The line between scale and 3 rail trains has blured considerably in the last number of years.
Originally lionel built 3 rail equipment to fit its curves. They pretty much ignored scale and designed the products to go around the sharp curves and proportioned accordinly. Most were undersized.
Then along came Williams, MTH and some others that started doing at least locomotives to run on 3 rail track, but scale size. Often they had to compromise some dimensions and features to fit the curves.
Lionel jumped on the band wagon and the others moved to mass produced rolling stock built pretty much to scale size.
The problem is that most of the manufacturers produce more than one "line" of equipment. Usually the name indicates scale size or anything goes, but not always. MTH has made scale size and toy size equipment in their Railking line, for example.
so the bottom line is, you should know what the prototype is and then measure the model to be sure, unless you know the manufacturers policies very well.
As for conversion, You can probably get by with just change wheel sets, rather than whole trucks. And if you use flathead rail, the scale wheels will probably work without change.