Machine-learning–guided bioelectrical impedance mapping has been evaluated as an adjunct during Mohs surgery, generating probability maps for BCC at the surgical margin while retaining conventional histopathology as the reference standard.
Another particularly interesting development is two-photon fluorescence microscopy, which can produce images very similar H&E preparetions from fresh Mohs specimens, without the need of a conventional slide preparation. A 2026 JAAD study evaluated 133 BCC specimens and addresses one of the fundamental limitations of Mohs surgery: the time and competences required for frozen-section processing.
This process testing is opening a possible change of the Mohs workflow to become:
Surgery → rapid digital imaging → AI-assisted margin interpretation → targeted additional excision
rather than :
Surgery → frozen section → manual microscopic interpretation.
These technologies are currently a possible implementation rather than a replacement for the Mohs surgeon and histopathology.