3D Total Body Photography as a Promising Innovation for Early Skin Cancer Detection: Scoping Review.

Background: Skin cancer (SC) is a global health concern because of its high and still increasing incidence and associated health care cost. Belgium is no exception as 1 in 5 people are diagnosed with SC before the age of 75 years. The VECTRA WB360, a 3D total body photography system, allows clinicians to objectively compare the totality of the skin on a macroscopic level on further appointments. The integrated lesion visualization software allows automated detection, counts, and assessment of skin lesions. Detailed comparison of individual lesions is possible through the attached digital dermatoscope. Objective: This study aims to review available literature on the use of the VECTRA in research and clinical settings and to summarize the clinical utility, advantages, and limitations reported for this system. Methods: An electronic literature search was conducted on PubMed from December 2023 to March 2024 using a combination of the following search terms: 3D imaging, VECTRA WB360, melanoma, nonmelanoma skin cancer, their synonyms, and associated entry terms. Publications that used a device other than the VECTRA WB360 were excluded, as were papers reporting on new technology without further research or without added cases. After a thorough screening of the papers and removal of duplicates, 11 papers remained. Results: Our literature search yielded 11 relevant papers, which included 2 case studies, 6 prospective studies, and 3 retrospective studies. According to multiple studies, the VECTRA WB360 images were of a high enough quality to allow on-screen diagnosis of some melanoma and nonmelanoma skin cancers by dermatologists. Sensitivity compared to face-to-face examination for melanoma is unknown. The integrated lesion visualization software is capable of detecting and counting naevi and distinguishing melanoma from other skin lesions with high accuracy, with convolutional neural network integration further enhancing its sensitivity and specificity. However, it is important to note that no comparison to the usual standard of care was made. Also, dermatologists achieved greater specificity and thus remained superior to machine and artificial intelligence (AI). Conclusions: Although the VECTRA 3D TBP holds substantial promise for the early detection and monitoring of SC, its application cannot yet replace the expertise of trained clinicians. Although the lesion visualizer and dermoscopy explainable intelligence (DEXI) score offer potential enhancements, they also pose risks, including a significant increase in unnecessary excisions due to lower specificity. Expert overview is still recommended and superior, since there is not enough evidence yet that 3D TBP or AI is reliable on its own or beneficial as a support tool. Given the small samples and lack of blinded trials, further studies are needed to explore and improve the diagnostic capacities of 3D TBP and the possible integration of CNNs or other AI extensions and to examine the VECTRA 360WB compared to the usual standard of care.