3D Total-Body Imaging: Fewer Biopsies, More Accurate Diagnosis – A New Era in Skin Cancer

Advanced imaging technology reduces biopsy numbers while improving accuracy in skin cancer diagnosis.

Why Does This Study Matter?

Skin cancer is one of the most common cancers worldwide. Nonmelanoma skin cancers (NMSC) in particular place a substantial burden on healthcare systems, even though they are often not life-threatening. Early, accurate diagnosis is critical to avoiding unnecessary biopsies and using healthcare resources efficiently.

A new study presented at the American Academy of Dermatology (AAD) 2025 Annual Meeting showed that automated three-dimensional total-body photography (3D TBP) has the potential to transform skin cancer diagnosis. Mayo Clinic researchers conducted the study, which both reduced biopsy numbers by 35% , resulting in fewer invasive procedures for patients, and significantly improved detection of cancerous lesions .

Study Details: Who Was Included, and What Was Done?

The retrospective study examined patients at Mayo Clinic Rochester, Minnesota, who attended a specialized 3D imaging clinic and had previously been diagnosed with melanoma: 410 adult patients . They were imaged using the Vectra WB360 3D TBP system at least twice. Their mean age was 51.6, and 53% were women.

In total:

• 5981 patient visits were assessed.

• 1150 dedicated Vectra imaging sessions were performed.

• 3006 biopsies were performed:

  • 56% were benign,

  • 32% malignant,

  • 12% premalignant lesions under this classification.

The Greatest Gain: More Accurate Diagnosis of Nonmelanoma Skin Cancers

The most striking of the main findings was improved diagnosis of nonmelanoma skin cancers :

• The diagnostic yield per biopsy reached 71% , a high level.

• The positive biopsy rate increased by 17% .

• The number of biopsies fell by 14% .

The melanoma detection rate per biopsy, however, decreased by 62% . The researchers noted that this was most likely related to the cohort consisting of people who had already had melanoma. Because melanoma is usually limited to a single primary tumor, detection of new melanomas was low in this group. Similar detection rates compared with a control group not imaged with Vectra suggested that the technology was not missing melanomas.

Fewer Unnecessary Biopsies: 50% Fewer Procedures for Actinic Keratoses

• Actinic keratosis and similar premalignant lesions had a 50% reduction in biopsies.

• For benign lesions, particularly seborrheic keratoses and benign pigmented nevi, biopsy rates decreased substantially.

• For severely dysplastic nevi , the positive diagnostic yield increased by 16%, while the need for biopsy decreased by 13%.

These results showed that 3D imaging not only detects cancerous lesions better but also substantially reduces unnecessary procedures for benign lesions that do not require treatment.

Effective, but Can It Be Used Everywhere?

Dr. Jordan Phillipps emphasized the improved diagnostic process but also highlighted limitations:

• The study population was highly selected (patients previously diagnosed with melanoma).

• 3D TBP systems are not yet widely available; economic and logistical challenges may currently make implementation difficult at every center.

• In the study, the absence of a direct comparison with clinical examinationmakes it difficult to establish how closely the method agrees with the gold standard.

Dr. Kristina Callis Duffin, Chair of Dermatology at the University of Utah, described the results as exciting but stated that randomized controlled trials are needed to measure the method's true effectiveness. In addition, its cost-effectiveness remains unclear. More accurate diagnoses and reductions in morbidity and unnecessary biopsies could provide long-term cost benefits, but more data are needed to assess this balance.

Conclusion: A Future Standard for Skin Cancer Screening?

3D total-body imaging shows promise, particularly by improving accurate diagnosis of nonmelanoma skin cancers and reducing unnecessary biopsies . It may play an important role in future skin cancer screening. However, widespread adoption requires larger studies with direct comparisons and cost analyses .