The CASH (color, architecture, symmetry, and homogeneity) algorithm for dermoscopy - 12/08/11
Reprint requests: Alfred W. Kopf, MD, Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 550 First Ave, New York, NY 10016.New York, New York; Fort Sam Houston, Texas; and Plantation, Florida
Abstract |
Background |
The color, architecture, symmetry, and homogeneity (CASH) algorithm for dermoscopy includes a feature not used in prior algorithms, namely, architecture. Architectural order/disorder is derived from current concepts regarding the biology of benign versus malignant melanocytic neoplasms.
Objective |
We sought to evaluate the accuracy of the CASH algorithm.
Methods |
A total CASH score (TCS) was calculated for dermoscopic images of 325 melanocytic neoplasms. Sensitivity, specificity, diagnostic accuracy, and receiver operating characteristic curve analyses were performed by comparing the TCS with the histopathologic diagnoses for all lesions.
Results |
The mean TCS was 12.28 for melanoma, 7.62 for dysplastic nevi, and 5.24 for nondysplastic nevi. These differences were statistically significant (P < .001). A TCS of 8 or more yielded a sensitivity of 98% and specificity of 68% for the diagnosis of melanoma.
Limitations |
This is a single-evaluator pilot study. Additional studies are needed to verify the CASH algorithm.
Conclusions |
The CASH algorithm can distinguish melanoma from melanocytic nevi with sensitivity and specificity comparable with other algorithms. Further study is warranted to determine its intraobserver and interobserver correlations.
Le texte complet de cet article est disponible en PDF.Abbreviations used : ABCD, AIC, AUC, BIC, CASH, DN, MM, MN, PLS, ROC, TCS
Plan
| 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. |
Vol 56 - N° 1
P. 45-52 - janvier 2007 Retour au numéro
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