Nature Communications (Jan 2025)
Discordance, accuracy and reproducibility study of pathologists’ diagnosis of melanoma and melanocytic tumors
- Sarah Haggenmüller,
- Christoph Wies,
- Julia Abels,
- Jana T. Winterstein,
- Lukas Heinlein,
- Carina Nogueira Garcia,
- Jochen S. Utikal,
- Sebastian A. Wohlfeil,
- Friedegund Meier,
- Sarah Hobelsberger,
- Frank F. Gellrich,
- Mildred Sergon,
- Axel Hauschild,
- Lars E. French,
- Lucie Heinzerling,
- Justin G. Schlager,
- Kamran Ghoreschi,
- Max Schlaak,
- Franz J. Hilke,
- Gabriela Poch,
- Sören Korsing,
- Cosimo Sarfert,
- Carola Berking,
- Markus V. Heppt,
- Michael Erdmann,
- Sebastian Haferkamp,
- Konstantin Drexler,
- Dirk Schadendorf,
- Wiebke Sondermann,
- Matthias Goebeler,
- Bastian Schilling,
- Jakob Nikolas Kather,
- Stefan Fröhling,
- Mar Llamas-Velasco,
- Luis C. Requena,
- Gerardo Ferrara,
- Maite Fernandez-Figueras,
- Sylvie Fraitag,
- Cornelia S. L. Müller,
- Hans Starz,
- Heinz Kutzner,
- Raymond Barnhill,
- Richard Carr,
- Kenneth S. Resnik,
- Stephan Alexander Braun,
- Tim Holland-Letz,
- Titus J. Brinker
Affiliations
- Sarah Haggenmüller
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Christoph Wies
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Julia Abels
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Jana T. Winterstein
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Lukas Heinlein
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Carina Nogueira Garcia
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- Jochen S. Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg
- Sebastian A. Wohlfeil
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg
- Friedegund Meier
- Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden
- Sarah Hobelsberger
- Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden
- Frank F. Gellrich
- Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden
- Mildred Sergon
- Institute of Pathology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden
- Axel Hauschild
- Department of Dermatology, University Hospital (UKSH)
- Lars E. French
- Department of Dermatology and Allergy, University Hospital, LMU Munich
- Lucie Heinzerling
- Department of Dermatology and Allergy, University Hospital, LMU Munich
- Justin G. Schlager
- Department of Dermatology and Allergy, University Hospital, LMU Munich
- Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Max Schlaak
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Franz J. Hilke
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Gabriela Poch
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Sören Korsing
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Cosimo Sarfert
- Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Carola Berking
- Department of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen – European Metropolitan Region Nürnberg, CCC Alliance WERA
- Markus V. Heppt
- Department of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen – European Metropolitan Region Nürnberg, CCC Alliance WERA
- Michael Erdmann
- Department of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen – European Metropolitan Region Nürnberg, CCC Alliance WERA
- Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg
- Konstantin Drexler
- Department of Dermatology, University Hospital Regensburg
- Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University Hospital Essen
- Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University Hospital Essen
- Matthias Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg and National Center for Tumor Diseases (NCT) WERA Würzburg
- Bastian Schilling
- Goethe University Frankfurt, University Hospital, Department of Dermatology
- Jakob Nikolas Kather
- Else Kroener Fresenius Center for Digital Health, Technical University Dresden
- Stefan Fröhling
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ)
- Mar Llamas-Velasco
- Department of Dermatology, University Hospital La Princesa
- Luis C. Requena
- Dermatology Department, Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain; Anatomic Pathology Service, Fundación Jiménez Díaz
- Gerardo Ferrara
- Anatomic Pathology and Cytopathology Unit, Istituto Nazionale Tumori I.R.C.C.S. Fondazione ‘G. Pascale’
- Maite Fernandez-Figueras
- University General Hospital of Catalonia, Grupo Quironsalud, International University of Catalonia, Sant Cugat del Vallés
- Sylvie Fraitag
- Pathology department, Necker-Enfants Malades Hospital, Université Paris-Cité, Assistance Publique des Hopitaux de Paris
- Cornelia S. L. Müller
- Center for Histology, Cytology and Molecular Diagnostics
- Hans Starz
- Dermpath München
- Heinz Kutzner
- Dermatopathology Friedrichshafen
- Raymond Barnhill
- Departments of Pathology and Translational Research, Institut Curie
- Richard Carr
- Department of Pathology, Warwick Hospital
- Kenneth S. Resnik
- Institute for Dermatopathology
- Stephan Alexander Braun
- Department of Dermatology, University of Münster, Münster, Germany; Department of Dermatology, Medical Faculty, Heinrich-Heine-University
- Tim Holland-Letz
- Department of Biostatistics, German Cancer Research Center (DKFZ)
- Titus J. Brinker
- Digital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ)
- DOI
- https://doi.org/10.1038/s41467-025-56160-x
- Journal volume & issue
-
Vol. 16,
no. 1
pp. 1 – 8
Abstract
Abstract Accurate melanoma diagnosis is crucial for patient outcomes and reliability of AI diagnostic tools. We assess interrater variability among eight expert pathologists reviewing histopathological images and clinical metadata of 792 melanoma-suspicious lesions prospectively collected at eight German hospitals. Moreover, we provide access to the largest panel-validated dataset featuring dermoscopic and histopathological images with metadata. Complete agreement is achieved in 53.5% of cases (424/792), and a majority vote ( ≥ five pathologists) in 90.9% (720/792). Considerable discordance is observed for non-invasive melanomas (complete agreement in only 10/73 cases). The expert panel disagrees with the local pathologists’ and dermatologists’ diagnoses in 14.9% and 33.5% of cases, respectively. This variability highlights the diagnostic challenges of early-stage melanomas and the need to reconsider how ground truth is established in routine care and AI research. Including at least two pathologists or virtual panels may contribute to more consistent diagnostic results.
