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Colposcopy combined with dynamic spectral imaging. A prospective clinical study

  • Pluvio J. Coronado
    Correspondence
    Corresponding author at: Departamento de Obstetricia y Ginecología, Hospital Clínico San Carlos, C/ Martín Lagos s/n, 28040 Madrid, Spain. Tel.: +34 91 3303526; fax: +34 91 3303525.
    Affiliations
    Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain
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  • María Fasero
    Affiliations
    Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
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Published:October 15, 2015DOI:https://doi.org/10.1016/j.ejogrb.2015.09.007

      Abstract

      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.

      Keywords

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