Review: Optical Micrometer Resolution Scanning for Non-invasive Grading of Precancer in the Human Uterine Cervix

Abstract

Management of cervical precancer is archetypal for other cancer prevention programmes but has to consider diagnostic and logistic challenges. Numerous optical tools are emerging for non-destructive near real-time early diagnosis of precancerous lesions of the cervix. Non-destructive, real-time imaging modalities have reached pre-commercial status, but high resolution mapping tools are not yet introduced in clinical settings. The NCBI PubMed web page was searched using the keywords 'CIN diagnosis' and the combinations of 'cervix {confocal, optical coherence tomography, ftir, infrared, Raman, vibrational, spectroscopy}'. Suitable titles were identified and their relevant references followed. Challenges in precancer management are discussed. The following tools capable of non-destructive high resolution mapping in a clinical environment were selected: confocal microscopy, optical coherence tomography, IR spectroscopy, and Raman spectroscopy. Findings on the clinical performance of these techniques are put into context in order to assist the reader in judging the likely performance of these methods as diagnostic tools. Rationale for carrying out research under the prospect of the HPV vaccine is given.

Optical coherence tomography as a non‐invasive imaging technique for preinvasive and invasive neoplasia of the uterine cervix

“…These measures are complex, time consuming and expensive and not feasible for many healthcare systems14–17. To overcome these impediments new optical tools such as confocal microscopy, infrared and NIR spectroscopy, Raman spectroscopy, reflectance spectroscopy and OCT have been investigated to facilitate rapid and non‐invasive evaluation of the cervix18–20.…”

Correlation of p16INK4A expression and HPV copy number with cellular FTIR spectroscopic signatures of cervical cancer cells

“…The use of p16 INK4A immunocytochemical analysis as a complement to conventional screening programmes could potentially aid in the reduction of false positive and false negative results 12 . 5 In the first part of this study, expression of p16 INK4A [13][14][15][16][17][18][19] . The development of applications of vibrational spectroscopy to medical diagnostics has recently been 30 reviewed by Diem et al 20 .…”

Ex vivo investigations on the potential of optical coherence tomography (OCT) as a diagnostic tool for reproductive medicine in a bovine model

“…As oviductal alterations are a major cause of idiopathic infertility in females, precise OCT application might become a valuable diagnostic tool to develop proper therapeutic strategies according to the different alterations seen. With regard to OCT application of the uterus, the main focus was to differentiate neoplasms like dysplasia or cancer especially of the cervix . As OCT imaging also allows visualization of the endometrium, including the epithelial lining and the glands in the underlying connective tissue, it could be used for adding microscopic information in combination with hysteroscopy.…”