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Interview: Automation for the earliest possible skin cancer detection

FotoFinder has set new standards in cancer screening with automated skin examination. Managing Director Andreas Mayer explained the background to the development in an interview about the advances through robotics and how poor imitations can compromise the screening.

FotoFinder bodystudio ATBM system for time-saving Automated Total Body Mapping and digital dermoscopy

Mr Mayer, the possibilities for examining skin are becoming ever more precise. FotoFinder has also been developing solutions for detecting skin cancer even earlier for over 20 years. And yet there are still more and more people being diagnosed with the disease. What explanation can you offer for that?
Nowadays we don't just get our fill of sunshine in summer, we take Christmas holidays to warmer climes too. The digital examination possibilities are helping to improve the detection rate. Changes to the skin which are barely perceptible to the naked eye weren't identified as skin cancer at such an early stage in the past. For this reason, the higher numbers of cases are indicative of better and, above all, earlier detection. And as such I think that we can take something positive from this development: the earlier skin cancer is detected, the better the chances of being able to treat it.

Dermatologists undergo extensive training to be able to diagnose skin cancer. To what extent does medical technology support the early detection of malignant skin changes?
In the past, the skin was merely examined with the naked eye or a special magnifying loupe – a dermatoscope. The findings were written down in the patient file and that was that. Due to a lack of photographic documentation, it was practically impossible to identify minute changes at subsequent check-ups. In the meantime, digital video documentation has been able to establish itself: The doctor can inspect the skin in detail and take microscopic images of suspicious sites with a special camera. In the next check-up, a new image can be taken of the same site and any changes identified by comparing the two.

Still, not all melanomas develop from an existing mole. Many appear on healthy skin. For this reason, so-called "total body mapping" visualizes not only the individual moles, but the whole surface of the skin. In the first step, the patient is systematically photographed from all sides and from head to toe. Suspicious moles can then be examined and documented with the help of dermoscopy. However, you have to remember: the skin is the biggest organ in the human body. As such, the examination and the manual setting up of the camera were really time-consuming in the past.

For this reason, we tried to find a solution which offered high-resolution images of the whole skin, which is standardised so that exact image comparison is possible and which is considerably quicker than manual total body mapping.

...that sounds like a fantasy.
Well, luckily, it isn't any more. The ATBM system satisfies all these requirements. The automated imaging station for standardised skin images with integrated digital dermoscopy follows a fixed pattern, photographing the patient from head to toe and from all sides. The patient only has to turn four times. To ensure perfect comparability of the follow-up images, the image capture is computer assisted and employs reproducible camera parameters. Special analysis modules help the doctor to identify new and changed moles, which he then examines with the medical video camera to determine whether they are malignant.

So many innovations in one device. How did you come up with the idea for the automated procedure?
We have already been active on the market with systems for manual total body mapping for many years and received lots of feedback from our customers. They needed a long time to take all the pictures and then to inspect each mole individually, especially on patients with more than 50 moles. On a visit to an automobile production department, the automated production and software processes running in parallel made a lasting impression on me. I wanted to be able to offer doctors the same rapid precision in skin cancer diagnosis. Thanks to the automation, this examination takes just a few minutes with the ATBM Tower.

FotoFinder invented this technology and caused a sensation among doctors and patients. What has changed for you and your company since it was launched?
Naturally, the fact that it was so well received by doctors and patients alike overwhelmed me and was a great reward for the long development time. After it was launched in May 2013, word quickly got around about the ATBM procedure all over the world. Very quickly!

What do you mean?
Being able to document the skin in such a short time is a breakthrough, especially since analysis processes can run in the background at the same time. It has already spurred imitators to launch rashly developed copies on the market.
As a layman, it seems like you just need a good camera with automatic adjustment and a computer to offer the doctor a reliable means for diagnosis and analysis. The decisive element, however, is the comparability. After all, identifying changes at the earliest point possible is the key aspect of skin cancer diagnosis. The interplay of software, mechanics, documentation, electrical stability and integration in existing processes is incredibly complex. And it doesn't just stop with one functioning device. We invest a lot of development work in it to guarantee the operational reliability and keep failures and maintenance times as low as possible.
Poorly functioning devices merely frustrate doctors and are detrimental to the early detection of skin cancer, which is so important.

Now they have automation and digital analysis support, do patients still need the doctor?
Yes. The emergence of digital dermatoscopy in recent years didn't change that fact and ATBM technology won't either. The latest generation of devices display more and more detailed structures, which only a specialised doctor can assess properly. The technology is intended to help the doctor, but never replace him!

Thank you very much for your time, Mr Mayer.



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