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Journal of Biomedical Optics • Open Access

Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia without colposcopic tissue information; a step toward automation for low resource settings
Author(s): Jose-Miguel Yamal; Getie A. Zewdie; Dennis D. Cox; Edward N. Atkinson; Scott B. Cantor; Calum E. MacAulay; Timon P. Buys; Kalatu Davies; Michele Follen; Isaac Adewole

Paper Abstract

Optical spectroscopy has been proposed as an accurate and low-cost alternative for detection of cervical intraepithelial neoplasia. We previously published an algorithm using optical spectroscopy as an adjunct to colposcopy and found good accuracy (sensitivity = 1.00 [95% confidence interval (CI) = 0.92 to 1.00], specificity = 0.71 [95% CI = 0.62 to 0.79]). Those results used measurements taken by expert colposcopists as well as the colposcopy diagnosis. In this study, we trained and tested an algorithm for the detection of cervical intraepithelial neoplasia (i.e., identifying those patients who had histology reading CIN 2 or worse) that did not include the colposcopic diagnosis. Furthermore, we explored the interaction between spectroscopy and colposcopy, examining the importance of probe placement expertise. The colposcopic diagnosis-independent spectroscopy algorithm had a sensitivity of 0.98 (95% CI = 0.89 to 1.00) and a specificity of 0.62 (95% CI = 0.52 to 0.71). The difference in the partial area under the ROC curves between spectroscopy with and without the colposcopic diagnosis was statistically significant at the patient level (p = 0.05) but not the site level (p = 0.13). The results suggest that the device has high accuracy over a wide range of provider accuracy and hence could plausibly be implemented by providers with limited training.

Paper Details

Date Published: 5 April 2012
PDF: 13 pages
J. Biomed. Opt. 17(4) 047002 doi: 10.1117/1.JBO.17.4.047002
Published in: Journal of Biomedical Optics Volume 17, Issue 4
Show Author Affiliations
Jose-Miguel Yamal, The Univ. of Texas Health Science Ctr. at Houston (United States)
Getie A. Zewdie, The Univ. of Texas Health Science Ctr. at Houston (United States)
Dennis D. Cox, Rice Univ. (United States)
Edward N. Atkinson, The Univ. of Texas M.D. Anderson Cancer Ctr. (United States)
Scott B. Cantor, The Univ. of Texas M.D. Anderson Cancer Ctr. (United States)
Calum E. MacAulay, The BC Cancer Agency Research Ctr. (Canada)
Timon P. Buys, The BC Cancer Agency Research Ctr. (Canada)
Kalatu Davies, Drexel Univ. College of Medicine (United States)
Michele Follen, Drexel Univ. College of Medicine (United States)
Isaac Adewole, Univ. of Ibadan (Nigeria)


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