Analysis: 3D Imaging Yields Higher Costs Without Detection Benefit in High-Risk Melanoma Patients
Key Takeaways
3D total-body photography-sequential digital dermoscopy imaging resulted in higher costs per person over two years.
Quality-adjusted life years were nearly identical between intervention and control groups.
New research indicates 3D total-body photography (TBP) paired with sequential digital dermoscopy imaging (SDDI) leads to higher care costs without significantly improving the detection of malignant melanomas when compared to usual care for high-risk patients.
The study authors followed 314 adults (18+) identified as being at high risk for melanoma and randomly assigned to an intervention group or a control group. The intervention included 3D TBP-SDDI and clinical skin examinations by junior clinicians every six months, with teledermatologist reviews. Control group participants continued with standard care and completed biannual online surveys.
The results showed the mean per-person cost for the intervention group was $1,708 (95% CI, $1,455 to $1,961), compared to $763 (95% CI, $655 to $870) for the control group. Despite this higher cost, quality-adjusted life-years (QALYs) were nearly identical between the two groups, with both achieving 1.84 QALYs over 2 years. Participants in the intervention group saw fewer melanoma excisions, but had more biopsies, benign excisions, and keratinocyte carcinoma removals.
Incremental costs per additional malignant tumor excised were $40 (95% CI, $34 ot $48). Although the intervention offered advanced technological methods, the study authors concluded that its higher cost did not yield substantial improvements in melanoma detection.
"The study results suggest that, in the short term, 3D TBP in addition to usual care was not cost-effective for patients with high-risk melanoma vs usual care only," they wrote.
They also emphasized the importance of cost-effectiveness in evaluating new medical interventions but noted that further investigation is needed.
“Other benefits of 3D TBP-SDDI may arise once artificial intelligence clinician support systems are integrated,” they added.
Source: Lindsay D, et al. JAMA Dermatology. 2025. Doi:10.1001/jamadermatol.2025.0219