Total Body Imaging in Dermatology: A New Concept in Belgium

At the 2025 EADO Congress, Dr Katrien Vossaert (Dermatologie Maldegem, Belgium) presented early results from an innovative total body imaging concept introduced in Belgium in 2023. The project addresses two major issues: the lack of accessible imaging systems for high-risk patients and the growing number of low-risk individuals seeking full-body checks, contributing to long waiting lists.

To tackle this, an independent imaging center, SPOTWATCH, equipped with the Vectra WB360 was established. Operating without a dermatologist on-site, it is currently available in three locations (near Ghent, Antwerp, and Hasselt). Patients can book an appointment directly or via referral. After completing a short medical questionnaire, they undergo a full-body 3D scan, followed by dermoscopic imaging of selected lesions. A report, including both patient-friendly and medical versions, is sent within a week. Suspicious findings are referred back to the patient’s own doctor.

Augmented intelligence supports two steps in the process: first, AI highlights the most atypical lesions to guide the technician’s image selection; second, a DEXY score (0–10) is used to assess the malignancy risk of dermoscopic images.

The system is designed as an assist scan for high-risk patients, supporting dermatologists in long-term follow-up, and as a triage scan for low—and mid-risk patients, reducing unnecessary consultations.

In 2024, over 3,000 patients were scanned, two-thirds without referral. Patients were grouped by risk level; approximately 10% were referred for suspicious lesions. In total, 94 malignant lesions were identified, including 14 melanomas. Notably, more than half of patients with melanoma were unaware of the lesion. The overall detection rate was 4.8%, with a low number needed to excise (NNE): two for all malignancies and three for melanomas.

Significantly, around 1,590 low- and mid-risk patients avoided unnecessary consultations, fulfilling the project’s goal of reducing specialist burden while maintaining early detection.

Although the concept was introduced under the term “population screening,” it more accurately represents a person-oriented approach. For low-risk individuals, a single scan may aid future self-monitoring; intermittent scans could support early detection for mid-risk groups. The project highlights the potential of AI in dermatology, underscoring the importance of clinician involvement in its ongoing development and integration into care pathways.