermoscopic algorithms (Table IV).
Pattern analysis, or modifications thereof, is probably the most widely used algorithm by dermoscopists.7 However, this method requires considerable dermoscopic experience. The CASH algorithm is a simplified version of pattern analysis,
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2022, Computers in Biology and MedicineCitation Excerpt :These systems simulate expert-designed diagnostic methods, to quantify the malignancy of the lesions based on the appearance of specific structures. Some of these diagnostic methods are pattern analysis Pehamberger, Steiner, and Wolff [3]; the ABCD rule Stolz [4]; the 7-point checklist Argenziano, Fabbrocini, Carli, De Giorgi, Sammarco, and Delfino [5]; the Menzies method Menzies, Ingvar, Crotty, and McCarthy [6]; the CASH method Henning, Dusza, Wang, Marghoob, Rabinovitz, Polsky, and Kopf [7] and the Chaos & Clues method Kittler [8]. In most of these protocols, the symmetry of lesions plays a key role, although not all of them have the same definition of symmetry.
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Supported by the Stavros S. Niarchos Foundation, The Rahr Family Foundation.
Conflicts of interest: None identified.
Presented at the First Congress of the International Dermoscopy Society, Naples, Italy, on April 25-29, 2006.
The opinions expressed here are the private views of the authors and do not represent the official position of the Department of the Army.