title: Multimodal Hyperspectroscopic Imaging for Detection of High-Grade Cervical Intraepithelial Neoplasia.
abstract: OBJECTIVE
  Numerous new alternative digital colposcopy techniques have been developed, of which multimodal hyperspectroscopy (MHS) showed a high sensitivity in previous studies. The objective of this prospective single-center cohort study was to evaluate the clinical value of MHS for detecting high-grade cervical intraepithelial neoplasia in a colposcopy referral population and colposcopy follow-up population, to assess whether MHS could be safely used to improve care for women at risk for high-grade cervical intraepithelial neoplasia.
  
  
  METHODS
  A total of 125 women from a colposcopy referral population and colposcopy follow-up population were evaluated with MHS and tested for the presence of high-risk human papillomavirus (HPV) with HPV-16/18 genotyping. Spectroscopic measurements of the cervix were taken and compared with an end point based on histology, high-risk HPV, and cytology. Evaluable data for analysis were collected from 102 of the subjects. Sensitivity, specificity, and predictive values were calculated for MHS and colposcopic impression based on conventional colposcopic examination.
  
  
  RESULTS
  From the total study population of the 102 patients, 47 were enrolled in the colposcopy referral group and 55 in the colposcopy follow-up group. The MHS yielded a sensitivity of 93.6% (95% CI = 78.6-99.2), with a corresponding specificity of 42.3% (95% CI = 30.6-54.6) in the group with a composite end point. No adverse effects occurred, and patient acceptability was high.
  
  
  CONCLUSIONS
  Multimodal hyperspectroscopy is a digital colposcopy technique that offers an easy, rapid, well-tolerated point-of-care assessment with a high sensitivity for the presence of high-grade cervical intraepithelial lesions, however, with a low specificity, resulting in limited clinical value.
authors.affiliation: 1Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands; 2Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands; and 3Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
authors.forename: Renée M F
authors.initials: RMF
authors.lastname: Ebisch
authors.forename: Marjolein
authors.initials: M
authors.lastname: Hermens
authors.forename: Petronella A J
authors.initials: PAJ
authors.lastname: van den Akker
authors.forename: Leon F A G
authors.initials: LFAG
authors.lastname: Massuger
authors.forename: Willem J G
authors.initials: WJG
authors.lastname: Melchers
authors.forename: Ruud L M
authors.initials: RLM
authors.lastname: Bekkers
mesh_terms: D000328:Adult; D003127:Colposcopy / Q000379:methods*; D060005:Genotyping Techniques; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000000981:diagnostic imaging*