Imaging evolution in cutaneous melanoma: from symptom-driven radiography to multimodal AI

Immune checkpoint inhibitors in melanoma can cause pseudoprogression, requiring immune-adapted response criteria. Multimodality imaging (CT, MRI, FDG PET/CT) guides staging, surgery, and surveillance, but imaging for low-risk stages remains controversial.

• Noninvasive imaging (dermoscopy, total-body photography, reflectance confocal microscopy) has expanded primary melanoma detection.
• Lymphoscintigraphy and SPECT/CT are used for sentinel node mapping.
• Emerging technologies include AI-assisted image analysis, radiomics, and image-guided surgery.

Automated summary

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