Research Article | | Peer-Reviewed

Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients

Received: 17 July 2024     Accepted: 15 August 2024     Published: 6 September 2024
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Abstract

Relevance: ten years ago, artificial intelligence (AI), particularly neural networks (NN), as a diagnostic option in practice seemed a distant prospect. Today, the use of AI is becoming an increasingly popular and daily improving approach in all aspects of clinical and fundamental medicine. Purpose: design and learning of a NN to recognize four types of benign melanocytic skin tumors, integration into a mobile app to apply in practice. Material and methods: сlinical and dermatoscopic analysis of skin tumors was carried out in 600 children. In 65 cases the tumors were removed. Histological types were dermal nevus – 43% (n=28), complex nevus - 33.8% (n=22), pyogenic granuloma - 10.8% (n=7), Spitz-nevus - 6.2% (n=4), blue nevus - 3.1% (n=2), melanoma - 3.1% (n=2). Seven patients with pyogenic granulomas and two patients with melanoma were excluded. The test set included 56 dermatoscopic images. Due to the small number of images augmentation was performed. The database has been increased from 600 images to 1800. NN is written in the machine language Python. The machine learning framework was TensorFlow 2.0. The network architecture is based on the pre-trained model “EfficientNet B7”. This model uses the “supervised learning” paradigm. Each element of the sample had a class affiliation. Results: an accuracy of 83% was achieved after a period of learning on the test set. Mathematical metrics calculated in the Scikit-learn library. Sensitivity was 100% (blue nevus), 73% (complex nevus), 93% (dermal nevus), 75% (Spitz-nevus), and specificity were 98%; 94%; 82%; 98%, respectively. AI was integrated into the mobile app “KIDS NEVI”. Conclusion: AI as an auxiliary method for the skin tumors diagnosis in children and adolescents has demonstrated high potential and great opportunities. Dermatoscopic analysis of a skin tumor and a mobile app are able to provide “double control”, quick and correct clinical diagnosis and determination treatment tactics.

Published in European Journal of Clinical and Biomedical Sciences (Volume 10, Issue 2)
DOI 10.11648/j.ejcbs.20241002.12
Page(s) 28-37
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Children, Benign Skin Tumors, Artificial Intelligence, Neural Network, Dermatoscopy

1. Introduction
Childhood is a dynamic period of melanocytic skin tumors development. The importance of a quick diagnostics and decision to follow-up or remove the tumor is unquestionable .
Information about natural evolutionary transformations of nevi is still rare. In some cases, diagnostics is difficult. Clinical or the “naked eye” research of a skin tumor has quite low information . Dermatoscopy is a non-invasive, highly informative diagnostic method increasingly used in clinical oncologic and dermatologic practice. This painless technique is optimal for assessing skin tumors in children and adolescents. The high accuracy of dermoscopy was also confirmed in a study by the N. N. Petrov National Medical Research Center of Oncology on pediatric cohort .
Today, the need to create auxiliary methods of non-invasive diagnostics is evident. New developments will make it possible to determine patient treatment tactics and avoid unnecessary surgery.
Ten years ago, artificial intelligence (AI), particularly neural networks (NN), as a diagnostic option in practice seemed only a distant prospect. The understanding of the potential machine learning and the technical component was beginning. Today the use of NN in all aspects of clinical and fundamental medicine is an increasingly popular and daily improving approach .
No publications have been found on the topic of AI in the diagnosis of skin tumors in children and adolescents. The absence of articles on this theme notes the scientific novelty of the research.
The main aims of study were the development and learning a neural network to recognize four types of benign melanocytic skin tumors, evaluate diagnostic information content, and integrate the AI into a mobile app for practical use. The combined use of dermatoscopic and mobile applications can provide “double control”, fast and correct clinical diagnosis, and determination of treatment tactics.
The NN was developed on the basis of the "EfficientNet B7" architecture. Learning was conducted on 1800 (including augmentation) dermatoscopic images of pediatric and adolescent patients observed at the N. N. Petrov National Medical Research Center of Oncology. The accuracy was assessed on the test sample and the diagnostic information value (sensitivity, specificity and other metrics) was determined.
2. Materials and Methods
Clinical and dermatoscopic analysis of skin tumors was performed in 600 pediatric and adolescent patients from 2016 to 2022. The study protocol was approved by the biomedical ethics committee of NMRC of Oncology named after N.N.Petrov of MoH of Russia. Protocol №42 dated 28.10.2020. Removal of lesions with morphologic verification was performed in part of patients (n = 65). The indications for removal were different: from signs of superficial trauma to atypical dermatoscopic picture requiring pathomorphological and immunohistochemical analysis.
The gender ratio was 1: 1; boys 33 (50.8%) and girls 32 (49.2%).
The age of the patients ranged from 2 to 17 years, with a median of 14 years. More than half of the children were of pubertal age (n = 45 or 69.2%).
Maximum follow-up period was 1569 days, with a median of 16.5 days.
Diameter of skin neoplasms varied from small nevi to the size of giant congenital nevi. The minimum diameter was 0.2 cm and the maximum diameter was 60 cm.
Localization of tumors varied: 16 (24.6%) patients had elements on the limbs, 61.5 (40%) on the trunk, 2 (3.1%) on the scalp, and 7 (10.8%) on the neck (Figure 1).
The dermatoscopic pattern was analyzed according to generally accepted algorithms for the diagnosis of adult skin neoplasms with an age-adapted approach according to the ABCDE rule (A - asymmetry, B - border, C - color, D - diameter, E - evolution) (Stolz W. et al., 1994), 11 - positional test (Menzies S. W. et al., 1996), 7 - positional test (Argenziano G. et al., 1998). Dermatoscopic criteria (abs., %) are presented in Table 1.
Skin lesions were removed by excision, ablative laser surgery, and total panch biopsy. Staged morphological diagnosis verifies the diagnosis in all patients, allowing to choose the adequate extent of surgical procedures. Dermal nevus was detected in 43% of cases (n = 28), complex nevus was detected in 33.8% (n = 22), pyogenic granuloma was detected in 10.8% (n = 7), Spitz-nevus was detected in 6.2% (n = 4), blue nevus was detected in 3.1% (n = 2), and melanoma was detected in 3.1% (n = 2) (Figure 2).
Benign skin melanocytic tumors of four histological types - blue nevus, complex nevus, dermal nevus and Spitz - nevus - were selected for further analysis and NN development.
Seven patients with vascular neoplasms - pyogenic granulomas (capillary-lobular granulomas) and 2 patients with skin melanoma were excluded from the test sample. Exclusion of patients with pyogenic granulomas is justified by an another tumorogenesis. Children with verified melanoma were also removed from study due to poor photographic material. Melanoma is an acute problem in the structure of oncologic pathology. This tumor is extremely rare in young patients . Pediatric melanoma is detected in less than 2 cases per 1 million . The rarity of disease limits the dermatoscopic image database set and makes it impossible to attempt correct machine learning (ML) and NN development.
Augmentation was performed due to the small number of images in the training sample. The database was enlarged from 600 to 1800 by reflecting, enlarging, lighting, changing the lighting and contrast of the images (Figure 3). Image augmentation generates random images based on existing training data to improve the generalization ability of models. The accuracy of the model did not exceed 70 percent without the use of augmentation. The test sample included 56 dermatoscopic images.
Figure 1. Distribution of tumor localization (16 (24.6%) on the limbs, 61.5 (40%) on the trunk, 2 (3.1%) on the scalp, and 7 (10.8%) on the neck).
Figure 2. Distribution of histological type (dermal nevus was detected in 43% of cases (n = 28), complex nevus in 33.8% (n = 22), pyogenic granuloma in 10.8% (n = 7), Spitz-nevus in 6.2% (n = 4), blue nevus in 3.1% (n = 2), melanoma in 3.1% (n = 2).
Figure 3. Augmentation.
Figure 4. The architecture model “EfficientNet B7”.
Figure 5. Adjustment of synaptic weights, 83% accuracy on the test set.
Figure 6. Neural network model after learning.
Figure 7. Confusion matrix.
Figure 8. ROC curve, AUC. *AUC - area under the curve, (blue nevus - 0.99; complex nevus - 0.79; dermal nevus - 0.89; Spitz-nevus - 0.76).
Figure 9. Mobile app “Kids nevi”.
Table 1. Dermatoscopic criteria.

Dermatoscopic criteria

abs

%

Typical pigment network

5

7,7

Atypical pigment network

3

4,6

Diameter < 2 mm

-

-

Diameter 3-5 mm

20

30,7

Diameter 6-8 mm

23

35,4

Diameter 9-10 mm

8

12,3

Diameter > 11 mm

17

26,2

Peripheral pigment network

2

3

Peripheral pigment globules

7

10,8

Network break to the periphery

1

1,5

Vascular structures in the form of comma

22

33,8

Typical globules

21

32,3

Atypical vascular pattern

1

1,5

Atypical globules

6

9,2

Homogeneous pink areas

7

10,8

Blue-white veil

3

4,6

Pigment blots

16

24,6

Pigment points

5

7,7

Asymmetry

24

36,9

Regressive areas

2

3

Irregular borders

26

40

Central hyperpigmentation

16

24,6

Irregular coloring

51

78,5

«Cobblestone street» structure

3

4,6

Multicolor (more than 3 colors)

17

26,2

Homogeneous blue-gray pigmentation

2

3

Homogeneous area of dark brown / black color

4

6,2

Multicomponent

10

15,4

«Starburst»

3

4,6

Homogeneous structureless area

33

50,8

Ulceration

5

7,7

Table 2. Mathematical metrics (accuracy, sensitivity, specificity, f1-score).

Histological type

Artificial intelligence

precision

recall

specificity

F1-score

Complex nevus

0,89

0,73

0,94

0,8

Dermal nevus

0,84

0,93

0,82

0,8

Blue nevus

0,67

1

0,98

0,8

Spitz-nevus

0,75

0,75

0,98

0,75

3. Results
The NN was written in the Python programming language based on the training and test sample data. The TensorFlow 2.0 framework was used in ML. The network architecture is based on the pre-trained model “EfficientNet B7” (Figure 4). This model uses the “supervised learning” paradigm. Each element of the sample had a class affiliation.
The method of error back propagation was applied. 83% accuracy was achieved after 15 epochs of learning on the test sample (Figure 5).
The training is done on an NVIDIA 2080Ti GPU for 8 hours.
AI recognition was considered correct when there was a match (e.g., complex/complex). Prediction was incorrect when there was a mismatch (e.g., complex/dermal).
A fragment of the model developed and trained by NN is shown in Figure 6. Two morphologic variants are displayed above each dermatoscopic image: the first is the result of the NN prediction and the second is the true (histologic) type of the neoplasm. AI recognition was considered correct if there was a match (e.g., complex/complex). Prediction was considered incorrect when there was a mismatch (e.g., complex/dermal) (Figure 6).
Visual assessment of diagnostic error was performed by comparing actual and predicted values after constructing a confusion matrix (Figure 7).
Matrix columns - predicted values of the target variable based on the results of pattern recognition by trained NN; rows - actual (resulting) indicators (morphological verification). Numbers outside the main diagonal correspond to the number of diagnostic errors. Single numbers outside the main diagonal confirm high information content of this method. The maximum diagnostic error was found in the identification of complex nevus. In five cases, the lesion was identified as a dermal nevus (Figure 7).
Figure 7 interpretation:
1) number of patients (n = 56) - the total value in the matrix;
2) the main diagonal (from left to right, from top to down) corresponds to the matching of AI and histologic diagnosis;
3) numbers in the main diagonal correspond to matches in the diagnoses;
4) numbers outside the main diagonal correspond to the number of diagnostic errors (row demonstrates the correct histologic diagnoses; column demonstrates the incorrect predicted diagnoses);
5) color gradation (from light to dark) corresponds to increasing numbers.
Accuracy (proportion of objects truly belonging to a given class relative to all objects), sensitivity (proportion of true positive classifications), specificity (proportion of true negative classifications) and f1-score (joint estimate of accuracy and sensitivity) are estimated using the following formulas:
Precision (PPV- positive predictive value):
PV=TPTP+FP
TP – true positive rate и FP – false positive rate.
Sensitivity (recall, hit rate, TPR true positive rate):
TPR=TPTP+FN
FN – false negative rate.
Specificity (selectivity, TNR):
TNR=TNFP+TN
TN – true negative rate.
F1-score (joint assessment of accuracy and sensitivity):
F1=2×precision×recallprecision+recall
Calculation of mathematical metrics is performed in the Scikit-learn library (Table 2).
Sensitivity was 100% for blue nevus, 73% for complex nevus, 93% for dermal nevus, and 75% for Spitz-nevus; specificity was 98%, 94%, 82%, and 98%, respectively, despite the limited sample.
Receiver Operator Characteristic (ROC) curves were constructed and Area Under Curve (AUC) was determined to analyze the association between several determinants, technique, and morphology (the resulting characteristics were nevus blue, complex nevus, dermal nevus, and Spitz's nevus). The AUC for blue nevus was 0.99; for complex nevus, 0.79; for dermal nevus, 0.89; and for Spitz-nevus, 0.76 (Figure 8).
NN has been integrated into the “Kids nevi” mobile app. The app is available on the Android platform.
How the application works:
1) Launch the mobile application
2) Tap the "select photo" button, uploading the dermatoscopic image.
3) Tap the "recognize" button, analyzing the image.
4) Identifying the type of melanocytic nevus (blue nevus, complex nevus, dermal nevus or Spitz-nevus) with an accuracy of one thousandth (Figure 9).
4. Discussion
The availability of large-scale data combined with advances in high-performance computing and innovative deep learning architectures has led to the rapid adoption of artificial intelligence in practicing medicine, both oncology and other specialties .
The purpose of software developed and trained with AI in oncology is diagnosis, process staging, assessment of molecular characteristics of tumors and their microenvironment, finding new therapeutic options, prediction of treatment outcomes, etc. .
Foreign studies devoted to machine learning and NN in the diagnosis of skin neoplasms by analyzing digital images are presented in limited quantities. Most articles describe the possibilities of AI for the recognition and differential diagnosis of melanoma in adult patients. There is no similar experience in pediatric patients.
5. Conclusion
1) Benign skin neoplasms in children and adolescents are represented by a large variety of melanocytic, vascular and other genesis. The diversity of skin lesions explains the search for additional diagnostic possibilities adapted to age period.
2) The sample was limited, but artificial intelligence as an auxiliary method of melanocytic skin tumors diagnostic in children and adolescents showed high potential and great prospects. The feasibility of further improvement by expanding the database and morphological variants of tumors is beyond doubt.
3) The mobile app allows analyzing dermatoscopic image and recognizing nevus type. Dermatoscopic analysis of a skin tumor and a mobile app are able to provide “double control”, quick and correct clinical diagnosis and determination treatment tactics.
Abbreviations

AI

Artificial Intelligence

NN

Neural Network

ABCDE

A - Asymmetry, B - Border, C - Color, D - Diameter, E - Evolution

ML

Machine Learning

PPV

Positive Predictive Value

TP

True Positive

FP

False Positive

TPR

True Positive Rate

FN

False Negative

TN

True Negative

ROC curves

Receiver Operator Characteristic

AUC

Area Under Curve

DERM

Deep Ensemble for Recognition of Melanoma

Author Contributions
Rina Khabarova: Methodology, Software, Visualization, Writing – original draft
Svetlana Kulyova: Conceptualization, Data curation, Project administration, Validation, Supervision, Writing – review & editing
Evgeniy Senchurov: Resources, Visualization
Elena Mikhailova: Visualization, Writing – original draft
Kseniya Borokshinova: Visualization, Writing – original draft
Alika Kulyova: Visualization, Writing – original draft
Funding
The study was performed without external funding.
Data Availability Statement
The data supporting the outcome of this research work has been reported in this manuscript.
Conflicts of Interest
The authors declare no conflicts of interest.
References
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Cite This Article
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    Khabarova, R., Kulyova, S., Senchurov, E., Mikhailova, E., Borokshinova, K., et al. (2024). Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients. European Journal of Clinical and Biomedical Sciences, 10(2), 28-37. https://doi.org/10.11648/j.ejcbs.20241002.12

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    Khabarova, R.; Kulyova, S.; Senchurov, E.; Mikhailova, E.; Borokshinova, K., et al. Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients. Eur. J. Clin. Biomed. Sci. 2024, 10(2), 28-37. doi: 10.11648/j.ejcbs.20241002.12

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    AMA Style

    Khabarova R, Kulyova S, Senchurov E, Mikhailova E, Borokshinova K, et al. Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients. Eur J Clin Biomed Sci. 2024;10(2):28-37. doi: 10.11648/j.ejcbs.20241002.12

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  • @article{10.11648/j.ejcbs.20241002.12,
      author = {Rina Khabarova and Svetlana Kulyova and Evgeniy Senchurov and Elena Mikhailova and Kseniya Borokshinova and Alika Kulyova},
      title = {Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients
    },
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {10},
      number = {2},
      pages = {28-37},
      doi = {10.11648/j.ejcbs.20241002.12},
      url = {https://doi.org/10.11648/j.ejcbs.20241002.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20241002.12},
      abstract = {Relevance: ten years ago, artificial intelligence (AI), particularly neural networks (NN), as a diagnostic option in practice seemed a distant prospect. Today, the use of AI is becoming an increasingly popular and daily improving approach in all aspects of clinical and fundamental medicine. Purpose: design and learning of a NN to recognize four types of benign melanocytic skin tumors, integration into a mobile app to apply in practice. Material and methods: сlinical and dermatoscopic analysis of skin tumors was carried out in 600 children. In 65 cases the tumors were removed. Histological types were dermal nevus – 43% (n=28), complex nevus - 33.8% (n=22), pyogenic granuloma - 10.8% (n=7), Spitz-nevus - 6.2% (n=4), blue nevus - 3.1% (n=2), melanoma - 3.1% (n=2). Seven patients with pyogenic granulomas and two patients with melanoma were excluded. The test set included 56 dermatoscopic images. Due to the small number of images augmentation was performed. The database has been increased from 600 images to 1800. NN is written in the machine language Python. The machine learning framework was TensorFlow 2.0. The network architecture is based on the pre-trained model “EfficientNet B7”. This model uses the “supervised learning” paradigm. Each element of the sample had a class affiliation. Results: an accuracy of 83% was achieved after a period of learning on the test set. Mathematical metrics calculated in the Scikit-learn library. Sensitivity was 100% (blue nevus), 73% (complex nevus), 93% (dermal nevus), 75% (Spitz-nevus), and specificity were 98%; 94%; 82%; 98%, respectively. AI was integrated into the mobile app “KIDS NEVI”. Conclusion: AI as an auxiliary method for the skin tumors diagnosis in children and adolescents has demonstrated high potential and great opportunities. Dermatoscopic analysis of a skin tumor and a mobile app are able to provide “double control”, quick and correct clinical diagnosis and determination treatment tactics.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Artificial Intelligence (Neural Network) in the Diagnosis of Benign Skin Tumors in Pediatric Patients
    
    AU  - Rina Khabarova
    AU  - Svetlana Kulyova
    AU  - Evgeniy Senchurov
    AU  - Elena Mikhailova
    AU  - Kseniya Borokshinova
    AU  - Alika Kulyova
    Y1  - 2024/09/06
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ejcbs.20241002.12
    DO  - 10.11648/j.ejcbs.20241002.12
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 28
    EP  - 37
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20241002.12
    AB  - Relevance: ten years ago, artificial intelligence (AI), particularly neural networks (NN), as a diagnostic option in practice seemed a distant prospect. Today, the use of AI is becoming an increasingly popular and daily improving approach in all aspects of clinical and fundamental medicine. Purpose: design and learning of a NN to recognize four types of benign melanocytic skin tumors, integration into a mobile app to apply in practice. Material and methods: сlinical and dermatoscopic analysis of skin tumors was carried out in 600 children. In 65 cases the tumors were removed. Histological types were dermal nevus – 43% (n=28), complex nevus - 33.8% (n=22), pyogenic granuloma - 10.8% (n=7), Spitz-nevus - 6.2% (n=4), blue nevus - 3.1% (n=2), melanoma - 3.1% (n=2). Seven patients with pyogenic granulomas and two patients with melanoma were excluded. The test set included 56 dermatoscopic images. Due to the small number of images augmentation was performed. The database has been increased from 600 images to 1800. NN is written in the machine language Python. The machine learning framework was TensorFlow 2.0. The network architecture is based on the pre-trained model “EfficientNet B7”. This model uses the “supervised learning” paradigm. Each element of the sample had a class affiliation. Results: an accuracy of 83% was achieved after a period of learning on the test set. Mathematical metrics calculated in the Scikit-learn library. Sensitivity was 100% (blue nevus), 73% (complex nevus), 93% (dermal nevus), 75% (Spitz-nevus), and specificity were 98%; 94%; 82%; 98%, respectively. AI was integrated into the mobile app “KIDS NEVI”. Conclusion: AI as an auxiliary method for the skin tumors diagnosis in children and adolescents has demonstrated high potential and great opportunities. Dermatoscopic analysis of a skin tumor and a mobile app are able to provide “double control”, quick and correct clinical diagnosis and determination treatment tactics.
    
    VL  - 10
    IS  - 2
    ER  - 

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Author Information
  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation; Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Rina Khabarova: Cand. of Sci. (Med.), Pediatric Oncologist of the Children Oncology Department, postgraduate student of the Research Department of Innovative Therapeutic Oncology and Rehabilitation Methods of N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Assistant of the Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University.

  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation; Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Svetlana Kulyova: Dr. of Sci. (Med.), Associate Professor, Head of Pediatric Oncology Department, Leading Researcher of the Research Department of Innovative Therapeutic Oncology and Rehabilitation Methods, Professor of the Training and Methodology Department of N.N. Petrov National Medical Research Center of Oncology, Head of the Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University, Chief Freelance Children's Specialist Oncologist of Saint-Petersburg Health Committee.

  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation; Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Evgeniy Senchurov: Pediatric Oncologist of the Children Oncology Department, postgraduate student of the Research Department of Innovative Therapeutic Oncology and Rehabilitation Methods of N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Assistant of the Department of Oncology, Children’s Oncology and Radiotherapy of Saint Petersburg State Pediatric Medical University.

  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Elena Mikhailova: Pediatric Oncologist of the Children Oncology Department, postgraduate student of the Research Department of Innovative Therapeutic Oncology and Rehabilitation Methods of N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation.

  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Kseniya Borokshinova: Pediatric Oncologist of the Children Oncology Department, postgraduate student of the Research Department of Innovative Therapeutic Oncology and Rehabilitation Methods of N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation.

  • Children Oncology Department, N. N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation

    Biography: Alika Kulyova: Postgraduate Student of the N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of the Russian Federation.