Molecular imaging may significantly reduce the need for unnecessary melanoma biopsies, according to a new study published in the February issue of JAAD International. The research, led by Dr. Douglas Grossman, co-leader of the Melanoma Center at Huntsman Cancer Institute at the University of Utah and professor of dermatology, evaluates the accuracy of Skin Fluorescent Imaging (SFI), a noninvasive technology developed by Orlucent, Inc. SFI uses a fluorescent dye that binds to αvβ3, a protein associated with tumor growth and aggressiveness, to detect molecular signals linked to melanoma. The system is designed to analyze the molecular makeup of skin lesions without requiring tissue removal. In a Phase 2 clinical trial, researchers tested SFI on 240 pigmented lesions suspected of being melanoma after a visual skin exam. The results showed that SFI successfully identified all cases of invasive melanoma—the most dangerous form of the disease. It also distinguished between normal moles and atypical ones, which may have features resembling melanoma but are not yet cancerous. This ability to target only the most concerning lesions could help clinicians make more informed decisions about which cases require biopsy. “By identifying the molecular signals that drive melanoma early on, SFI has the potential to help clinicians decide which suspicious lesions to biopsy while sparing patients unnecessary procedures,” said Grossman. “SFI is a promising step forward in noninvasive approaches to catching melanoma early and reducing biopsies of moles.” Melanoma is the deadliest form of skin cancer, responsible for 90% of skin cancer-related deaths. Once it spreads beyond its original site, treatment becomes much more difficult. Early detection through timely removal dramatically improves survival rates, which has led many doctors to adopt a “when in doubt, cut it out” approach—often resulting in the removal of benign lesions. However, many early melanomas and atypical moles look similar visually, making it challenging to determine which ones are truly cancerous. SFI offers a more precise method by providing molecular-level insights, allowing for a more targeted and less invasive screening process. The handheld imaging device captures real-time fluorescent images after the dye is applied to the lesion and surrounding skin. A machine-learning algorithm then analyzes the data to assess the likelihood of melanoma. The technology could be especially beneficial in rural and underserved areas like the Mountain West, where Huntsman Cancer Institute is based. These regions face high melanoma rates and limited access to dermatologists, making noninvasive screening tools a valuable asset. While the results are promising, further validation is needed before SFI can be widely adopted outside of clinical trials. Researchers emphasize that the system is not yet a replacement for biopsy but a powerful tool to guide clinical decisions and reduce unnecessary procedures.