title: Colposcopy combined with dynamic spectral imaging. A prospective clinical study.
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).
  
  
  METHODS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain. Electronic address: pcoronadom@sego.es.
authors.forename: Pluvio J
authors.initials: PJ
authors.lastname: Coronado
authors.affiliation: Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Fasero
mesh_terms: D000328:Adult; D003127:Colposcopy / Q000379:methods*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*
keywords: Cervical intraepithelial neoplasia; Colposcopy; Dynamic spectral imaging; HPV; Sensitivity