Allan Halpern (left) and Michael Marchetti review images assembled into a 3-D digital model of a patient.
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 topThe 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 topAre 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.
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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 topComments
Debbie Athanas
Mar 19, 2015 • 6:51 PM
Memorial Sloan Kettering
Mar 20, 2015 • 10:12 AM
In reply to my daugther was born with a by Debbie Athanas
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.
Janet
Apr 21, 2015 • 6:45 PM
Henry Malarkey IV, MD
Sep 19, 2015 • 7:34 PM
Memorial Sloan Kettering
Sep 21, 2015 • 9:47 AM
In reply to To follow up on the question… by Henry Malarkey IV, MD
Henry, thank you for reaching out. We suggest you contact MSK’s Melanoma Screening and Surveillance Program at 646-888-6016 for this question.
Anonymous
Oct 10, 2015 • 10:01 AM
Memorial Sloan Kettering
Oct 12, 2015 • 2:45 PM
In reply to what is the cost of the 3D… by Anonymous
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.
Henry Malarkey
Oct 26, 2015 • 2:41 PM
Memorial Sloan Kettering
Oct 28, 2015 • 9:06 AM
In reply to Have you published any peer… by Henry Malarkey
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:
25515157.
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.
Nanette Yavel
Dec 14, 2015 • 11:07 AM
Nanette, please call our referral specialists at Hauppauge to discuss this with them. The number is 631-863-5100. Thank you for your comment.
Molli Carter
Feb 16, 2016 • 10:45 AM
Memorial Sloan Kettering
Feb 16, 2016 • 10:56 AM
In reply to I contacted my insurance… by Molli Carter
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.
Jack C.
Mar 19, 2016 • 1:55 AM
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.
Marie
Apr 11, 2016 • 8:43 AM
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.
Kumari
Nov 24, 2016 • 7:40 PM
I consulted 3 doctors.My disease is white moles & red rashes are spreading on the body.They gave me pills,lotions,creams but they dont work on my disease.one of the doctor gave me medicines and also told me to whole body photography is required to my body as 12 times per month for 3 months . I want to know how much it costs. Plz comment me the actual price for this but not your phone number
Kumari, thank you for your question. The cost for each individual may vary, but the 3D photography offered at MSK is for a specific group of patients — those at high risk for melanoma.
We suggest you contact the screening program at 646-888-6016, to find out whether you are a good candidate for melanoma screening with this technology. In addition they should be able to answer any questions you have about cost and insurance coverage.
Nivedita Singh
Feb 3, 2017 • 1:01 AM
Dear Nivedita, MSK is directing an international collaboration that provides images of skin lesions for research purposes. These images originate from multiple centers from around the world, including MSK. You can go to https://isic-archive.com/ for more information. Thank you for your comment.
Helen
Feb 21, 2017 • 9:24 AM
Dear Helen, we are very sorry for the loss of your mother. Generally one family member with cancer (even a close relation) is not enough to be considered a family history, but if you have close relatives with other types of cancer, there may be an increased risk. If you are interested in learning more, we suggest you speak with a genetic counselor who specializes in cancer. If you’re in the New York area and would like to meet with someone at MSK, you can go to https://www.mskcc.org/cancer-care/risk-assessment-screening/hereditary-… to learn more. Thank you for your comment, and best wishes to you.
John S.
Dec 7, 2017 • 11:57 AM
Dear John, this scanner is actually being installed next week and will be available starting in January. If you would like to make an appointment, you can call 800-525-2225 or go to https://www.mskcc.org/locations/directory/mskcc-basking-ridge to schedule online. Thank you for your comment, and best wishes to you.
Peter
Apr 30, 2018 • 7:44 AM
I went to a gala fundraiser last night to support diagnosis and treatment of melanoma. The state of the art camera you have developed is phenomenal and has made, what previously took hours of photo-taking, very short and much more reliable.
Kudos to you all for your work. The gala was very hard for me as my Uncle died the night before from cancer - he had spent so much time caring for my Aunt who has had MS for nearly 50 years, that he ignored his own pain and symptoms until it was too late.
I was beyond happy to donate and will spread the good word. Melanoma has impacted my family and your work here is ground-breaking. I encourage all to read and look deeper and this and be philanthropic --- every penny helps --- but every donation takes a step closer to early detection and treatment of something that could impact us all!
Patricia Connors
May 7, 2018 • 9:25 PM
Memorial Sloan Kettering
May 9, 2018 • 2:55 PM
In reply to How does this 3D Photography… by Patricia Connors
Dear Patricia, at Memorial Sloan Kettering, our doctors use 3-D total body photography in conjunction with other imaging modalities, such as dermoscopy and reflectance confocal microscopy, to more effectively monitor the spots on your skin during office examinations.
MoleSafe is a commercial company (i.e., not your doctor) that offers skin cancer screenings using serial total body photography and dermoscopy. To our knowledge, the total body photography system used by MoleSafe is not based on 3D-stereophotogrammetry imaging.
Thank you for your comment.
Anonymous
Jul 25, 2018 • 1:41 PM
Ronald L
Aug 5, 2018 • 11:33 AM
Ronald, thank you for your question. The cost for each individual may vary, depending on insurance coverage.
If you contact the screening program at 646-888-6016, they can provide more details.
NY2LA
Sep 25, 2018 • 5:37 PM
Roz
Jan 7, 2019 • 12:55 AM
Dear Roz, you can reach our International Center at 1-212-639-4900 or use AT&T Direct Access by dialing the access number for the country you are calling from, then dialing 888-675-7722.
You can go to this page for more information on coming to MSK from outside the US: https://www.mskcc.org/experience/become-patient/international-patients
Thank you for your comment and best wishes to you.
my daugther was born with a large mole on her belly dr knows it there can it become cancer