BackgroundMelanoma is one of the deadliest tumors in the world. Early detection is critical for first-line therapy in this tumor pathology and it remains challenging due to the need for histological analysis to ensure correctness in diagnosis. Therefore, multiple computer-aided diagnosis (CAD) systems working on melanoma images were proposed to mitigate the need of a biopsy. However, although the high global accuracy is declared in literature results, the CAD systems for the health fields must focus on the lowest false negative rate (FNR) possible to qualify as a diagnosis support system. The final goal must be to avoid classification type 2 errors to prevent life-threatening situations. Another goal could be to create an easy-to-use system for both physicians and patients.ResultsTo achieve the minimization of type 2 error, we performed a wide exploratory analysis of the principal convolutional neural network (CNN) architectures published for the multiple image classification problem; we adapted these networks to the melanoma clinical image binary classification problem (MCIBCP). We collected and analyzed performance data to identify the best CNN architecture, in terms of FNR, usable for solving the MCIBCP problem. Then, to provide a starting point for an easy-to-use CAD system, we used a clinical image dataset (MED-NODE) because clinical images are easier to access: they can be taken by a smartphone or other hand-size devices. Despite the lower resolution than dermoscopic images, the results in the literature would suggest that it would be possible to achieve high classification performance by using clinical images. In this work, we used MED-NODE, which consists of 170 clinical images (70 images of melanoma and 100 images of naevi). We optimized the following CNNs for the MCIBCP problem: Alexnet, DenseNet, GoogleNet Inception V3, GoogleNet, MobileNet, ShuffleNet, SqueezeNet, and VGG16.ConclusionsThe results suggest that a CNN built on the VGG or AlexNet structure can ensure the lowest FNR (0.07) and (0.13), respectively. In both cases, discrete global performance is ensured: 73% (accuracy), 82% (sensitivity) and 59% (specificity) for VGG; 89% (accuracy), 87% (sensitivity) and 90% (specificity) for AlexNet.