Optical detection of high-grade cervical intraepithelial neoplasia in vivo: results of a 604-patient study.

Academic Article

Abstract

  • OBJECTIVE: The purpose of this study was to assess the in vivo optical detection of high-grade cervical intraepithelial neoplasia (2/3+) on the whole cervix with a noncontact, spectroscopic device. STUDY DESIGN: Cervical scanning devices collected intrinsic fluorescence and broadband white light spectra and video images from 604 women during routine colposcopy examinations at 6 clinical centers. A statistically significant dataset was developed of intrinsic fluorescence and white light-induced cervical tissue spectra that was correlated to expert histopathologic determination. On the basis of a retrospective analysis of the acquired data, a classification algorithm was developed, validated, and optimized. RESULTS: Intrinsic fluorescence, backscattered white light, and video imaging each contribute complementary information to diagnostic algorithms for high-grade cervical neoplasia. More than 10000 measurements that were made on colposcopically identified tissue from >500 subjects were the basis for algorithm training and testing. Algorithm performance demonstrated a sensitivity of approximately 90%. This performance was confirmed by various training methods. With the use of a multivariate classification algorithm, optical detection is predicted to detect 33% more high-grade cervical intraepithelial neoplasia (2/3+) than colposcopy alone. CONCLUSION: Full cervix optical interrogation for the detection of high-grade cervical intraepithelial neoplasia is feasible and appears capable of detecting more high-grade cervical intraepithelial neoplasia than colposcopy alone. With the use of this classification algorithm, a multisite, randomized controlled trial is underway that compares the combination of optical detection and colposcopy versus colposcopy alone.
  • Keywords

  • Adolescent, Adult, Aged, Algorithms, Cervical Intraepithelial Neoplasia, Cohort Studies, Colposcopy, Female, Fiber Optic Technology, Humans, Middle Aged, Neoplasm Staging, Retrospective Studies, Sensitivity and Specificity, Spectrometry, Fluorescence, Uterine Cervical Neoplasms
  • Digital Object Identifier (doi)

    Pubmed Id

  • 13265435
  • Author List

  • Huh WK; Cestero RM; Garcia FA; Gold MA; Guido RS; McIntyre-Seltman K; Harper DM; Burke L; Sum ST; Flewelling RF
  • Start Page

  • 1249
  • End Page

  • 1257
  • Volume

  • 190
  • Issue

  • 5