Comprehensive Summary
This article examines past literature evaluating the clinical utility of the VECTRA WB360 3D whole body imaging system to visualize dermoscopic images and lesions specifically targeting melanocytic naevi. The findings across 11 PubMed studies were further examined with 3 retrospective, 2 case studies, and 6 prospective studies between December 2023 and March 2024. Specifically, 5 out of the 11 articles utilized results from the Mind Your Moles Protocol that included 200 participants from the Australian population with at least one naevus who underwent skin examinations every six months for 3 years. Results showed that the 3D-TBP CNN had 90% specificity and sensitivity largely improved with size. Also it showed that automated naevus/cherry angioma counting is feasible. The other 6 non-MyM studies focused on higher-risk patients for melanoma with the majority using 3D Total-Body Photography with VECTRA WB360. There was no statistically significant difference found between 3D-TBP and dermascopy. The addition of a lesion visualizer resulted in segmentation errors when evaluating the melanomas, but an AUC=0.94: high discrimination between melanoma vs benign. The use of CNN/AI add-ons yielded high specificity and sensitivity, but in comparison to dermatologists had lower specificity. Overall, 3D-TBP can be seen as useful for high-risk surveillance where AI can have a large focus on lesions and tracking changes.
Outcomes and Implications
With the recent improvements in AI to make diagnostic decisions, the question of its reliability and practicality is critical. The use of 3D total-body photography can be seen as a valuable adjunct to dermatological care to improve longitudinal surveillance and increase efficiency. It is useful for automated lesion counts and baseline mapping, however, due to the limitations found by lesion segmentation errors and incomplete coverage, definitive decisions made about diagnosis and biopsy should largely be based on clinical judgment.