Molecular Imaging in Early Skin Cancer Detection: Advances, Limitations, and Future Directions

Early detection of skin cancer is crucial for effective treatment and improved patient outcomes. Recent advancements in oncologic imaging, particularly molecular imaging techniques, have revolutionized cancer diagnostics and treatment by enabling the visualization of tumors and cellular activities at the molecular level. These techniques facilitate the identification of early-stage cancers that might remain undetectable through traditional imaging methods. Innovative technologies such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) which visualize skin at near-histologic detail and skin fluorescent imaging (SFI), which targets αvβ3 integrin expression, are promising for non-invasive early detection of melanoma. By integrating in vivo molecular imaging with tumor biomarkers, clinicians can gain more precise insights into processes integral to cancer biology, leading to improved diagnosis, prognosis and the development of personalized treatment strategies. This review explores imaging modalities used in skin cancer diagnosis, highlighting their advantages and limitations, with an emphasis on molecular imaging, stressing its potential to improve early detection, personalize treatment and monitor therapeutic responses.