title: Detection of cervical intraepithelial neoplasia by using optical coherence tomography in combination with microscopy.
abstract: Optical coherence tomography (OCT) is a noninvasive high-resolution imaging technique that permits the detection of cancerous and precancerous lesions of the uterine cervix. The purpose of this study was to evaluate a new system that integrates an OCT device into a microscope. OCT images were taken from loop electrosurgical excision procedure (LEEP) specimens under microscopic guidance. The images were blinded with respect to their origin within the microscopic image and analyzed independently by two investigators using initially defined criteria and later compared to the corresponding histology. Sensitivity and specificity were calculated with respect to the correct identification of high-grade squamous intraepithelial lesions (HSIL). The interinvestigator agreement was assessed by using Cohen’s kappa statistics. About 160 OCT images were obtained from 20 LEEP specimens. Sixty randomly chosen images were used to define reproducible criteria for evaluation. The assessment of the remaining 100 images showed a sensitivity of 88% (second investigator 84%) and a specificity of 69% (65%) in detecting HSIL. Surgical microscopy-guided OCT appears to be a promising technique for immediate assessment of microanatomical changes. In the gynecological setting, the combination of OCT with a colposcope may improve the detection of high-grade squamous intraepithelial lesions.
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Gallwas
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Aydan
authors.initials: A
authors.lastname: Jalilova
authors.affiliation: Ludwig-Maximilians University Munich, Innenstadt Medical Campus, Department of Surgery, Nussbaumstrasse 20, 80336 Munich, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Ladurner
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Theresa Maria
authors.initials: TM
authors.lastname: Kolben
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kolben
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Ditsch
authors.affiliation: cLudwig Maximilians University Munich, Grosshadern Medical Campus, Laser-Research Laboratory, LIFE Center, Feodor-Lynen-Strasse 19, 81377 Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Homann
authors.affiliation: OptoMedical Technologies GmbH, Maria Goeppert Strasse 9, 23562 Luebeck, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Lankenau
authors.affiliation: Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Dannecker
mesh_terms: D005260:Female; D006801:Humans; D008853:Microscopy / Q000379:methods*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging*; D002578:Uterine Cervical Dysplasia / Q000000981:diagnostic imaging*