Single fiber reflectance spectroscopy on cervical premalignancies: the potential for reduction of the number of unnecessary biopsies

Abstract

We have assessed the value of single fiber reflectance (SFR) spectroscopy in prediction of cervical squamous intraepithelial lesions (SIL). SFR was used to measure reflected light from 32 patients undergoing standard colposcopy. Seven parameters extracted from the spectra in addition to two biographic parameters were compared in biopsy-confirmed SIL versus nonSIL. The significant parameters in the model were determined using stepwise logistic regression. The classification performance was evaluated by a leave-one-out cross-validation method and reported by receiver operating characteristic (ROC) curves. Light absorption properties and biographic characteristics of the patient contributed significantly to the accuracy of the model. Combining important parameters, the best retrospective sensitivity, specificity and area under the ROC curve for SIL sites versus nonSIL were 89%, 80% and 0.89%, respectively. SFR spectroscopy shows promise as a noninvasive, real-time method to guide the clinician in reducing the number of unnecessary biopsies. Discrimination of SIL from other abnormalities compares favorably with that obtained by fluorescence alone and by fluorescence combined with reflectance spectroscopy while the simplicity and low cost of the presented system are dominant.

The Effect of Probe Pressure on In Vivo Single Fiber Reflectance Spectroscopy

“…It has comparable characteristics to uterine cervix which is under investigation by the authors. 7,8 Also, the tissue was tested in its normal situation rather than exposing to the probe barely like other studies. 11,13 Investigation of the sole effect of probe pressure on a comparable tissue and with similar experimental setup, confirmed the previous cervical tissue results.…”

“…7 Because of the similarity of the lower lip tissue with the cervical tissue, the same model was used to analyze the measured spectra. However, melanin was added to the model in addition to previously described absorbers, including blood and beta-carotene.…”

“…7 Briefly, it included an optical fiber spectrophotometer and a tungsten halogen light source. A pair of bifurcation connected the two devices to a common fiber by two 200 μm diameter optical fibers.…”

“…3 It has shown its potential in diagnosis of cancer and pre-cancer in lung lymph nodes, 4 brain, 5 skin 6 and uterine cervix. 7 In order to obtain clinically useful information about the measured tissue, the spectroscopy results must depend solely on the tissue characteristics rather than environmental parameters, such as probe pressure. 8 Probe pressure effect on fluorescence [9][10][11][12] and reflectance 9,11,13,14 spectroscopy has been studied by several authors.…”

Contrast-Enhancing Snapshot Narrow-Band Imaging Method for Real-Time Computer-Aided Cervical Cancer Screening

“…With the spectral difference-enhanced optical biopsy, a CAD method can be established for automatic and objective diagnosis of the precancerous lesions. Sterenborg proposed a spectral imaging method for diagnosing cervical tissues using an optical fiber to collect reflective lights from cervical squamous and achieved 89 and 80% of sensitivity and specificity, respectively [5]. Recently Wang and coworkers proposed a multi-scale hyperspectral imaging method to detect cervical neoplasia at both tissue and cellular levels [6].…”