The TRIAGE and ASSIST scan: A new concept in 3D total body imaging for early melanoma detection

<h2>Abstract</h2><h3>Background</h3> Concerning early melanoma detection, dermatologists experience two major challenges: an overwhelming number of patients seeking total body skin examinations, and limited access to a standardized imaging system for monitoring their patients with increased risk for melanoma. This study introduces, for the first time, the concept of an independent imaging center utilizing a three-dimensional (3D) imaging system operated without a dermatologist present on site. The 3D scan performed in low-and mid-risk patients serves as a ‘TRIAGE scan' to filter the patients who require a dermatology consultation. In high-risk patients, it functions as an ‘ASSIST scan', assisting dermatologists during follow-up consultations. <h3>Data collection</h3> In 2024, 3228 scans were performed. Of these, 1169 patients were referred by a dermatologist, while 2059 patients presented on their own initiative. This publication focuses on the self-referred cohort, which was stratified into low-, mid-, and high-risk groups. <h3>Results</h3> The overall skin cancer detection rate across these groups was 4.8 %. Melanoma detection rates were 0.58 % in the low-risk group, 1.10 % in the mid-risk group, and 0.33 % in the high-risk group. The observed number needed to excise (NNE) to detect one skin cancer was 2.0. <h3>Conclusions</h3> The TRIAGE and ASSIST scan approach provides an accessible and cost-effective method for skin cancer screening, particularly for individuals who are uncomfortable relying on self-examination. It offers mid-risk patients the opportunity for efficient screening without placing additional strain on the healthcare system. Furthermore, it supports dermatologists in the follow-up of high-risk patients by providing high-quality, standardized imaging, without requiring substantial infrastructure investment.