Diagnostic Role of Portable Colposcope (Gynocular) for Diagnosis of Pre-Invasive Lesions of Cervix

Abstract

Introduction Colposcopy-guided biopsy is the standard method to diagnose cervical pre-invasive lesions. However, standard colposcopes are expensive, require lot of space and depend on electricity for its use. A mobile version of colposcope (Gynocular) has been recently introduced which overcomes such issues. We conducted this study to evaluate the diagnostic accuracy of Gynocular for cervical intraepithelial lesions. Materials and Methods This cross sectional study was conducted over one year in a tertiary care referral centre in North India. Total 222 women with abnormal Pap smear were included. To avoid observer bias, Gynocular and standard colposcope examinations were performed by two different observers at different places. Patients with swede score 5 or above by standard colposcopy were subjected to biopsy. Kappa statistics was applied for analysing correlation of swede score by the two methods and diagnostic efficacies were calculated with histopathology as gold standard. Results 100 women had swede score of 5 or above with Gynocular and 86 of these had high swede score on colposcopy also. Histopathology was available for these 86 women. Both colposcopy methods were in strong agreement (Kappa = 0.795; p \ 0.001) for swede scoring. HPE showed CIN 1 in 13.95%, CIN 2 in 4.65%, CIN3 in 6.98% and invasive cancer in 13.95% women. The HPE based sensitivity, specificity, negative and positive predictive values for Gynocular(100%, 61%, 100% and 22% respectively) were comparable with Standard colposcope. Conclusions Gynocular has comparable diagnostic accuracy with standard colposcope in diagnosing CIN.

Use of Smartphones for the Detection of Uterine Cervical Cancer: A Systematic Review

“…A total of 707 studies were retrieved during the systematic review. After excluding duplicate studies and studies that did not meet the inclusion criteria, 16 studies were selected, including four retrieved from the reference review of the selected articles [ 3 , 4 , 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…One study evaluated concordance between the images captured with the mobile colposcope (smartcopy) vs. the standard colposcope [ 11 ]. Another study found a high degree of concordance (79.5%) when comparing the Swedish scoring results between the mobile (gynocular) colposcope vs. the standard colposcope (Singh et al) [ 12 ]. On the other hand, another study evaluated the quality of the images taken with a smartphone for the detection of uterine cervical lesions among three gynecologists who were colposcopy experts (45%, Gallay et al) [ 13 ].…”

“…Subsection: The review of the 16 publications allowed us to identify five studies that had similar characteristics. These studies used a basic smartphone as a technological tool to obtain images of the cervix, following which they performed the VIA and/or VILI examination [ 3 , 4 , 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The histology was standard, and the on-site and off-site operators were physicians that reported sensitivity and specificity [ 3 , 4 , 5 , 8 , 19 ].…”

Cervical Imaging in the Low Resource Setting: A Review

“…The Gynocular has been compared to a standard colposcope in multiple clinical studies in Uganda, India, Bangladesh and Sweden [ 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. One study tested VIA positive women in a clinical study in a hospital setting in Uganda.…”

“…Another clinical study performed in a colposcopy clinic in Bangladesh determined that the Gynocular had a sensitivity of 83.3% and a specificity of 23.6%, with a positive predictive value of 88.6% and a negative predictive value of 16.6% [ 64 ]. There was no significant difference between the Gynocular and the colposcope for identifying CIN2+ lesions in all clinical trials performed [ 62 , 64 , 65 , 66 , 68 ].…”