title: Non-invasive tools for the diagnosis of cutaneous melanoma.
abstract: BACKGROUND
  While the excisional biopsy and histological examination of suspicious lesions remains the current gold standard for diagnosing cutaneous melanoma (CM), there is a demand for more objective and non-invasive examination methods that may support clinicians in their decision when to biopsy or not.
  
  
  METHODS
  This review is based on publications and guidelines retrieved by a selective search in PubMed and MEDLINE and focused on non-invasive diagnostic strategies for detecting melanoma.
  
  
  RESULTS
  Ten different non-invasive techniques were compared with regard to applicability, status of development, and resources necessary for introduction into clinical routine (dermoscopy, sequential digital dermoscopy, total body photography, computer-aided multispectral digital analysis, electrical impedance spectroscopy, Raman spectroscopy, reflectance confocal microscopy, multiphoton tomography, stepwise two-photon-laser spectroscopy, quantitative dynamic infrared imaging). In an effort to create a classification based on our analyses, we suggest to differentiate i) tools for screening of patients in daily clinical routine, ii) tools for examination of a restricted number of preselected lesions that produce an automated diagnostic score, iii) tools for examination of a restricted number of preselected lesions at specialized centers requiring extensive training, iv) devices at an experimental stage of development.
  
  
  CONCLUSIONS
  None of the discussed examination techniques is able to provide a definite and final diagnosis or to completely replace the histopathological examination. Up to date, the need for fully automated devices offering a complete skin cancer screening has not been satisfied.
authors.affiliation: Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Fink
authors.affiliation: Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: H A
authors.initials: HA
authors.lastname: Haenssle
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D046169:Dermoscopy / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D003937:Diagnosis, Differential; D058266:Dielectric Spectroscopy / Q000295:instrumentation / Q000379:methods; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D018613:Microscopy, Confocal / Q000379:methods; D010781:Photography / Q000379:methods; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D013059:Spectrum Analysis, Raman / Q000295:instrumentation / Q000379:methods; D000096142:Cutaneous Malignant Melanoma
keywords: Raman spectroscopy; atypical nevus; computer-aided multispectral digital analysis; dermoscopy; diagnostic devices; dysplastic nevus; electrical impedance spectroscopy; in vivo multiphoton tomography; infrared thermal image analysis; melanoma; reflectance confocal microscopy; sequential digital dermoscopy; stepwise two-photon-laser spectroscopy; total body photography