Discrimination of malignant transformation from benign endometriosis using a near‑infrared approach

Abstract

Abstract. The aim of the present single-center retrospective study was to investigate the discrimination of malignant transformation from ovarian endometrioma (OE) using a near-infrared approach ex vivo. Cystic fluid samples were collected from patients with OE (n=34) and endometriosis-associated ovarian cancer (EAOC) (n=12). The light reflected from each sample of cystic fluid [change in luminance, Δl (cd/m 2 ) = background luminance-cystic fluid luminance at 800 nm] was spectrally measured by a near-infrared CCD camera with band-path filter (800 nm). The Δl in EAOC was significantly lower compared with that in OE. On regression analysis, a positive correlation was observed between the Δl and Hb level in the cystic fluid, and this association was exponential. The diagnostic sensitivity and specificity of Δl was 83.3 and 94.1% at the cutoff value of 21.5 cd/m 2 , with an area under the ROC curve of 0.897. The present ex vivo study potentially provides a powerful near-infrared approach for quantitative discrimination between EAOC and benign OE, with high sensitivity and specificity, which may have clinical applications.

New insights about endometriosis-associated ovarian cancer: pathogenesis, risk factors, prediction and diagnosis and treatment

“…proposed a model that integrates the marker value HE4 and the ADNEX, resulting in increased the discriminatory ability and sensitivity for distinguishing benign from malignant ovarian tumors ( 127 ). The application of transvaginal near-infrared (NIR) imaging might provide diagnostic insights into the malignant advancement of endometriosis and could potentially yield further clinical ramifications, and the incorporation of MR relaxation measurements facilitates the identification of conservative therapeutic approaches ( 128 , 129 ). A pioneering composite optical ultrasound system, employing near infrared guidance and transvaginal ultrasound, is proposed for the purpose of noninvasively quantifying fluid hemoglobin (Hb) levels.…”

Effect of the cyst fluid concentration of iron on infertility in patients with ovarian endometrioma

“…In addition, near infrared spectroscopy is a validated method that allows for the quantification of the CF concentration of iron non-invasively and repeatedly (11). A new device, consisting of transvaginal ultrasonography and near infrared spectroscopy system (composite-type optical device), is currently under development for the non-invasive quantification of iron concentration in endometriotic CF (11,33). Iron quantification may assist in the identification of patients at high risk of infertility.…”

Modern approaches to noninvasive diagnosis of malignant transformation of endometriosis

“…A near-infrared light can overcome the main limitation of visible light imaging, indicating beneficial effects in applications in humans. Kawahara et al (16), used noninvasive near-infrared spectrophotometric method to determine cyst fluid absorption and scattering coefficients and absolute cyst fluid Hb and total iron concentrations. This study provided the design, characterization, performance, and preclinical validation of a broadband near-infrared spectroscopic system for determining total iron concentration of a biological sample.…”

“…To estimate sufficient barrier penetration, the prepared cuvette was covered with a commercially available chicken with a different thickness (0, 5, 10 and 20 mm) ( Fig. 4B and C) (16). This model mimics the anatomical structure, including vaginal wall layer and tumor surface layer.…”

“…5). The-Δl level exhibits significant negative correlation with total iron concentration and could serve as a simple, rapid and accurate method to discriminate EAOC from benign OE, with high sensitivity (85%) and specificity (95%) (16). A 800 nm near infrared light reached the depth of 2 cm and delivered approximately 5% of the surface power density.…”