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.
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.
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.Back to top
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.”Back to top
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.Back to top