TY - JOUR
T1 - The clinical effectiveness of optical spectroscopy for the in vivo diagnosis of cervical intraepithelial neoplasia
T2 - Where are we?
AU - Cardenas-Turanzas, Marylou
AU - Freeberg, J. Adrian
AU - Benedet, J. L.
AU - Atkinson, E. Neely
AU - Cox, Dennis D.
AU - Richards-Kortum, Rebecca
AU - MacAulay, Calum
AU - Follen, Michele
AU - Cantor, Scott B.
N1 - Funding Information:
Financial support for this study was provided by grant PO1-CA82710 from the National Cancer Institute. The funding agreement ensured the authors' independence in study design, data interpretation, and writing of the paper.
PY - 2007/10
Y1 - 2007/10
N2 - Objective: In this review, we evaluate the diagnostic efficacy of optical spectroscopy technologies (fluorescence and reflectance spectroscopy) for the in vivo diagnosis of cervical neoplasia using both point probe and multispectral imaging approaches. Methods: We searched electronic databases using the following terms: cervical cancer, cervical intraepithelial neoplasia, squamous intraepithelial lesion, and spectroscopy, fluorescence spectroscopy, or reflectance spectroscopy. We included studies that evaluated fluorescence and reflectance spectroscopy devices for in vivo diagnosis, compared those results with biopsy results, and reported on the sensitivity and specificity of the devices tested. Results: Twenty-six studies, including seven phase II trials and one randomized clinical trial, met our acceptability criteria. We found several important differences across the studies including device approach (multispectral versus point probe), study population, disease classification system, and disease threshold. This heterogeneity prevented formal combination of sensitivity and specificity results. Conclusion: Optical spectroscopy has similar performance to colposcopy and may help localize lesions and therefore be an effective adjunct to colposcopy. Reports on the diagnostic accuracy of these devices should use common thresholds for the construction of receiver operating characteristic curves to enable comparisons with standard technologies and facilitate their adoption. Optical spectroscopy has also been identified for possible use as ASCUS triage and primary screening, yet neither has been sufficiently evaluated to warrant a conclusion as to their suitability in this role.
AB - Objective: In this review, we evaluate the diagnostic efficacy of optical spectroscopy technologies (fluorescence and reflectance spectroscopy) for the in vivo diagnosis of cervical neoplasia using both point probe and multispectral imaging approaches. Methods: We searched electronic databases using the following terms: cervical cancer, cervical intraepithelial neoplasia, squamous intraepithelial lesion, and spectroscopy, fluorescence spectroscopy, or reflectance spectroscopy. We included studies that evaluated fluorescence and reflectance spectroscopy devices for in vivo diagnosis, compared those results with biopsy results, and reported on the sensitivity and specificity of the devices tested. Results: Twenty-six studies, including seven phase II trials and one randomized clinical trial, met our acceptability criteria. We found several important differences across the studies including device approach (multispectral versus point probe), study population, disease classification system, and disease threshold. This heterogeneity prevented formal combination of sensitivity and specificity results. Conclusion: Optical spectroscopy has similar performance to colposcopy and may help localize lesions and therefore be an effective adjunct to colposcopy. Reports on the diagnostic accuracy of these devices should use common thresholds for the construction of receiver operating characteristic curves to enable comparisons with standard technologies and facilitate their adoption. Optical spectroscopy has also been identified for possible use as ASCUS triage and primary screening, yet neither has been sufficiently evaluated to warrant a conclusion as to their suitability in this role.
KW - Cervical intraepithelial neoplasia (CIN)
KW - Fluorescence spectroscopy
KW - High-grade SIL (HG-SIL)
KW - Multispectral imaging
KW - Optical spectroscopy
KW - Point probe imaging
KW - Real-time diagnosis
KW - Reflectance spectroscopy
KW - Sensitivity and specificity
KW - Sqaumous intraepithelial lesion (SIL)
KW - in vivo cervical diagnosis
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U2 - 10.1016/j.ygyno.2007.08.082
DO - 10.1016/j.ygyno.2007.08.082
M3 - Article
C2 - 17908588
AN - SCOPUS:34748859926
SN - 0090-8258
VL - 107
SP - S138-S146
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1 SUPPL.
ER -