Cited by 119AI in cancer detectionCutaneous Melanoma Detection and ManagementArtificial Intelligence in Healthcare and Education

Diagnostic Performance of Deep Learning Algorithms Applied to Three Common Diagnoses in Dermatopathology

Open access
Olsen, Thomas George, Jackson, B. Hunter, Feeser, Theresa Ann, Kent, Michael N., Moad, John C., Krishnamurthy, Smita, Lunsford, Denise D., Soans, Rajath E.·2018·Journal of Pathology Informatics

Abstract

BACKGROUND: Artificial intelligence is advancing at an accelerated pace into clinical applications, providing opportunities for increased efficiency, improved accuracy, and cost savings through computer-aided diagnostics. Dermatopathology, with emphasis on pattern recognition, offers a unique opportunity for testing deep learning algorithms. AIMS: This study aims to determine the accuracy of deep learning algorithms to diagnose three common dermatopathology diagnoses. METHODS: Whole slide images (WSI) of previously diagnosed nodular basal cell carcinomas (BCCs), dermal nevi, and seborrheic keratoses were annotated for areas of distinct morphology. Unannotated WSIs, consisting of five distractor diagnoses of common neoplastic and inflammatory diagnoses, were included in each training set. A proprietary fully convolutional neural network was developed to train algorithms to classify test images as positive or negative relative to ground truth diagnosis. RESULTS: Artificial intelligence system accurately classified 123/124 (99.45%) BCCs (nodular), 113/114 (99.4%) dermal nevi, and 123/123 (100%) seborrheic keratoses. CONCLUSIONS: Artificial intelligence using deep learning algorithms is a potential adjunct to diagnosis and may result in improved workflow efficiencies for dermatopathologists and laboratories.

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Crossref · 10.4103/jpi.jpi_31_18

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44 of 44 references verified0 citation errors · 0 not checkable

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  • Olsen et al. found CNNs obtained 99.0% accuracy on carefully selected image patches but only 52.3% on non-selected ones; on whole-slide images, accuracy was 92%, sensitivity 85%, and specificity 99%.

    “They discovered that CNNs obtained 99.0% accuracy on carefully selected image patches while this was only 52.3% on non-selected ones. On WSI the performance was better as CNNs had an accuracy of 92%, sensitivity of 85% and specificity of 99%.”

    From Revolutionizing dermatopathology using AI in skin diagnostics: scoping review (2026) · cites this paper as [28]

    The Results (Sensitivity and specificity analysis; page unavailable) report whole-slide balanced accuracies of 99.45% for nodular BCC, 99.4% for dermal nevi, and 100% for seborrheic keratoses—not the claimed 92%. They also report 100% sensitivity and 98.9% specificity for nodular BCC. The Methods discuss image patches but do not report the claimed 99.0% versus 52.3% patch comparison. (LLM, conf=0.86)

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  • The performance decline identified by Olsen et al. confirms the generalizability gap noted in Hart et al., suggesting this constraint is systemic among CNN-based models rather than an isolated occurrence.

    “The performance decline identified by, Olsen et al. (28) confirms the generalizability gap noted in Hart et al. (22) suggesting that this constraint is systemic among CNN-based models rather than an isolated occurrence.”

    From Revolutionizing dermatopathology using AI in skin diagnostics: scoping review (2026) · cites this paper as [28]

    The Results (Sensitivity and specificity analysis; page unavailable) report 99.45%, 99.4%, and 100% balanced accuracy on the three test sets, not a performance decline. The Discussion (page unavailable) describes the train–test split as showing generalizability and performance on out-of-sample observations. It does not establish a systemic constraint among CNN models. (LLM, conf=0.87)

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    Experimental — accuracy not yet measured
  • The scoping review captures how model performance reduces when datasets used are non-curated or in real-world scenarios, as seen in Hart et al. and Olsen et al.

    “The scoping review also captures how model performance reduces when the datasets used are non-curated or in real-world scenarios, as seen in the works of Hart et al. (22) and Olsen et al. (28).”

    From Revolutionizing dermatopathology using AI in skin diagnostics: scoping review (2026) · cites this paper as [28]

    The Results (Sensitivity and specificity analysis; page unavailable) report 99.45% and 99.4% balanced accuracy for two algorithms and 100% correct classification for seborrheic keratosis. The Discussion (page unavailable) says the seborrheic keratosis training and test set was more rigorous, yet it had the highest yield—the opposite of reduced performance on a more challenging set. The paper does not report a separate test on non-curated datasets or in real-world deployment. (LLM, conf=0.82)

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    Experimental — accuracy not yet measured
  • Olsen et al. used and compared CNNs for identifying dermatopathological diseases and found 99% accuracy on curated image patches, decreasing to 52.3% on non-curated patches.

    “Technically, Olsen et al. (28) used and compared CNNs for identifying dermatopathological diseases and found that it gives 99% accuracy on curated image patches, but decreases to 52.3% on non-curated patches.”

    From Revolutionizing dermatopathology using AI in skin diagnostics: scoping review (2026) · cites this paper as [28]

    The Methods (Algorithm development and training) describe CNNs used to identify dermatopathological lesions, and the Results (Sensitivity and specificity analysis) report 99.45% balanced accuracy for nodular BCC. The paper does not report a comparison of curated with non-curated image patches or a decrease to 52.3%; its reported accuracy concerns a different testing setup. Page numbers are not available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • This was especially true when circumstances displayed similar visual traits, highlighting the necessity for improved and more diverse data sets.

    “This was especially true when the circumstances displayed similar visual traits, highlighting the necessity for improved and more diverse data sets.”

    From Revolutionizing dermatopathology using AI in skin diagnostics: scoping review (2026) · cites this paper as [28]

    The Discussion (page unavailable) identifies diagnoses with similar visual appearances and says future data collection should include more look-alike distractors to strengthen the algorithms. It does not show that performance problems were especially pronounced for visually similar diagnoses; the Results (page unavailable) report high accuracy, including perfect classification in the seborrheic keratosis test set. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 3

  1. [20]Kent MN Deploying a Digital Pathology Solution in a Dermatopathology Reference Lab. Abstract presented at: Association for Pathology Informatics Digital Pathology Workshop, Henry Ford Hospital 2017 12 8-9 Detroit, MI
  2. [36]Simonyan K Zisserman A Very deep convolutional networks for large-scale image recognition.arXiv preprint arXiv: 1409.1556 2014 · arXiv
  3. [37]Ashiquzzaman A Tushar AK Islam R Kim JM Kim K Kim H Baek N Reduction of overfitting in diabetes prediction using deep learning neural network IT Convergence and Security 2017. Lecture Notes in Electrical Engineering 2018 Singapore Springer

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Authors
Olsen, T. G., Jackson, B. H., Feeser, T. A., Kent, M. N., Moad, J. C., Krishnamurthy, S., Lunsford, D. D., & Soans, R. E.
Affiliations
Wright State University (US)
Corresponding author
Kent, Michael N.
Venue
Journal of Pathology Informatics
Publisher
Elsevier BV
Published
2018-01
Volume
9
Issue
1
Pages
32
ISSN
2153-3539 (ISSN-L)
OpenAlex
W2894398812
Cited by
119
References
44
Citations by year
2026: 9 · 2025: 18 · 2024: 14 · 2023: 13 · 2022: 21 · 2021: 14 · 2020: 17 · 2019: 12 · 2018: 1
FWCI
6.19
Type
journal article
Language
en
Open access
Locations
  • Journal of Pathology Informatics (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Keywords
deep learning, dermatopathology, computer-aided diagnosis, nodular basal cell carcinoma, seborrheic keratosis, whole slide images, convolutional neural networks, diagnostic accuracy, skin lesions

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