Comparison of Colposcopic Impression Based on Live Colposcopy and Evaluation of Static Digital Images

Liu, Angela H.; Gold, Michael A.; Schiffman, Mark; Smith, Katie; Dunn, S. Terence; Gage, Julia C.; Walker, Joan L.; Wentzensen, Nicolas

doi:10.1097/lgt.0000000000000194

Cited by 22 publications

(17 citation statements)

References 25 publications

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“…The insufficiencies of traditional colposcopy have been widely documented. In the diagnosis of cervical lesions, the overall exact concordance between traditional colposcopy and histology was reported to be a disappointing 37–52%, even when performed by experienced colposcopists. This is caused by many reasons, such as the picture is not clear enough and the vascular image is not sharp enough, which may reduce the detection rate of lesions.…”

Section: Discussionsupporting

confidence: 90%

High resolution multispectral endoscopy significantly improves the diagnostic accuracy of cervical intraepithelial lesions

Long

Zhu

et al. 2020

J of Obstet and Gynaecol

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Colposcopy is a visual technique to examine the cervix and determine selection of sites for biopsies and eligibility for treatment. It's always been a critical part of identifying preinvasive and early invasive cervical carcinoma. Unfortunately, challenges exist with regards to the accuracy of traditional colposcopy. Hence, to fully exploit the benefit of increasing diagnostic sensitivity, there is a pressing need to improve the performance of colposcopy by applying novel innovations and techniques. In this case report, we used a recently developed, high-resolution multispectral endoscopy and evaluated its performance by comparing colposcopic image features (the vascular pattern, in particular, depending upon the improved optics and illumination) with histology results. High-resolution multispectral endoscopy makes it easier to distinguish the features of pathological vessels, so that it has a higher sensitivity and specificity to detect cervical lesions, especially in discriminating the vascular pattern using multispectral technology.

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Section: Discussionsupporting

confidence: 90%

High resolution multispectral endoscopy significantly improves the diagnostic accuracy of cervical intraepithelial lesions

Long

Zhu

et al. 2020

J of Obstet and Gynaecol

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“…Previous landmark papers using the ASCUC/LSIL triage study for cervical cancer (ALTS) data questioned the accuracy of static images in detecting borderline lesions [ 28 , 29 ]. However, others have shown that the development of smartphones (not yet developed at the time of the above study) and static images can be a useful adjunct to colposcopy [ 8 , 12 , 32 – 34 ]. Gauthier et al [ 12 ] performed a cross-sectional study using photographs (taken with 13 megapixels, autofocus and 2X optical zoom) as an adjunct to VIA and VILI.…”

Section: Discussionmentioning

confidence: 99%

“…In an effort to address the issue of inter-observer variability, the live colposcopist also assessed the static images four months after the original assessment, which increased the sensitivity to 71.4 (95% CI 29–96.3). Further, Liu et al [ 32 ] evaluated the largest number of static colposcopy images, where 558 women were assessed by six live colposcopists and one static image colposcopist. This study reported a 92% agreement between live and static assessments (ĸ statistic = 0.39 95% CI 0.21–0.57) using colposcopic signs including acetowhitening.…”

Section: Discussionmentioning

confidence: 99%

Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study

et al. 2018

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BackgroundThis cross-sectional pilot study evaluates diagnostic accuracy of live colposcopy versus static image Swede-score evaluation for detecting significant precancerous cervical lesions greater than, or equal to grade 2 severity (CIN2+).MethodsVIA or HrHPV positive women were examined using a mobile colposcope, in a rural clinic in Kolkata, India. Live versus static Swede-score colposcopy assessments were made independently. All assessments were by gynecologists, junior or expert. Static image assessors were blinded to live scoring, patient information and final histopathology result. Primary outcome was the ability to detect CIN2+ lesions verified by directed biopsies. Diagnostic accuracy was calculated for live versus static Swede-score in detecting CIN2+ lesions, as well as for interclass correlation.Results495 images from 94 VIA positive women were evaluated in this study. Thirteen women (13.9%) had CIN2+ on biopsy. No significant difference was found in the detection of CIN2+ lesions between live and static assessors (area under curve = 0.69 versus 0.71, p = 0.63). A Swede-score of 4+, had a sensitivity of 76.9% (95% CI 46.2–95.0%) and 84.6% (95% CI 54.6–98.1%), for live- and static-image assessment respectively. The corresponding positive predictive values were found to be 90.9% (95% CI 75.7–98.1%) and 92.6% (95% CI 75.7–99.1%). The interclass correlation was good (kappa statistic = 0.60) for the senior static assessors.ConclusionsSwede-score evaluation of static colposcopy images was found to reliably detect CIN2+ lesions in this study. Larger studies are needed to further develop the colposcopy telemedicine concept which may offer reliable guidance in management where direct specialist input is not available.Trial registrationEthical approval of the study was obtained by the Chittaranjan National Cancer Institute (CNCI) Human Research Ethics Committee (4.311/27/2014). The trial was retrospectively registered in the Clinical Trails Registry of India CTRI/2018/03/012470.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0569-1) contains supplementary material, which is available to authorized users.

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“…By providing an efficient and practical quality control system, the smartphone-based VIA approach circumvents the main issues that limit the naked eye VIA’s efficacy. A previous study showed that the overall agreement between the diagnoses’ quality obtained from live colposcopic visualization and static digital imaging of the cervix was 43.0% corresponding to a moderate agreement 15. Hence, further improvement of the application is imperative in order to optimize its performance as a CC screening tool.…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy

Gallay¹,

Girardet²,

Viviano³

et al. 2017

IJWH

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BackgroundVisual inspection after application of acetic acid (VIA) and Lugol’s iodine (VILI) is a cervical cancer (CC) screening approach that has recently been adopted in low- and middle-income countries (LMIC). Innovative technologies allow the acquisition of consecutive cervical images of VIA and VILI using a smartphone application. The aim of this study was to evaluate the quality of smartphone images in order to assess the feasibility and usability of a mobile application for CC screening in LMIC.MethodsBetween May and November 2015, women aged 30–65 years were recruited in a CC screening campaign in Madagascar. Human papillomavirus-positive women were invited to undergo VIA/VILI assessment. Pictures of their cervix were taken using a Samsung Galaxy S5 with an application called “Exam”, which was designed to obtain high-quality images and to classify them in the following sequence: native, VIA, VILI and posttreatment. Experts in colposcopy were asked to evaluate if the quality of the pictures was sufficient to establish the diagnosis and to assess sharpness, focus and zoom.ResultsThe application use was simple and intuitive, and 208 pictures were automatically classified and recorded in the patient’s file. The quality was judged as adequate for diagnosis in 93.3% of cases. The interobserver agreement was κ =0.45 (0.23–0.58), corresponding to a moderate agreement on the common scale of kappa values.ConclusionThis smartphone application allows the acquisition of good quality images for VIA/VILI diagnosis. The classification of images in a patient database makes them accessible to on- and off-site experts, and allows continuous clinical education. Smartphone applications may offer an alternative to colposcopy for CC screening in LMIC.

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Comparison of Colposcopic Impression Based on Live Colposcopy and Evaluation of Static Digital Images

Cited by 22 publications

References 25 publications

High resolution multispectral endoscopy significantly improves the diagnostic accuracy of cervical intraepithelial lesions

High resolution multispectral endoscopy significantly improves the diagnostic accuracy of cervical intraepithelial lesions

Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study

Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy

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