DecisionDx-Melanoma Test Shows Greater Accuracy in Identifying Low-Risk Patients

June 26, 2026
A prospective study found that Castle Biosciences' DecisionDx-Melanoma i31-SLNB test more accurately identifies melanoma patients who may safely avoid sentinel lymph node biopsy compared to the Melanoma Institute Australia nomogram.

Castle Biosciences announced in a press release that a newly published prospective study found its DecisionDx-Melanoma i31-SLNB test result more accurately identifies melanoma patients at low and high risk of sentinel lymph node positivity than the Melanoma Institute Australia (MIA) nomogram.

The study analyzed 912 patients who were considering sentinel lymph node biopsy and were enrolled in the multicenter DECIDE study. It directly compared the performance of the i31-SLNB result with the MIA nomogram.

Patients classified as low risk by the i31-SLNB result had a 2.6 percent observed sentinel lymph node positivity rate, which is below the 5 percent threshold set by the National Comprehensive Cancer Network for considering avoidance of the biopsy. In comparison, patients classified as low risk by the MIA nomogram had a 5.8 percent positivity rate.

According to the findings, incorporating tumor biology through the DecisionDx-Melanoma i31-SLNB test can improve risk assessment, helping clinicians determine which patients may safely forgo sentinel lymph node biopsy and which should consider undergoing the procedure.

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