title: Effect of anatomy on spectroscopic detection of cervical dysplasia.
abstract: It has long been speculated that underlying variations in tissue anatomy affect in vivo spectroscopic measurements. We investigate the effects of cervical anatomy on reflectance and fluorescence spectroscopy to guide the development of a diagnostic algorithm for identifying high-grade squamous intraepithelial lesions (HSILs) free of the confounding effects of anatomy. We use spectroscopy in both contact probe and imaging modes to study patients undergoing either colposcopy or treatment for HSIL. Physical models of light propagation in tissue are used to extract parameters related to tissue morphology and biochemistry. Our results show that the transformation zone, the area in which the vast majority of HSILs are found, is spectroscopically distinct from the adjacent squamous mucosa, and that these anatomical differences can directly influence spectroscopic diagnostic parameters. Specifically, we demonstrate that performance of diagnostic algorithms for identifying HSILs is artificially enhanced when clinically normal squamous sites are included in the statistical analysis of the spectroscopic data. We conclude that underlying differences in tissue anatomy can have a confounding effect on diagnostic spectroscopic parameters and that the common practice of including clinically normal squamous sites in cervical spectroscopy results in artificially improved performance in distinguishing HSILs from clinically suspicious non-HSILs.
authors.affiliation: Massachusetts Institute of Technology, George R. Harrison Spectroscopy Laboratory, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA. jedza@mit.edu
authors.forename: Jelena
authors.initials: J
authors.lastname: Mirkovic
authors.forename: Condon
authors.initials: C
authors.lastname: Lau
authors.forename: Sasha
authors.initials: S
authors.lastname: McGee
authors.forename: Chung-Chieh
authors.initials: CC
authors.lastname: Yu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Nazemi
authors.forename: Luis
authors.initials: L
authors.lastname: Galindo
authors.forename: Victoria
authors.initials: V
authors.lastname: Feng
authors.forename: Teresa
authors.initials: T
authors.lastname: Darragh
authors.forename: Antonio
authors.initials: A
authors.lastname: de Las Morenas
authors.forename: Christopher
authors.initials: C
authors.lastname: Crum
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stier
authors.forename: Michael
authors.initials: M
authors.lastname: Feld
authors.forename: Kamran
authors.initials: K
authors.lastname: Badizadegan
mesh_terms: D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013050:Spectrometry, Fluorescence / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*