Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

Abstract

Spoiled gradient echo sequences can only reach a homogeneous steady state if sufficiently strong crusher gradients are used in combination with RF phase cycling (RF spoiling). However, the signal depends quite sensitively on the chosen phase increment ϕ and—lacking analytical solutions—numerical simulations must be used to study the transient and steady‐state magnetization. For the steady state an exact analytical solution is derived, which holds for arbitrary sequence and tissue parameters. Besides a considerably improved computation performance, the analytical approach enables a better understanding of the complicated dependence on ϕ. For short repetition times (TR) the regime of small ϕ turns out to be particularly interesting: It is shown that the typical ϕc, where RF spoiling starts to become effective, is essentially inversely proportional to T2. This tissue dependence implies that contrasts can be considerably larger with partial spoiling (ϕ ≈ ϕc) than with conventional RF spoiling (ϕ ≫ ϕc). As an example, the uptake of contrast agents in tissues is investigated. For typical parameters a considerably improved contrast enhancement can be obtained, both theoretically and experimentally. Magn Reson Med, 2006. © 2005 Wiley‐Liss, Inc.

The role of human papillomavirus testing in the management of women with low‐grade abnormalities: multicentre randomised controlled trial

“…4 Hence, the flip side of the management controversy relates to minimising the risk of overtreatment of women who do not need therapy. The relatively high NPV found in our study (over 90%) and in previous cross-sectional studies 19,20,47,48,[53][54][55][56][57] suggests that a negative hrHPV test may be of value in avoiding referral to colposcopy, particularly in women with BNA. Women who tested negative for hrHPV had a low rate of CIN2 or worse over 3 years (cumulative incidence 36 per 1000 personyears); their risk was less than one-third that of women who were hrHPV positive (114 per 1000 person-years).…”

“…Positive and negative controls from a commercial source were included in each batch of assays. Adequate samples underwent HPV polymerase chain reaction (PCR) using GP5+/6+ consensus primers, followed by enzyme immunoassay to amplify the LI (late gene) region of 14 'high-risk' HPV types that have been associated with increased risk of cervical cancer (types 16,18,31,33,35,39,45,51,52,56,58,59, 66 and 68). 42 Women were classified as hrHPV positive (hrHPV+ve) if their sample had an optical density three times greater than the optical density of the batch negative control, implying that they carried at least one of the hrHPV strains.…”

Sensitivity, Specificity, and Clinical Value of Human Papillomavirus (HPV) E6/E7 mRNA Assay as a Triage Test for Cervical Cytology and HPV DNA Test

“…1B), the mRNA test showed a strong reduction in colposcopies. On the other hand, the sensitivity was low and comparable to that of repeating the cytological test (7,41), one of the most commonly used strategies used to avoid direct colposcopy referral for women with L-SIL. In contrast, the triage with HPV DNA (see Fig.…”

Prevalence of Human Papillomavirus Types in High-Grade Cervical Intraepithelial Neoplasia and Cancer in Italy

“…Five articles reported results for histologically confirmed invasive cancers (18)(19)(20)22, and 27), six reported results for preinvasive lesions according to histologic findings (17)(18)(19)(20)(21)(22)(23)(24), six reported results only according to cytologic results (25)(26)(27)(28)(29), and one by both classifications (17). Results are summarized in Table 1.…”