Skin imaging techniques for melanoma detection: A scoping review of modalities, clinical viability, and deployment strategies

Melanoma incidence is rising, whereas access to dermatologists remains limited. In this review, we identified 114 diagnostic-accuracy studies evaluating 11 noninvasive imaging modalities for melanoma detection: photography-based, dermoscopy, electrical impedance spectroscopy, reflectance confocal microscopy, optical coherence tomography based, multispectral/hyperspectral imaging, high-frequency ultrasound, Raman/surface-enhanced Raman spectroscopy, infrared/thermal imaging, multiphoton tomography, and elastic scattering spectroscopy. Across modalities, sensitivities ranged from 37 to 100%, and specificities ranged from 15 to 100%. Dermoscopy (32 studies/34,700 lesions) and reflectance confocal microscopy (33 studies/10,365 lesions) studies had the largest evidence base. Integrating accuracy with regulatory, reimbursement, and cost data, we propose a 3-tier deployment model from home-based triage to specialist clinic based.