CD-ROMs Track Patients at Risk for Melanoma

DURHAM, NC--A researcher at Duke Comprehensive Cancer Center haspioneered the use of CD-ROM technology to preserve a photographicrecord of the skin and to detect the earliest signs of melanoma.

While "total body photography" has become a common toolto help physicians screen patients at high risk for melanoma,James Grichnik, MD, believes that he is the first to take theadditional step of preserving photographs of his patients' skinon CDs for computers.

Dr. Grichnik, assistant professor of medicine, combines conventionalphotography with CD technology to create a digital baseline. Healso uses epilumines-cence, a procedure carried out with a hand-heldmicroscope, to look even more closely at any moles that appearto have changed. A new computer database allows him to track hispatients.

Patients who come to the pigmented lesion clinic directed by Dr.Grichnik and who are found to be at high risk for melanoma arephotographed from 33 different angles, covering as much of theskin surface as possible. Instead of being stored as slides orprints, the images are transferred to CD-ROMS (see photograph).The disks are economical to create, easy to store, and convenientto use, Dr. Grichnik said.

Each patient has his or her own disk. When the patient comes infor a visit, Dr. Grichnik pops the disk into his computer andmakes a direct comparison between moles on the patient's skinand the images on the computer screen, where he can easily zoomin on specific moles.

For now, the CD-ROM record remains at Duke, he said. However,it may one day become a part of the patient's electronic medicalrecord.

The real key to early detection, Dr. Grichnik said, is for patientsto recognize their risk and to get regular, high-quality screenings."CD-ROMs and epilumines-cence just give us new tools to determinemoles that are changing."