Reflectance confocal microscopy versus dermoscopy for the diagnosis of cutaneous melanoma: a head-to-head comparative meta-analysis

Abstract

This meta-analysis aimed to evaluate the comparative diagnostic performance of reflectance confocal microscopy (RCM) and dermoscopy in detecting cutaneous melanoma patients. An extensive search was conducted in the PubMed and Embase databases to identify available publications up to December 2023. Studies were included if they evaluated the diagnostic performance of RCM and dermoscopy in patients with cutaneous melanoma. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Performance Studies (QUADAS-2) tool. A total of 14 articles involving 2013 patients were included in the meta-analysis. The overall sensitivity of RCM was 0.94 [95% confidence interval (CI), 0.87–0.98], while the overall sensitivity of dermoscopy was 0.84 (95% CI, 0.71–0.95). These results suggested that RCM has a similar level of sensitivity compared with dermoscopy (P = 0.15). In contrast, the overall specificity of RCM was 0.76 (95% CI, 0.67–0.85), while the overall specificity of dermoscopy was 0.47 (95% CI, 0.31–0.63). The results indicated that RCM appears to have a higher specificity in comparison to dermoscopy (P < 0.01). Our meta-analysis indicates that RCM demonstrates superior specificity and similar sensitivity to dermoscopy in detecting cutaneous melanoma patients. The high heterogeneity, however, may impact the evidence of the current study, further larger sample prospective research is required to confirm these findings.