title: Detection of cervical lesions by multivariate analysis of diffuse reflectance spectra: a clinical study.
abstract: Diffuse reflectance (DR) spectroscopy is a non-invasive, real-time, and cost-effective tool for early detection of malignant changes in squamous epithelial tissues. The present study aims to evaluate the diagnostic power of diffuse reflectance spectroscopy for non-invasive discrimination of cervical lesions in vivo. A clinical trial was carried out on 48 sites in 34 patients by recording DR spectra using a point-monitoring device with white light illumination. The acquired data were analyzed and classified using multivariate statistical analysis based on principal component analysis (PCA) and linear discriminant analysis (LDA). Diagnostic accuracies were validated using random number generators. The receiver operating characteristic (ROC) curves were plotted for evaluating the discriminating power of the proposed statistical technique. An algorithm was developed and used to classify non-diseased (normal) from diseased sites (abnormal) with a sensitivity of 72 % and specificity of 87 %. While low-grade squamous intraepithelial lesion (LSIL) could be discriminated from normal with a sensitivity of 56 % and specificity of 80 %, and high-grade squamous intraepithelial lesion (HSIL) from normal with a sensitivity of 89 % and specificity of 97 %, LSIL could be discriminated from HSIL with 100 % sensitivity and specificity. The areas under the ROC curves were 0.993 (95 % confidence interval (CI) 0.0 to 1) and 1 (95 % CI 1) for the discrimination of HSIL from normal and HSIL from LSIL, respectively. The results of the study show that DR spectroscopy could be used along with multivariate analytical techniques as a non-invasive technique to monitor cervical disease status in real time.
authors.affiliation: Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India.
authors.forename: Vasumathi Gopala
authors.initials: VG
authors.lastname: Prabitha
authors.affiliation: Regional Cancer Centre, Medical College P.O., Thiruvananthapuram, 695 011, Kerala, India.
authors.forename: Sambasivan
authors.initials: S
authors.lastname: Suchetha
authors.affiliation: Regional Cancer Centre, Medical College P.O., Thiruvananthapuram, 695 011, Kerala, India.
authors.forename: Jayaraj Lalitha
authors.initials: JL
authors.lastname: Jayanthi
authors.affiliation: Department of Statistics, Government College for Women, Thiruvananthapuram, 695014, Kerala, India.
authors.forename: Kamalasanan Vijayakumary
authors.initials: KV
authors.lastname: Baiju
authors.affiliation: Regional Cancer Centre, Medical College P.O., Thiruvananthapuram, 695 011, Kerala, India.
authors.forename: Prabhakaran
authors.initials: P
authors.lastname: Rema
authors.affiliation: Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India.
authors.forename: Koyippurath
authors.initials: K
authors.lastname: Anuraj
authors.affiliation: Regional Cancer Centre, Medical College P.O., Thiruvananthapuram, 695 011, Kerala, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Mathews
authors.affiliation: Regional Cancer Centre, Medical College P.O., Thiruvananthapuram, 695 011, Kerala, India.
authors.forename: Paul
authors.initials: P
authors.lastname: Sebastian
authors.affiliation: Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India. subhashnarayanan@gmail.com.|Sascan Meditech Pvt Ltd., CIME, BMS College of Engineering, Basavanagudi, Bull Temple Road, Bangalore, 560019, India. subhashnarayanan@gmail.com.
authors.forename: Narayanan
authors.initials: N
authors.lastname: Subhash
mesh_terms: D000328:Adult; D000465:Algorithms; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D025341:Principal Component Analysis; D012372:ROC Curve; D013057:Spectrum Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
keywords: Cervical cancer detection; Diffuse reflectance spectroscopy; Linear discriminant analysis; Multivariate analysis; Optical biopsy; Principal component analysis