3-D Photography Helps Early Detection in Patients at High Risk for Melanoma

By Rosie Foster,

Tuesday, March 17, 2015

Pictured: Two doctors look at a computer screen showing a 3-D image of a patient.

Memorial Sloan Kettering is the only institution in the world now offering 3-D total-body photography to patients at high risk for melanoma. An array of 46 cameras photograph the body and a computer assembles the images into a 3-D avatar of the patient. This approach creates a baseline of a person’s entire skin surface, allowing MSK dermatologists to track changes in the appearance of moles or lesions.

  • MSK is the only institution offering 3-D total-body photography.
  • The method uses 46 cameras to photograph the entire skin surface.
  • Images are assembled into a 3-D avatar of the patient.
  • This can help early detection of melanoma.

The creation of three-dimensional avatars is not just a feature of the latest movie blockbuster. It’s happening now at Memorial Sloan Kettering — and it’s changing the way doctors are monitoring people at increased risk of melanoma, a serious skin cancer that is curable when found early.

MSK is the only institution in the world now offering 3-D total-body photography to patients at high risk for the disease due to personal or family history or having multiple abnormal moles. The approach creates a 3-D record of the entire surface of a person’s skin, allowing our dermatologists to track any changes in the appearance of moles or lesions that could indicate early stages of melanoma.  

This new system, developed under the leadership of Allan Halpern, Chief of MSK’s Dermatology Service, is available through our Melanoma Screening and Surveillance Program at the 60th Street Outpatient Center in Manhattan. It is also planned to be offered beginning in May 2015 at our suburban outpatient locations in West Harrison, in Westchester County, and in Hauppauge, Long Island. It is scheduled to debut at MSK’s outpatient location in Basking Ridge, New Jersey, in 2016.

A computer uses specialized software to process and assemble the images into a 3-D model of a patient’s body.

Here’s how the 3-D approach works: A patient stands in the middle of an array of 46 digital cameras mounted on scaffolding, and the cameras all take photos simultaneously. Within a few minutes, a computer uses specialized software to process and assemble the images into a 3-D avatar — a digital model of the patient — showing all of his or her lesions.

During the same visit, suspicious moles or lesions are photographed with two-dimensional close-ups or dermoscopy, a noninvasive method that uses a special magnifying lens and a light source to see features below the skin’s surface. These images are tagged so they can be linked to their corresponding location on the 3-D avatar for analysis and monitoring by the dermatologist.

All of this assembled information serves as a baseline to which dermatologists can refer later when examining the patient. This system helps doctors avoid unnecessary biopsies (procedures that remove tissue for examination) by providing a more accurate depiction of a person’s lesions to determine whether they have actually changed over time. “We can turn an image and zoom in. This is very helpful for closely examining the size and shape of the lesions,” explains MSK dermatologist Michael Marchetti.

From Film to Digital to 3-D

Dermatologists first recognized the value of tracking abnormal skin lesions over time in people at risk for melanoma about 30 years ago. “Detecting a change in a lesion is the most sensitive way to pick up cancers early,” says Dr. Halpern. “We learned years ago that the best way to do that was to periodically take photos of a person’s entire body, so if we saw a suspicious skin problem, we’d have something to compare it to.” By the late 1990s, total-body photography using traditional film cameras was widely practiced.

Dr. Halpern started working with Canfield Scientific to bring total-body photography into the digital era, developing a two-dimensional digital approach that made it easier to process the photos. But there were still issues. For example, because multiple photos needed to be taken, there’d be areas of overlap between them — showing some parts of the body more than once — and a single lesion could have two different appearances depending on the camera angle.

The assembled information serves as a baseline to which dermatologists can refer later when examining the patient.

In 2011, MSK and Canfield began to address these concerns by developing the 3-D total-body photography system, supported by a grant from the Melanoma Research Alliance.

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The 3-D Advantage

Daphne Demas, a senior medical photographer in the Dermatology Service, likens the evolution of total-body photography to the progression from film to digital photography. “When I started my career, I was working with film in the darkroom. Compared with the 3-D approach, 2-D total-body photography is now like the darkroom,” she says.

Patients like the 3-D approach too, especially those who have had 2-D total-body photography in the past — which can take up to an hour and a half, compared with eight minutes for the 3-D process. “Patients tell us they love it,” says Daphne Leon, a systems/applications analyst in the Dermatology Service. “They prefer not having to stand there for so long, naked, and they like the instant gratification of seeing their images on the computer screen shortly afterward.”

Just as patients who get 2-D total-body photography receive a book of their photos for comparison when they’re doing self-checks at home, patients undergoing 3-D photography will soon get a flash drive of their images (encrypted for privacy) that they can view on their home computers. “These images will empower patients to do self-checks and to make those self-exams more effective,” Dr. Halpern notes. The images can also be shared with a patient’s primary dermatologist or other physician.

As the Dermatology Service ramps up the 3-D total-body photography program, more people stand to benefit from its advantages. “We’re looking forward to a time when 2-D becomes passé and 3-D becomes the norm,” says Ms. Leon. “At MSK, that’s already happening.”

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Are you a candidate for the melanoma screening and surveillance program?

You may benefit from the services of this program if the following apply to you.

  • You’ve been newly diagnosed with melanoma and are seeking a treatment consultation.
  • You’re at increased risk of developing melanoma, which means:
    • You’ve previously been diagnosed with the disease.
    • You have many moles, atypical or dysplastic moles, and/or large moles present since birth or early life (i.e., “congenital” moles).
    • You have a family history of melanoma in multiple blood relatives.

To learn more about the Melanoma Screening and Surveillance Program, please call 646-888-6016.

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my daugther was born with a large mole on her belly dr knows it there can it become cancer

Dear Debbie, unfortunately, we cannot offer personal medical advice or make that kind of assessment on our blog. We encourage you to have a conversation about your concerns with her doctor. For more information about skin cancer, including its causes and recommended screening guidelines, please visit the National Cancer Institute's website: http://www.cancer.gov/

Thank you for reaching out to us.

Is this covered by most insurance plans?

Good question! We reached out to Dr. Michael Marchetti, and he advises that patients check with their insurance companies first to find out coverage and reimbursement information. The insurance code for total body photography is 96904. Thanks for asking, Janet.

To follow up on the question of does insurance cover it. If Insurance does not cover it what would an individual patient have to pay for the Total body photography?

Henry, thank you for reaching out. We suggest you contact MSK's Melanoma Screening and Surveillance Program at 646-888-6016 for this question.

what is the cost of the 3D photos?

Thank you for your question. We suggest you contact MSK's Melanoma Screening and Surveillance Program at 646-888-6016 for more information. We also advise that you check with your insurance company to find out coverage and reimbursement information. The insurance code for total body photography is 96904.

Have you published any peer review studies of the total body photography?

Henry, we have not yet published any studies on the 3-D total body photography discussed in this article, but there have been several published studies on the general use of total body photography, according to Dr. Halpern. This is the list he provided:

1: Secker LJ, Bergman W, Kukutsch NA. Total Body Photography as an Aid to Skin
Self-Examination: A Patient's Perspective. Acta Derm Venereol. 2015 Aug 28. doi:
10.2340/00015555-2228. [Epub ahead of print] PubMed PMID: 26315708.

2: Dengel LT, Petroni GR, Judge J, Chen D, Acton ST, Schroen AT, Slingluff CL Jr.
Total body photography for skin cancer screening. Int J Dermatol. 2015
Nov;54(11):1250-4. doi: 10.1111/ijd.12593. Epub 2014 Dec 16. PubMed PMID:

3: Moye MS, King SM, Rice ZP, DeLong LK, Seidler AM, Veledar E,
Curiel-Lewandrowski C, Chen SC. Effects of total-body digital photography on
cancer worry in patients with atypical mole syndrome. JAMA Dermatol. 2015
Feb;151(2):137-43. doi: 10.1001/jamadermatol.2014.2229. PubMed PMID: 25389923.

4: Moloney FJ, Guitera P, Coates E, Haass NK, Ho K, Khoury R, O'Connell RL,
Raudonikis L, Schmid H, Mann GJ, Menzies SW. Detection of primary melanoma in
individuals at extreme high risk: a prospective 5-year follow-up study. JAMA
Dermatol. 2014 Aug;150(8):819-27. doi: 10.1001/jamadermatol.2014.514. PubMed
PMID: 24964862.

Thank you for your comment.

I underwent a kidney transplant in May 2015 and am on anti-rejection drugs that warn of developing skin cancers as a side effect. Would I be eligible for screening. I live in Suffolk County NY near your Hauppage location.

Nanette, please call our referral specialists at Hauppauge to discuss this with them. The number is 631-863-5100. Thank you for your comment.

I contacted my insurance about code 96904 and it is an ineligible service. However, when I contacted the insurance folks at MSK, they said that code is not used alone. It is always put with another code of radiology. What would the correct coding be?

Molli, thank you for reaching out. We recommend you contact the Melanoma Screening and Surveillance Program at 646-888-6016 to see if there is an additional code.


How often is the 3D photography typically repeated once the baseline image is established ?


Dear Jack, we sent your inquiry to Dr. Halpern and he responded:

"The need to repeat total body photography is related to overall changes in the patient's body habitus and moles. For patients with fairly stable weight and moles, a set of images may remain a valid source of comparison for around 5 years. In the setting of significant overall changes, photographs may need to be repeated more often."

If you would like to learn more about our Melanoma Screening and Surveillance Program, please call 646-888-6016. Thank you for reaching out to us.

I am interested in the 3d melanoma screening. Can you tell me what the cost is? I participate in United Health Care at the moment

Marie, if you contact the screening program at 646-888-6016, they should be able to answer any questions you have about cost and insurance coverage. Thank you for your comment.

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