Colposcopy combined with dynamic spectral imaging. A prospective clinical study.

OBJECTIVE

To analyze the value of dynamic spectral imaging (DSI) compared to, and as an adjunct to, conventional colposcopy (CC) in the diagnosis of cervical intraepithelial neoplasia (CIN).

STUDY

DESIGN

Four hundred seventy-nine women referred for colposcopy after an abnormal Pap-smear (≥ASC-US) to the Low Genital Tract Unit of the San Carlos Clinical Hospital in Madrid, Spain during the years 2012-2014 were examined simultaneously by CC and DSI. Thirty-six cases (8.1%) were excluded because the DSI map was not calculated. The gold standard for comparisons was the final histological diagnosis performed by punch biopsy or LEEP.

RESULTS

Out of the 443 cases, 293 were found to be negative for CIN, 109 had CIN1 and 41 were found with CIN2+. The sensitivity of CC to detect those with CIN2+ lesions was 73.2% and the specificity 92.3%. Using the DSI map as an adjunct, led to a statistically significant increase of the sensitivity to 87.8% with a concomitant drop in specificity to 85.6%. The adjunctive use of DSI increased the sensitivity for CIN2+ also in the high-risk group of the 65 cases with an identified HPV16/18 infection; CC had a sensitivity of 88.9%, which increased to 100%. The specificity dropped from 91.1% to 87.5%.

CONCLUSIONS

Combining conventional colposcopy with DSI mapping improves the capability to detect cervical lesions.