Mapping Melanoma Lymphoscintigraphy Data onto a 3D Anatomically Based Model

Abstract

This study describes three-dimensional (3D) visualization of two-dimensional (2D) melanoma lymphatic mapping data, to provide a framework for analysis of melanoma spread patterns and a platform for recording new lymphoscintigraphy (LS) data more accurately in 3D. Specifically, the Sydney Melanoma Unit's LS database of over 5000 patients' primary cutaneous melanoma sites and sentinel lymph nodes have been mapped from 2D images onto a 3D anatomically based model. Anatomically accurate model geometries were created using the Visible Human dataset, giving a bicubic finite element skin mesh and discrete sentinel lymph node model. The full dataset of 2D melanoma site coordinates, excluding the head and neck, has been transformed onto this 3D skin mesh via free-form deformation and projection techniques. Sentinel lymph nodes were mapped onto the generic lymph node model for each patient. Preliminary spatial analysis indicates that a patient with a primary melanoma on the torso around the waist (on the standardized 3D model this region is 180 mm above and 130 mm below the umbilicus) with lymphatic drainage to the left axilla or left groin, will have a 17.7% probability of dual drainage to both node fields, with 95% confidence limits between 14.5 and 21.0%.

Segmental Limb Volume Change as a Predictor of the Onset of Lymphedema in Women With Early Breast Cancer

“…The concept of segmental drainage is historically referred to in lymphatic anatomy, and these patterns of segmental drainage have been implicated in the development of lymphedema [27]. This concept is further supported by the recent work of Reynolds et al [28], Uren et al [29], and Suami et al [30], whose segmental lymphatic drainage evidence has propelled the concept of sentinel lymph node biopsy in melanoma of the extremities.…”

Functional anatomy of the lymphatics draining the skin: a detailed statistical analysis

“…The torso was first divided according to its anatomy, into anterior and posterior regions both above and below the umbilicus. Further division of the upper anterior torso was based on the geometrical boundaries defined on the skin model, which were arbitrarily defined during skin mesh construction (Reynolds et al. 2007a).…”

“…Our previous work has involved mapping the SMU’s extensive LS database of over 5232 patients onto a 3D computer model of the skin and lymph nodes (Reynolds et al. 2007a).…”

“…The SMU defined 43 separate node fields that directly drained the skin as listed in Table 1 and each of these node fields has also been modeled relative to the skin model using Visible Human images. Each of the primary melanoma sites in the LS database was then mapped onto the skin model using techniques previously reported by Reynolds et al. (2007a), giving the mapped model in Fig.…”

“…1, which shows the melanoma sites scaled according to their frequency. Corresponding draining node fields for each patient were mapped onto one or more of the model’s 43 node fields (Reynolds et al. 2007a).…”