Hoping to deliver free skin cancer screening worldwide, two software developers used artificial intelligence to create an app to detect skin cancer in real-time.
After losing a close friend to cancer last year, Mike Borozdin wanted to do something to stem the tide of cancer-related deaths in the world.
At TechCrunch Disrupt’s 2017 hackathon in San Francisco, he and fellow software engineer Peter Ma got inspired to create an artificial intelligence (AI)-powered app that could detect skin cancer by simply analyzing a photo of a mole.
Dubbed Doctor Hazel, the app sorts through a database of images, classifies the mole in question and instantly lets the person know if the mole looks benign or potentially cancerous. If the app raises a red flag, the person is advised to follow up with a dermatologist.
“Early detection is critical to the management of skin cancers,” said Rajiv Bhatnagar, a senior staff dermatologist and geographic medical director at Palo Alto Medical Foundation. “Even the most serious skin cancers are often cured if detected early.”
Skin cancer is the most common cancer in the U.S., according to the Skin Cancer Foundation. By the age of 65, half of the population will be diagnosed with some form of skin cancer.
Without early detection, the five-year survival rate falls to 62 percent when the disease reaches the lymph nodes and to 18 percent when it metastasizes to distant organs.
However, when melanoma is found early, the survival rate is extremely high.
“Melanoma is a potentially fatal skin cancer, but when it is detected and treated in the early stages, it is quite curable,” said Bhatnagar.
Citing recently published data from the American Joint Committee on Cancer (AJCC), Bhatnagar said that the five-year survival rate for early intervention with early-stage melanoma is 98 percent.
Though there may be challenges in refining the tech and even with dermatologists adapting to this new type of screening, Bhatnagar said he sees tools like Doctor Hazel providing access to care sooner for patients with suspicious lesions.
“I think Doctor Hazel and similar tools will be in widespread use and will ultimately save lives,” said Bhatnagar.
Borozdin and Ma started with a high-powered endoscope camera they found for roughly $30 on Amazon to capture high-resolution images of questionable moles.
A fellow in the Intel Software Innovator Program, Ma proposed using the Movidius Neural Compute Stick (NCS) for the project. The Intel program supports independent developers by offering access to the latest technology and open source software.
The NCS is a tiny, fanless, deep-learning USB drive designed for high-performance AI programming. It enables processing at previously unimagined speeds to run real-time deep neural networks directly from the device.
“We’re basically able to do real-time screening for patients without any waiting time,” said Ma. “That’s a huge leap forward in engineering.”
Much like an experienced dermatologist sees thousands of moles and other skin lesions over time and can quickly ascertain whether a biopsy may be warranted, Doctor Hazel can scan thousands of images for comparison and analysis, all in the blink of an eye.
This speed was evident when Borozdin and Ma demonstrated their app in their final TechCrunch pitch. Impressive, as well, was the accuracy rate achieved within just 24 hours at the hackathon: 85 percent.
This figure will only increase as more data is collected and the AI becomes more precise, said Ma. The more images the AI can scan and analyze, the more the accurate it becomes.
“The worst thing would be to tell someone who has cancer that they have nothing to worry about,” said Borozdin.
Digging up the Data
Borozdin and Ma are intent on boosting accuracy. However, getting more data has proved challenging.
For the hackathon, Borozdin and Ma used open data from the University of Iowa, including approximately 10,000 photos for comparison and analysis.
“But we really need more data,” said Ma. “That’s part of the AI’s deep learning.”
The more images Doctor Hazel can process, the better it will be at detecting abnormalities, much like a toddler needs to see numerous vehicles before understanding the difference between a car and a truck.
The two have reached out to universities, including Stanford’s Artificial Intelligence Laboratory where similar research has been conducted using a database of 130,000 images. Additionally, they’ve launched a Doctor Hazel beta site for people to submit photos.
Borozdin and Ma said their initial plan is to get Doctor Hazel into the hands of first-level care providers — primary care doctors, nurses, technicians and pharmacists — where patients can get quick and inexpensive diagnoses before pursuing higher-level care.
Bhatnagar sees potential applications for primary care clinicians and, eventually, the patients themselves.
“It could certainly be helpful to the primary care team to help with triage, reassurance and referrals, and may provide a good environment for validation of the tool in the early stages,” he said. “In that setting, the patient is already in a care system and next steps are well defined.”
Ultimately, Bhatnagar sees value in patients being able to directly access the tools.
“For the individual user case, it will be important for the AI tools to be coupled with information on what to do and where to go if the findings are worrisome,” he said.
Of course, there are other hurdles to get there. Gaining FDA approval through trials and testing of new devices can take years.
Borozdin and Ma believe the benefits will be worth overcoming such challenges. Doctor Hazel, for example, could provide medical care to people in remote locales.
“Someone in rural Kansas or remote Africa can now get access to screening without having to spend the time or incur the cost of traveling to a bigger city,” said Borozdin.
Time and cost savings are another plus. Because specialists are often busy and schedules are booked out far in advance, patients can get in for an initial screening with their primary care doctor or a lab tech much more quickly.
At the same time, dermatologists will be able to focus on the patients most in need of their expertise, expediting the treatment process for those who have the least time to spare.
“Ultimately,” said Ma, “our goal is to deliver free skin cancer screening to everyone in the world.”