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    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Decision Support Software for Melanoma Skin Cancer Detection (DECIME)</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Carlos E. B. Sousa</string-name>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Federal Institute of Education, Science and Technology of Ceara ́, Copyright © 2020 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0). This volume is published and copyrighted by its editors. Advances in Artificial Intelligence for Healthcare</institution>
        </aff>
      </contrib-group>
      <abstract>
        <p>In this paper is proposed a software to decision support for the detection of melanoma cancer. This approach is proposed, as this type of skin cancer is the only one that can metastasize, that is, proliferate to other organs such as lungs, liver, etc. The proposed system is elaborated through the acquisition of a set of images with 17805 samples, extractors of attributes gray level co-occurrence matrix (GLCM), Local Binary Pattern (LBP) and Central Moments. For the training and sample classification process, the Single Layer Perceptron (SLP), Multilayer Perceptron (MLP) and Support Vector Machine (SVM) classifiers are used. Subsequently, the best-evaluated model is implanted in a Raspberry Pi computer that, together with a webcam and a computer screen, allows the capture and classification of skin lesions in real-time. In the applied methodology, the authors obtained the best result of a 93 % accuracy from the use of Central Moments extractor and MLP classifier. In contrast to the state of the art of this problem, a high level of similarity is found between the accuracy rates of the Single Layer Perceptron (SLP) and the Multilayer Perceptron (MLP), demonstrating a possible resolution of the problem in a linear format.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>INTRODUCTION</title>
      <p>
        Skin cancer is currently presented as the most common illness in the
world among fair-skinned people, the non-melanoma type being the
most common kind of skin cancer worldwide. There are two major
types of skin cancer: melanoma and non-melanoma [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ][
        <xref ref-type="bibr" rid="ref7">7</xref>
        ].
      </p>
      <p>
        Melanoma skin cancer is a malign tumor that stems from
the uncontrolled proliferation of melanocytes (pigment producing
cells)[
        <xref ref-type="bibr" rid="ref2">2</xref>
        ][
        <xref ref-type="bibr" rid="ref1">1</xref>
        ][
        <xref ref-type="bibr" rid="ref11">11</xref>
        ][
        <xref ref-type="bibr" rid="ref16">16</xref>
        ]. There are recent records of increase in mortality
rates recurring from melanoma. The costs for melanoma treatment
can be evaluated in several billions to countries that display a larger
incidence of the disease. Several preventive strategies have been
implemented in various high risk regions, with different success rates.
Over the last four decades, melanoma incidence has increased
worldwide, the highest of which being in Australia, where there are records
of 40 new cases for every 100.000 citizens per year [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ].
      </p>
      <p>
        In this paper, therefore, is proposed a decision support software
tool that employs techniques from Computer Vision and
Artificial Intelligence using the classifiers Single Layer Perceptron (SLP)
[
        <xref ref-type="bibr" rid="ref19">19</xref>
        ], Multilayer Perceptron (MLP) [
        <xref ref-type="bibr" rid="ref14">14</xref>
        ] and Support Vector Machine
(SVM) [
        <xref ref-type="bibr" rid="ref22">22</xref>
        ] to make decision, providing healthcare professionals
with a technological tool and giving the patients the possibility of
a faster treatment.
      </p>
      <p>The paper has the following organization: the Section 2 presents
the related works that helped in the construction of this work. In
Section 3 it is described the proposed method, that is, the acquisition of
the set of images, elaboration of data sets, parameterization of the
machine learning algorithms and implementation of the solution in
a Raspberry Pi. The results obtained are presented in Session 4 and,
finally, Section 5, the final considerations are presented.
2</p>
    </sec>
    <sec id="sec-2">
      <title>RELATED WORKS</title>
      <p>
        Mariam A. Sheha, Mai S. Mabrouk and Amr Sharawy [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] propose
an automated method applied to a set of dermoscopic images for the
diagnosis of melanoma. The extracted resources are based on Gray
Level Co-occurrence Matrix (GLCM) and use of the MultiLayer
Perceptron classifier (MLP) to classify melanoma cancer. The classifier
chosen was used with two different techniques in the training and
testing process: traditional and automatic. Traditional MLP obtained
a superior performance to automatic MLP. While automatic MLP
obtained a 93.4 % accurac y of the training set and 76 % on the testing
set, traditional MLP obtained 100 % accuracy on the training set and
92 % on the testing set.
      </p>
      <p>
        On another approach, H. Alquran et al [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] propose a method
for detection, presentation, extraction and classification to detect
melanoma, using image processing techniques that were applied on
dermoscopic image samples suspect of melanoma. The classification
system uses a SVM to classify the lesions. The study’s SVM
classifier obtained 92,1% accuracy in the classification, and appears to be a
promising approach on the distinction of skin lesions of both benign
and malign melanoma.
      </p>
      <p>
        Ansari, U. B. and Sarode, T. [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ] propose a system for early
detection of skin cancer. The diagnosis methodology uses image
processing techniques associated with a SVM classifier. The
dermoscopic skin cancer images are obtained and submitted to several
preprocessing techniques for noise removal and image enhancement.
They are subsequently submitted to image segmentation by
thresholding. The authors obtained an accuracy of 95 % with the
aforementioned techniques.
3
      </p>
    </sec>
    <sec id="sec-3">
      <title>THE PROPOSED METHOD</title>
      <p>As previously mentioned, the authors of this work propose a decision
support software for melanoma skin cancer detection. That said, as
shown in Fig. 1, the process is divided into 6 steps. The initial 4
stages consist of implementing the computational tool, while the last
two stages comprehend practical use of the software.</p>
      <p>As shown on Fig. 1, the implementation of the tool can be divided
into 4 stages: the acquisition of the image set, the elaboration of the
data set, the use of machine learning techniques and the deployment
on Raspberry Pi. The methodologies used for each illustrated step
are presented next.
3.1</p>
    </sec>
    <sec id="sec-4">
      <title>Acquiring the image set</title>
      <p>The information is extracted from an image set named ”dermoscopic
pigmented skin lesions from HAM10k”3. This set contains 8903
samples of melanoma skin cancer images and 8902 samples of
nonmelanoma skin cancer images (Fig. 2) , with a total of 17805
samples.</p>
      <p>
        As for the ABCDE rule, professionals use The first five letters of
the alphabet a guide to help people recognize the warning signs of
melanoma. They are: Asymmetry (A) - wounds or stains are
presented asymmetrically; Borders (B) - tend to be irregular; Colors (C)
- they present different colors in the same wound; D (Diameter)
equal to or greater than 6mm; and Evolution (E) - whether it evolves
in shape, color or elevation [
        <xref ref-type="bibr" rid="ref21">21</xref>
        ].
      </p>
      <p>In this sense, based on the aforementioned rule, the authors
propose the use of attribute techniques based on textures and shapes, as
they are similar to the way of detecting the problem in a practical
way. The techniques used are presented next.
3 The data set is made available by Alexander Scarlat through the link:
https://www.kaggle.com/drscarlat/melanoma
3.2</p>
    </sec>
    <sec id="sec-5">
      <title>Elaborating the dataset</title>
      <p>
        The authors propose the use of the extractors Gray Level
Cooccurrence Matrix (GLCM) [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ], Local Binary Pattern (LBP) [
        <xref ref-type="bibr" rid="ref17">17</xref>
        ]
and Central Moments. The GLCM describes texture through a set
of characteristics for the occurrences of each level of gray in the
pixels of the image considering multiple directions [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]. In this way, the
size of the matrix is determined from the distinct number of levels of
pixels contained in the original image [
        <xref ref-type="bibr" rid="ref20">20</xref>
        ]. Haralick, K. Shanmugam
and Dinstein [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ] proposed a method to which 14 statistical measures
of texture can be obtained from its use, however, only 13 are actually
used, since the latter presents computational instability.
      </p>
      <p>
        D. Huang et al. [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ] state that in recent years, LBP has sparked
a growing interest in image processing and computer vision. This
method efficiently summarizes local image structures, comparing
each pixel with its neighbor pixels. P. Mohanaiah and P.
Sathyanarayana and L. GuruKumar [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ] cite that one of the most
important properties of this operator is computational simplicity, it makes
it possible to analyze images in challenging configurations in
realtime.
      </p>
      <p>
        Moments are the statistical expectation of certain power functions
of a random variable. The central moment is widely used in pattern
recognition because of their discrimination power and robustness [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
The main advantage of this extractor is their invariances to
translations of the object. Therefore they are suited well to describe the
shape of the object [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ], which can become a strong tool for the
elaboration of a data set that represents well the problem of the detection
of melanoma cancer.
3.3
      </p>
    </sec>
    <sec id="sec-6">
      <title>Applying machine learning techniques</title>
      <p>Regarding the artificial intelligence algorithms, the single-layer
Perceptron algorithm is implemented to verify the possibility of dealing
with linear problems and, subsequently, the Multilayer Perceptron
(MLP) and the Support Vector Machine, as they present themselves
as robust algorithms to obtain better results, in case of a nonlinear
problem.</p>
      <p>To verify the efficiency of the proposed methodology, experiments
are carried out with the Single Layer Perceptron (SLP) classifier,
using learning rates of 0.01, 0.05, 0.1 and 0.5, signal function and
reduction linear or exponential learning rates.</p>
      <p>For the MLP classifier, we implemented several learning rates that
vary between 0.1 and 0.5, linear or exponential reduction of these
rates, logistic function or hyperbolic tangent. The values referring to
the number of neurons in the hidden layer of the MLP are entered
empirically, ranging from 2 to 100 neurons.</p>
      <p>For the SVM classifier, 4 types of kernels are used; linear, RBF,
polynomial and sigmoid. The value of C, that is, the penalty
parameter is entered from the following values 0.01, 0.1, 1.0 and 10.</p>
      <p>For both algorithms, the training is conditioned to end when it
reaches an error rate of 10 5 and there are 2000 iterations, in which
the weights with the best accuracy are chosen as the ones that best
represent the results of the training.</p>
      <p>As mentioned, the authors used 17.805 images in total, which are
divided into 8.903 samples of the class ”melanoma” and 8.902, of
”non-melanoma”. In this sense, 7.122 samples selected at random
for each type of class were used to compose the training/tests set.
The rest of the data, that is, 1.781 samples of the class ”melanoma”
and 1.780 samples of the class ”non-melanoma”, make up the test
set.</p>
      <p>For all classifiers, the K-Fold cross-validation technique is used,
where a value of K equals 10. The application of this method consists
of dividing the total set of training data into K subsets of the same
size (Fig. 3). Thus, each subset is used for validation, while the rest
of the set is applied to estimate the parameters.</p>
      <p>As shown in Fig. 3, the data set is divided into 2 parts. The first
is divided into 10 subsets that are used in the training and validation
process. Finally, the second part of the set, unknown by the classifier,
is used for the test process.
3.4</p>
    </sec>
    <sec id="sec-7">
      <title>Deploying the software in Raspberry Pi 3 B+ computer</title>
      <p>In order to make this application usable to healthcare professionals
as well as to attain low acquisition costs, the computer program (Fig.
4) was deployed to a Raspberry Pi 3B+ computer.</p>
      <p>After installing the classification software on the raspberry
computer, we can use the webcam to obtain images of the skin for
analysis, and the computer screen for verifying the suggested results.
3.5</p>
    </sec>
    <sec id="sec-8">
      <title>Confirming the detection with a doctor and generating results</title>
      <p>As previously mentioned, the authors propose a decision support
software. Thus, the results generated by it must be analyzed by a
doctor for proper conclusions.</p>
    </sec>
    <sec id="sec-9">
      <title>RESULTS OBTAINED</title>
      <p>In the Table 1 shows the best results obtained in this study. This
solution is obtained with the Central Moments extractor and Multilayer
Perceptron classifier. It should be noted that, in order to obtain the
best results, the authors use various combinations between their
attributes generated by the extractors. Thus, were obtained the best
results (Table 1) by applying the following Central Moments: mu11,
mu21, mu12, mu30, mu03.</p>
      <p>Although the Multilayer Perceptron classifier offers a better
solution from the data obtained by the Central Moments extractor, the
authors perceive similar results from the same attributes used with
the Single Layer Perceptron classifier. This perception demonstrates
that the problem of detecting melanoma cancer can be linearly
separable, making it an easily resolvable problem. Table 2 illustrates the
best results obtained from the classifier SLP.</p>
      <p>It is important to emphasize that by using the Central Moments
extractor, one can divide the data almost linearly. Therefore, the
decision limits for both classifiers have similarities and simplicity in
their structures.
5</p>
    </sec>
    <sec id="sec-10">
      <title>CONCLUSIONS</title>
      <p>In view of the literature involved, this work was differentiated by
using less robust techniques and achieving similar or even superior
results. Providing a lower computational cost in the early detection
of melanoma cancer.</p>
      <p>Although most Artificial Intelligence models require powerful
processing and extensive memory resources, there are still methods
that, when applied correctly, produce satisfactory results. Therefore,
the exact application of an attribute extractor related to the binary
detection of melanoma skin cancer produces a good solution to the
problem without requiring much processing power or memory. To
that extent, the use of attribute extractors suitable for a problem can
simplify its classification. In this scenario, a Perceptron can be a
significant resource for achieving satisfactory results.</p>
      <p>It should be noted that when deploying the software on the
raspberry pi board, a simple, fast and portable solution is created, which
enables support the decision to health care professionals regarding
melanoma skin cancer detection. The software also helps improve
accessibility to patients who live in regions of difficult access, since
the device is portable enough for professionals to provide home care
when the patient is unable to reach the care unit.</p>
    </sec>
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