Optical performance of handheld dermatoscopes in visualizing polarization-dependent structures - results of the polaris study

Background Polarization reveals critical diagnostic clues embedded in a range of diagnostic algorithms aimed at early skin cancer detection, but device-dependent visualization differences raise safety concerns. Objectives The POLARIS study compared polarization-dependent structure visibility across seven commercial handheld dermatoscopes. Methods Twenty international dermatoscopists, informed of the target polarization-dependent structure(s) in each case and partially blinded to dermatoscope model, evaluated standardized cases imaged using seven devices (DL3, DL4, DL5, Handyscope, DELTA 20 T, DELTA 30, and DELTA 30 PRO). Feature visibility was scored on a 5-point Likert scale and analyzed with a cumulative link mixed model. Results Device type significantly impacted visibility (10,779 ratings by 20 raters of 61 lesions; p < 0.001). Against DELTA 30, every other device had higher odds of a better rating: the smallest odds ratio was 7.0 and the largest, for Handyscope, was 43.2. DELTA 30 received low-visibility ratings in 69.5% of assessments. Handyscope also was rated above every other device (odds ratios 2.3–43.2), and no device was estimated to outperform it for any structure. Those other devices formed a graded order. DELTA 30 PRO was rated markedly higher than DELTA 30 (odds ratio 10.1, Bonferroni-adjusted 95% CI 4.6–22.4). Conclusions Hybrid dermatoscopes differ significantly in their visualization of polarization-dependent structures which remain vital diagnostic clues. The suboptimal recognition of these features by underperforming devices, highlights the need to understand how these disparities impact diagnostic accuracy. Consequently, dermatoscopists should be aware of the performance of the devices they use.

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Journal
Frontiers in Medicine
Published
2026-11-06
DOI
https://doi.org/10.3389/fmed.2026.1972723
Primary Topic
Cutaneous Melanoma Detection and Management
Type
article
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article

Optical performance of handheld dermatoscopes in visualizing polarization-dependent structures - results of the polaris study

Katarzyna Korecka, Carmen Cantisani, Christina Wlodek, Cliff O. Rosendahl et al.
Frontiers in Medicine
Cutaneous Melanoma Detection and Management
article

Optical performance of handheld dermatoscopes in visualizing polarization-dependent structures - results of the polaris study

Katarzyna Korecka, Carmen Cantisani, Christina Wlodek, Cliff O. Rosendahl, Herman Mayisoğlu, Mehdi Boostani, Piotr Giedziun, Jan Lapins, Ihor Kohut, Marian S. Voloshynovych, Chin Whybrew, Justin C. Chia, Awatef Kelati, Norbert Kiss, John Paoli, Georgia Pappa, Helena Collgros, Aleksandra Lesiak, Bengü Nisa Akay, Giuseppe Argenziano, Natalia Salwowska, Emmanouil Karampinis, Jacek Calik, Iris Zalaudek, Noureddine Litaiem, Pille Konno, Cristián Navarrete, Ashfaq A. Marghoob, Agnieszka Leszczyńska-Pietkiewicz, Verce Todorovska, Julien Anriot, Paweł Falkowski, Marta Koper, Michaela Starace, Natalia Gębka, Ružica Jurakić Tončić, Angelika Bigaj, Houda Hammami, Marwan Al Nasiri, Mikołaj Łanocha, Paweł Pietkiewicz, Dominiak Małgorzata
article en

Abstract

Background Polarization reveals critical diagnostic clues embedded in a range of diagnostic algorithms aimed at early skin cancer detection, but device-dependent visualization differences raise safety concerns. Objectives The POLARIS study compared polarization-dependent structure visibility across seven commercial handheld dermatoscopes. Methods Twenty international dermatoscopists, informed of the target polarization-dependent structure(s) in each case and partially blinded to dermatoscope model, evaluated standardized cases imaged using seven devices (DL3, DL4, DL5, Handyscope, DELTA 20 T, DELTA 30, and DELTA 30 PRO). Feature visibility was scored on a 5-point Likert scale and analyzed with a cumulative link mixed model. Results Device type significantly impacted visibility (10,779 ratings by 20 raters of 61 lesions; p < 0.001). Against DELTA 30, every other device had higher odds of a better rating: the smallest odds ratio was 7.0 and the largest, for Handyscope, was 43.2. DELTA 30 received low-visibility ratings in 69.5% of assessments. Handyscope also was rated above every other device (odds ratios 2.3–43.2), and no device was estimated to outperform it for any structure. Those other devices formed a graded order. DELTA 30 PRO was rated markedly higher than DELTA 30 (odds ratio 10.1, Bonferroni-adjusted 95% CI 4.6–22.4). Conclusions Hybrid dermatoscopes differ significantly in their visualization of polarization-dependent structures which remain vital diagnostic clues. The suboptimal recognition of these features by underperforming devices, highlights the need to understand how these disparities impact diagnostic accuracy. Consequently, dermatoscopists should be aware of the performance of the devices they use.

Frontiers in MedicineVol. 13
Semmelweis University (HU), Tunis University (TN), Wrocław University of Science and Technology (PL), Poznan University of Medical Sciences (PL), Roswell Park Comprehensive Cancer Center (US), Ivano-Frankivsk National Medical University (UA), Memorial Sloan Kettering Cancer Center (US), Karolinska University Hospital (SE), University Hospital Centre Zagreb (HR), University of Trieste (IT), University of Thessaly (GR), Medical University of Białystok (PL), Ankara University (TR), Pontificia Universidad Católica de Chile (CL), The University of Queensland (AU), Medical University of Silesia (PL), University of Calgary (CA), University of Zagreb (HR), University of Campania "Luigi Vanvitelli" (IT), Aristotle University of Thessaloniki (GR), University of Wrocław (PL), Sahlgrenska University Hospital (SE), Karolinska Institutet (SE), Wroclaw Medical University (PL), Hôpital Charles-Nicolle (FR), Centre Léon Bérard (FR), University Hospital of Larissa (GR), Hôpital Charles-Nicolle (TN), Université Mohammed VI des Sciences et de la Santé (MA), Medical University of Lodz (PL), Hôpital Universitaire International Cheikh Khalifa (MA), Faculté de médecine de Tunis (TN), Adam Mickiewicz University in Poznań (PL), Tunis El Manar University (TN), Sapienza University of Rome (IT), University of Gothenburg (SE)
Ankara Universitesi, University of Sydney, National and Kapodistrian University of Athens, Uniwersytet Łódzki, Università di Bologna, Śląski Uniwersytet Medyczny w Katowicach, Faculty of Medicine and Health, University of Sydney
Good health and well-being
Openalex Percentile: Top 16%
Cutaneous Melanoma Detection and Management
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