The computerized digital imaging colposcope: Future directions

Crisp, William E.; Craine, Brian L.; Craine, Eric A.

doi:10.1016/0002-9378(90)90911-p

Cited by 28 publications

(14 citation statements)

References 6 publications

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“…Previous gynaecological application of digital imaging technology includes objective assessment of cervical lesions at colposcopy. Several characteristics of lesions can be assessed, including surface area, edge regularity and definition, degree of acetowhitening and blood vessel pattern 11,12 . This may be useful in research studies evaluating new management strategies 13 and also as a permanent clinical record.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of an objective method of determining skin erythema to transdermal oestradiol patches

Ross

Whitehead

Pike

1999

BJOG

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IntroductionOne problem which has limited the acceptance of transdermal oestradiol patches is skin reaction at the site of patch application. The reported incidence ranges up to a maximum of approximately 40%14, with a smaller percentage of women discontinuing therapy. Skin reactions typically consist of erythema and oedema, with more severe reactions such as blistering occumng occasionally.The original patch (Estraderm TTS, Ciba-Geigy, Basel, Switzerland) consisted of a fluid filled reservoir containing oestradiol, covered by a semi-permeable inner membrane and kept in contact with the skin by a ring of adhesive. This was referred to as a 'reservoir' patch. Subsequently, the 'matrix' patch was developed. This looks quite different and contains oestradiol distributed in adhesive across the whole of the patch surface. Anecdotal and published reports"' suggest that the incidence of skin reactions differs between reservoir and matrix patch systems.Any study relying on subjective assessment of skin changes is potentially confounded by observer bias. This can never be excluded in a comparison of vkually dissimilar patches. Therefore we have developed an objective method of measuring patch site skin irritation using photographic digital image analysis. Methods Study designWe recruited 26 Caucasian women who had previously discontinued transdermal oestradiol therapy because of a skin reaction. Those with active dermatological disease or using non-inhaled corticosteroids were excluded. We enrolled them into a prospective randomised cross-over study of a reservoir and a matrix Correspondence: Dr D. Ross, Menopause Clinic, King's College Hospital, Denmark Hill, London SE5 9RS, UK.patch5. The patch systems compared were Estraderm TTS and Evorel (Janssen-Cilag Ltd, Saunderton, UK). Women used each patch, in randomly determined order, for eight weeks at the dose of 50 pg/24 h; the patches were changed twice weekly. Women with an intact uterus also received progestogen. This was usually in oral form, but if a transdermal progestogen was used, women were instructed to apply the progestogen-releasing patch on the opposite side of their body to that on which the study patch was applied. Full details of the clinical methodology are found elsewhere5.Women who experienced an unacceptable skin reaction could stop applying the current treatment at any time. Those stopping the first course of treatment progressed immediately to the second; those stopping the second treatment left the study. At each change of patch, women recorded the degree of local redness, swelling and itching on a diary card. Standardised clinical photography of patch sites was performed at the end of each phase. Photographic methodsThe site from which the most recent patch had been removed was photographed (Fig. 1). The timing of every visit for photography, including those following premature discontinuation, was standardised so that the last patch had been removed between 12 and 18 hours previously. Photographs of the patch site were taken using a 35 mm Nikon FM...

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Section: Discussionmentioning

confidence: 99%

Development and validation of an objective method of determining skin erythema to transdermal oestradiol patches

Ross

Whitehead

Pike

1999

BJOG

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“…Since the first description of colposcopy by Hinselmann there has been inadequate technological advancement in this field. We describe a system of digital imaging (Crisp et al 1990; Mikhail et al 1992) as applied to colposcopic assessment, and this technology may be applied in other fields, such as fundoscopy, and is currently being evaluated as a clinical tool. The system provides digital image capture and processing.…”

Section: Discussionmentioning

confidence: 99%

Digital imaging colposcopy, image analysis and quantification of the colposcopic image

Shafi¹,

Dunn²,

Chenoy³

et al. 1994

BJOG

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Objective To investigate the use of a digital imaging system for colposcopy, its use for image analysis and quantification of the colposcopic features that may predict histological outcome as defined by large loop excision of transformation zone. Design Prospective programme study of all patients undergoing colposcopy for cytological abnormalities. Setting Dudley Road Hospital, Birmingham. Subject Fifty consecutive patients having cytological and colposcopic abnormality treated with large loop excision of transformation zone formed the study group. Main outcome measures Pretreatment and colposcopic features correlated with histological diagnosis of excised transformation zone. Results Index cytology and current smoking status are the most important variables for prediction of histological diagnosis. Other important variables are focality of lesion, surface pattern, intercapillary distance and degree of acetowhiteness. Conclusion Digital imaging colposcopy allows image capture, processing and objective analysis. This methodology holds advantages for basic and clinical research, teaching, diagnostics and clinical audit. The system can act as a quality control tool for colposcopy units. This system should prove invaluable for further quantitative studies, for natural history studies and for those patients with deferred treatment of their cytological and colposcopic abnormalities. The statistical models described may be incorporated into the system and can aid the colposcopist in management of the woman with abnormal cervical cytology and colposcopic abnormality.

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“…5 Digital imaging in colposcopy has facilitated the development of archival records for many clinical purposes: auditing of cytology, colposcopy and histology correlations, quality assurance of care, and monitoring disease regression and progression with simple planar measurement tools. [6][7][8][9] Although the advance in digital imaging has been employed mainly for image archiving of patient records, the digitized colposcopic images contain two important types of diagnostic information: tissue structure and color. Structural information appears as morphological features reflecting underlying tissue architecture, while color content, which is affected by tissue optical absorption and scattering, reflects tissue biochemistry and substructure.…”

Section: Introductionmentioning

confidence: 99%

Image analysis for discrimination of cervical neoplasia

2000

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Colposcopy involves visual imaging of the cervix for patients who have exhibited some prior indication of abnormality, and the major goals are to visually inspect for any malignancies and to guide biopsy sampling. Currently colposcopy equipment is being upgraded in many health care centers to incorporate digital image acquisition and archiving. These permanent images can be analyzed for characteristic features and color patterns which may enhance the specificity and objectivity of the routine exam. In this study a series of images from patients with biopsy confirmed cervical intraepithelia neoplasia stage 2/3 are compared with images from patients with biopsy confirmed immature squamous metaplasia, with the goal of determining optimal criteria for automated discrimination between them. All images were separated into their red, green, and blue channels, and comparisons were made between relative intensity, intensity variation, spatial frequencies, fractal dimension, and Euler number. This study indicates that computer-based processing of cervical images can provide some discrimination of the type of tissue features which are important for clinical evaluation, with the Euler number being the most clinically useful feature to discriminate metaplasia from neoplasia. Also there was a strong indication that morphology observed in the blue channel of the image provided more information about epithelial cell changes. Further research in this field can lead to advances in computer-aided diagnosis as well as the potential for online image enhancement in digital colposcopy.

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The computerized digital imaging colposcope: Future directions

Cited by 28 publications

References 6 publications

Development and validation of an objective method of determining skin erythema to transdermal oestradiol patches

Development and validation of an objective method of determining skin erythema to transdermal oestradiol patches

Digital imaging colposcopy, image analysis and quantification of the colposcopic image

Image analysis for discrimination of cervical neoplasia

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