Dynamic Spectral Imaging Colposcopy: Higher sensitivity for detection of premalignant cervical lesions
Mrs. Afra Zaal
10 slide(s) – English – 2011-09-11
Adopting novel technologies can potentially increase the moderate sensitivity of
conventional colposcopy to detect (pre)malignant cervical lesions.
To validate the dynamic spectral imaging (DSI) colposcope\'s colour-coded map in
discriminating high- from low-grade cervical lesions and non-neoplastic tissue.
Prospective, comparative, multicentre clinical trial in three Dutch hospitals.
Patients of 18 years or over with an intact cervix, referred for colposcopy.
During a three minute image acquisition phase, the DSI colposcope was used as a video colposcope: the colposcopist located and graded lesions based on conventional
colposcopic criteria. Subsequently, a colour-coded map was calculated and displayed,
representing localisation and severity of the lesion. Biopsies were collected from all atypical sites, as identified by digital mapping and/or conventional colposcopy. An additional ´´control´´ biopsy was taken from each patient. Main outcome measure was histologically confirmed highgrade cervical disease (CIN2+).
In total 275 women were included in the study: 183 women were analysed in the
\'according to protocol\' (ATP) and 239 in the \'intention to treat\' (ITT) cohort. In the ATP cohort,the sensitivity of DSI colposcopy to identify patients with high-grade lesions was 79% (95%CI 70-88) and the sensitivity of conventional colposcopy was 55% (95%CI 44-65) (p=0.0006, asymptotic McNemar). When the DSI colour-coded map was combined with conventional
colposcopy, the sensitivity reached 88% (95%CI 82-95).
DSI colposcopy has a statistically significant higher sensitivity to detect cervical lesions than conventional colposcopy. If the colour-coded map is combined with conventional colposcopic examination, the sensitivity increases to 88%.