Dynamic Spectral Imaging: Improving Colposcopy

Abstract

Purpose: Colposcopy occupies a key role in the prevention of cervical cancer by identifying preinvasive or invasive lesions. However, colposcopy is subjective and is responsible for 52% of screening failures. Dynamic spectral imaging (DSI) is based on the objective, quantitative assessment of the acetowhitening effect. This study compared DSI with colposcopy. Experimental Design: Women referred for colposcopy were examined simultaneously with colposcopy and DSI using a precommercial DySIS model (FPC-03) in an international, multicenter trial. The colposcopy impression and DySIS values were compared with consensus histology reports of biopsies. Subjects were recruited to a training group and subsequently to a test group. Measures were taken to avoid verification bias. Results: The training and test groups comprised 82 and 308 eligible women, respectively. A cutoff value to identify high-grade disease was selected from the results of the training group and data from previous work. Receiver operator curve analysis of the test data showed an area under the curve of 0.844. DySIS detected 62.9% more high-grade cases than colposcopy (57 versus 35, P = 0.0001). DySIS exceeded end points approved by the Food and Drug Administration for similar studies, with increments in the true positive rate of 22/308 (7.1%; lower 95% CL, 4.5% versus 2%) and in the false positive rate of 32/308 (10.4%; upper 95% CL, 14.7% versus 15%). Conclusions: DySIS is more sensitive than colposcopy in detecting high-grade lesions and can provide improved guidance for biopsy. The results are obtained in a user-independent fashion, making it suitable for use by nursing personnel.

Agreement between colposcopic impression and histological diagnosis among human papillomavirus type 16‐positive women: a clinical trial using dynamic spectral imaging colposcopy

“…8 It has been shown that the DSI digital colposcope improves the sensitivity of colposcopy. 7,8 Our main finding in this study is that lesions are better detected among HPV16…”

“…[3][4][5][6] It has previously been shown by us and others that the sensitivity of colposcopy can be significantly improved when the dynamic spectral imaging (DSI) colposcope is used. 7,8 Recently in a sub-study of the ALTS trial (atypical squamous cells of undetermined significance [ASCUS]-lowgrade squamous intraepithelial lesion [LSIL] Triage Study) 9 Jeronimo et al 10 observed that HPV16 positive (HPV16 + ) lesions produce more defined visual abnormalities at colposcopy than lesions caused by other hrHPV types, regardless of final histological diagnosis. As a consequence, it has been hypothesised that HPV16 + lesions are detected earlier than other lesions.…”

Wide-field spectral imaging of human ovary autofluorescence and oncologic diagnosis via previously collected probe data

“…Several groups have demonstrated spectral image analysis enhancements with varying degrees of automation. [31][32][33][34][35][36][37] In the study described here, we have applied a 365 nm-excitation multispectral imager (MSI) to freshly resected whole human ovaries, collecting autofluorescence images in eight different spectral bands spanning the 400 to 640 nm visible range as well as reflectance images in four different visible spectral bands. To our knowledge, this is the first wide-field spectral imaging study of human ovary autofluorescence of this magnitude.…”

Dynamic spectral imaging: Innovative opportunities in colposcopy

“…Причины невысокой эффективности применения КС заключаются в целом ряде проблем, одна из которых -недостаточная подготовка кольпоскопистов (практическая, теоретическая). По мнению G. Mestwerdt [4], необходимо провести 500 самостоятельных осмотров кольпоскопом, чтобы овладеть начальными навыками по кольпоскопии [22]. Следующая проблема заключается в высокосубъективной интерпретации визуальных показа-телей разными врачами и отсутствие четкой стандартиза-ции метода.…”

“…В 2009 г. было проведено проспективное, многоцен-тровое, нерандомизированное, комбинированное клини-ческое испытание в сотрудничестве с Империал колледж (Лондон, Великобритания) на базе Первой гинекологиче-ской клиники Афинской медицинской школы (Афины, Греция) [22]. Исследование проходило в кольпоскопиче-Рис.…”