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Skin DiseasesNCT04679961

Deep Learning on 3D Cellular-resolution Tomogram

An observational study of Skin Diseases, run by Mackay Memorial Hospital at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Skin biopsy is the main method to diagnose skin tumors, skin inflammation, and pigmented diseases. However, biopsy is an invasive method that can cause wounds and scars. Optical coherent tomography (OCT) technology is a fast, non-invasive, non-radioactive, and label-free imaging method. Read more about this study

Who is it for?
Ages 20 years and olderHealthy volunteers can take part
Conditions the study is for
Skin Diseases
What is being tested?
ApolloVue® S100 Image System (Apollo Medical Optics)
Type of treatment
Medical device
How many people
107 participants
Where
1 siteTaiwan
Study dates
21 Dec 2020to 14 Dec 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The population from both experimental group and control group will be selected.

Who may be able to join

  • Experimental group:
  • Adults aged 20 years or older
  • Non-treat lesion of epidermal inflammatory disease: dermatitis and psoriasis
  • Benign tumors: seborrheic keratosis and nevus
  • Malignant tumors: actinic keratosis (AK), melanoma, basal cell carcinoma (BCC), Bowen's disease, squamous cell carcinoma (SCC), and extramammary Paget's disease (EMPD)
  • Pigmented diseases: solar lentigo, melasma, and vitiligo
  • Control group:
  • The healthy face (exposed site) and inner forearm (unexposed site) skin of epidermal tumors and pigmented diseases of the above experimental group were used as a control group, excluding epidermal inflammatory diseases.

Who cannot join

  • Experimental group:
  • Minors aged under 20 years
  • Suspected a transcutaneous infectious disease, including infections such as bacteria, fungi, viruses, and parasites.
  • All skin tumors that are in the subcutaneous tissue
  • All skin lesions are open wounds
  • All skin lesions are in a location that is difficult to scan
Show all 17Show fewer
  • Not willing to cooperate with methods and related procedures of this study
  • Vulnerable populations, including prisoners, pregnant women, handicapped, mentally disabled, known AIDS patients, and homelessness
  • Control group:
  • Minors under 20 years of age.
  • Epidermal inflammatory disease
  • Suspected a transcutaneous infectious disease, including infections such as bacteria, fungi, viruses, and parasites.
  • Individuals who have a systemic skin disorder.
  • Individuals who have a history of severe skin condition
  • Individuals with surgeries/cosmetic surgeries/micro cosmetic surgery (eg. cosmetic injections and/or laser etc.) on healthy skin at face and inner forearm in last 3 months and a physician determine the surgery will affect outcome of the OCT images.
  • Not willing to cooperate with methods and related procedures of this study
  • Vulnerable populations, including prisoners, pregnant women, handicapped, mentally disabled, known AIDS patients, and homelessness

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • Mackay Memorial Hospital

    New Taipei City, Tamsui District, 25160

Other trials in Taiwan

About this study

Skin biopsy is the main method to diagnose skin tumors, skin inflammation, and pigmented diseases. However, biopsy is an invasive method that can cause wounds and scars. Optical coherent tomography (OCT) technology is a fast, non-invasive, non-radioactive, and label-free imaging method. This technology generates real-time images of living tissue by detecting the variations in the refractive indexes of various components in soft tissues. Recently, there is a breakthrough progress that the newly designed ultrahigh resolution OCT can provide in vivo cellular resolution similar to histopathological sections in the high magnification. In our previous clinical trial "Early feasibility study: application of OCT imaging in dermatology" (approved by IRB of MacKay Memorial Hospital, no. 17CT062Be), it showed characteristic features of different skin inflammatory diseases and tumors can be distinguished successfully in tomograms. There were no adverse event or serious adverse event in this trial. Artificial intelligence technologies have been used widely in the image analysis in recent years. Hence, we aim to collect OCT tomograms of common skin inflammatory diseases, skin tumors, and pigmented diseases, and compare with normal skin for machine learning. We expect the integration of tomograms with deep learning artificial intelligence may assist identifying histological features in these images and provide new alternative way for non-invasive diagnosis in dermatology.

Read the detailed description

Introduction Optical coherent tomography (OCT) technology has been widely used in medical practice, such as ophthalmology. The application in dermatology is slowly progressed until the marked improvement of resolution recently. One of the newly designed OCT devices using in this study is based on the research and development of Professor Sheng-Lung Huang of National Taiwan University. The light source was made with original glass-covered crystalline fiber which has successfully provided sub-micron resolution on the skin, which is better than the traditional 5-10 micron resolution of high-definition OCT. This new OCT system (ApolloVue™ S100 image system, Viper1-S003, Apollo Medical Optics) has been used in this previous clinical trial "in vivo OCT images of different skin diseases" without adverse events. OCT images of different skin diseases collected in that trial were compared with HE-stained pathological sections. They provided useful information to physicians. The risk-benefit assessment of this clinical trial is the same as expected. The risk is low in clinical use, and both for the operators and the subjects. In recent years, the application of artificial intelligence technology in the analysis of tissue classification of medical images is rapidly developing. Therefore, we are going to use deep learning technology to improve the interpretation of OCT images to help the subsequent diagnosis of skin diseases.

Inclusion criteria

Experimental group:

  1. Adults aged 20 years or older
  2. Non-treat lesion of epidermal inflammatory disease: dermatitis and psoriasis: 300 participants.
  3. Benign tumors: seborrheic keratosis and nevus: 300 participants
  4. Malignant tumors: actinic keratosis (AK), melanoma, basal cell carcinoma (BCC), Bowen's disease, squamous cell carcinoma (SCC), and extramammary Paget's disease (EMPD): 100 participants
  5. Pigmented diseases: solar lentigo, melasma, and vitiligo: 300 participants

Control group:

The healthy face (exposed site) and inner forearm (unexposed site) skin of epidermal tumors and pigmented diseases of the above experimental group were used as a control group, excluding epidermal inflammatory diseases, 700 participants in the control group were expected.

Exclusion criteria

Experimental group:

  1. Minors aged under 20 years
  2. Suspected a transcutaneous infectious disease, including infections such as bacteria, fungi, viruses, and parasites.
  3. All skin tumors that are in the subcutaneous tissue
  4. All skin lesions are open wounds
  5. All skin lesions are in a location that is difficult to scan
  6. Not willing to cooperate with methods and related procedures of this study
  7. Vulnerable populations, including prisoners, pregnant women, handicapped, mentally disabled, known AIDS patients, and homelessness

Control group:

  1. Minors under 20 years of age.
  2. Epidermal inflammatory disease
  3. Suspected a transcutaneous infectious disease, including infections such as bacteria, fungi, viruses, and parasites.
  4. Individuals who have a systemic skin disorder.
  5. Individuals who have a history of severe skin condition
  6. Individuals with surgeries/cosmetic surgeries/micro cosmetic surgery (eg. cosmetic injections and/or laser etc.) on healthy skin at face and inner forearm in last 3 months and a physician determine the surgery will affect outcome of the OCT images.
  7. Not willing to cooperate with methods and related procedures of this study
  8. Vulnerable populations, including prisoners, pregnant women, handicapped, mentally disabled, known AIDS patients, and homelessness

Deep convolutional neural network (DCNN) was used to mark tissue and lesions in OCT images. When training DCNN models, transfer learning strategies will be used to fine-tune the parameters from pre-trained models that contain a lot of image knowledge, such as GoogLeNet, rather than training the models from scratch. This method retains the low-level image knowledge common to natural and medical images, and significantly reduces the time to train the model. During the training process, the parameters of the first few layers that store the low-order image knowledge in the model are fixed, and the parameters of the subsequent layers of the model are changed by the back-propagation algorithm. Finally, a layer of linear classifier is added to the end of the DCNN to determine the type / size of the symptoms in the input image.

Conditions
Skin Diseases
Being tested
ApolloVue® S100 Image System (Apollo Medical Optics)
Keywords
Optical coherence tomography (OCT), artificial intelligence, deep learning, skin diseases, dermatology
Medical subject headings
Skin Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ApolloVue® S100 Image System (Apollo Medical Optics)Device

    Also called 510(K) Number: K201552 (class II)

    The device is an in vivo non-invasive optical coherence tomography and will be used to obtain at least 6 medical images of normal and lesional skin, respectively, for both experimental group and control group.

Study groups in NCT04679961
Study groupRoleWhat they receive
Experimental1. Epidermal inflammations, including eczematous diseases and psoriasis 2. Epidermal tumors, including benign tumors and malignant tumors 3. Pigmented diseases, including hypopigmentation and hyperpigmentation
Receives: Device: ApolloVue® S100 Image System (Apollo Medical Optics)
ControlHealthy skin
Receives: Device: ApolloVue® S100 Image System (Apollo Medical Optics)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of subjects of tomograms that can be analyzed by artificial intelligence techniques

    Number of subjects of tomograms that can be analyzed by artificial intelligence techniques (including machine learning and deep learning) will be compared to that cannot be analyzed to identify the feasibility of using artificial intelligence techniques to analyze tomograms at study completion.

    Measured: 2.5 years

  2. Number of subjects with the similarity results of interpreting tomograms between artificial intelligence and experts

    Number of subjects with the similarity results of interpreting tomograms between artificial intelligence and experts will be compared to that with no similarity to verify whether artificial intelligence interpretation are comparable with gold standard methods expert interpretation at study completion.

    Measured: 2.5 years

Secondary outcomes (1)
  1. Number of subjects with the correlation between tomograms and gold standard methods, eg. existing clinical images or pathological images.

    Number of subjects with the correlation between tomograms and gold standard methods, eg. existing clinical images (including photographs, dermoscopic images, etc.) or pathological images (including H\&E stain, etc.) will be compared to that with no correlation to verify whether the tomograms are comparable with above gold standard methods at study completion.

    Measured: 2.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Dec 2020
  2. Study start21 Dec 2020
  3. Primary completion14 Dec 2022
  4. Study completion14 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
107 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04679961
Sponsor's protocol ID
20STW2-01
Other IDs
MOST 108-2634-F-002-014 -
Status last verified
Mar 2023
First submitted
18 Dec 2020
Last updated
17 Mar 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part I: Basic principles. J Am Acad Dermatol. 2019 Apr;80(4):1114-1120. doi: 10.1016/j.jaad.2018.11.042. Epub 2018 Dec 4.

    PubMed 30528311
  • Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part II: Applications and limitations. J Am Acad Dermatol. 2019 Apr;80(4):1121-1131. doi: 10.1016/j.jaad.2018.11.043. Epub 2018 Dec 4.

    PubMed 30528310
  • Dubois A, Levecq O, Azimani H, Siret D, Barut A, Suppa M, Del Marmol V, Malvehy J, Cinotti E, Rubegni P, Perrot JL. Line-field confocal optical coherence tomography for high-resolution noninvasive imaging of skin tumors. J Biomed Opt. 2018 Oct;23(10):1-9. doi: 10.1117/1.JBO.23.10.106007.

    PubMed 30353716
  • Wang YJ, Huang YK, Wang JY, Wu YH. In vivo characterization of large cell acanthoma by cellular resolution optical coherent tomography. Photodiagnosis Photodyn Ther. 2019 Jun;26:199-202. doi: 10.1016/j.pdpdt.2019.03.020. Epub 2019 Mar 30. No abstract available.

    PubMed 30940575
  • Tsai CC, Chang CK, Hsu KY, Ho TS, Lin MY, Tjiu JW, Huang SL. Full-depth epidermis tomography using a Mirau-based full-field optical coherence tomography. Biomed Opt Express. 2014 Aug 8;5(9):3001-10. doi: 10.1364/BOE.5.003001. eCollection 2014 Sep 1.

    PubMed 25401013
  • Chang CK, Tsai CC, Hsu WY, Chen JS, Liao YH, Sheen YS, Hong JB, Lin MY, Tjiu JW, Huang SL. Errata: Segmentation of nucleus and cytoplasm of a single cell in three-dimensional tomogram using optical coherence tomography. J Biomed Opt. 2017 Mar 1;22(3):39801. doi: 10.1117/1.JBO.22.3.039801. No abstract available.

    PubMed 28300273

Questions about this trial

What is this clinical trial studying?

An observational study of Skin Diseases, run by Mackay Memorial Hospital at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of subjects of tomograms that can be analyzed by artificial intelligence techniques (time frame: 2.5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04679961, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Mar 2023.

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