A number of new imaging applications for identifying melanoma have become available to dermatologists in the last 15 years, which can improve the sensitivity and specificity of total body skin examinations when used in the appropriate clinical setting, according to  Michael Marchetti, M.D., assistant attending physician at Memorial Sloan Kettering Cancer Center in New York.
“Screening efforts over the last 20 to 30 years have increased the number of melanomas we’re diagnosing at earlier stages, but there still remains a significant number of people diagnosed at later stages, as well as people who die from melanomas caught at relatively early stages,” says Dr. Marchetti, who spoke to colleagues about imaging technologies for pigmented lesions during the summer meeting of the American Academy of Dermatology (New York, 2015).
Dr. Marchetti notes that up to 85% of melanomas are not initially found by dermatologists.
“In general, high sensitivity of an imaging technology is important, but if used as a screening device specificity may even be more important,” he says. “The objectives of my talk included also pointing out the potential risks of melanoma over diagnosis associated with technology use, which are well-recognized in other medical conditions such as ultrasound with thyroid cancer and CT angiography with pulmonary embolism, and may lead to unnecessary treatment, cost, and morbidity” he adds.
To improve the sensitivity and specificity of skin examinations, dermatologists have access to a wide variety of technologies, some old, and some emerging, including total body photography, sequential dermoscopic imaging, and confocal laser microscopy, among others.
 
 
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