The use of optical spectroscopy for in vivo detection of cervical pre-cancer

Abstract

In order to investigate the effectiveness of optical spectroscopy for in vivo diagnosis of cervical pre-cancerous conditions, a series of published studies are surveyed. The six optical technologies investigated include fluorescence spectroscopy, reflectance spectroscopy, and their combination using point probe or multispectral imaging approaches. Searching in the well-known databases, the most recent published works were sought out. Various aspects of the studies were evaluated including the details of the technology used, the pathologic threshold for tissue classification and the gold standard, the study population and prevalence of disease in this population, the method of measurement, the number of clinicians involved in the study, the classification and validation algorithms, and the performance in terms of sensitivity, specificity and, when available, the area under the receiver operating characteristic curve. Forty-four studies conducted from 1994 to 2012 were evaluated. The data are gathered in two comprehensive tables, and five illustrations are provided to simplify a comparison between studies from different points of view. There is a broad band of studies from small pilot studies through phase III clinical trials. Among the reviewed articles, only three factors were found to influence the performance of the optical spectroscopy studies. Multispectral approaches show higher specificity than the point probe approaches (p = 0.001). The use of acetic acid before measurement and prevalence of disease among the studied population, also, have an impact on the sensitivity and specificity of the studies (p< 0.05), respectively.

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

“…29 However, fewer studies have been conducted to evaluate the CIN detection capability by reflectance spectroscopy alone using a white light source. 6 The present study showed good potential of reflectance spectroscopy using a very simple system incorporating only a white light source, a spectrophotometer and a single optical fiber in cervical tissue diagnosis. Also, very quick measurement of less than one second makes it a real-time tool as an adjunct to colposcopy routine in clinics.…”

“…Unlike other researches in which at least five optical fibers 6 were gathered in a probe to illuminate the tissue and collect the reflected light or the fluorescence spectra from it, the method introduced in this paper utilized only a single fiber. The small probe dimension and use of one optical fiber have the advantages of low cost, system simplicity and easier service and maintenance procedures.…”

“…Since the late 20th century, many researchers have investigated the use of optical spectroscopy as an adjunct to the routine colposcopy to reduce the screening and surveillance costs and to improve detection of high grade squamous intraepithelial lesions (HGSIL) in the diagnostic and screening populations. 6 Reflectance spectroscopy is a method that allows noninvasive determination of the scattering and absorption properties of a turbid medium, such as tissue. This information can be used to describe aspects of the tissue physiology (e.g., vascular oxygen saturation, blood volume fraction) and morphology (e.g., tissue, cell, organelle size and density).…”

Spatially-Resolved Multiply-Excited Autofluorescence and Diffuse Reflectance Spectroscopy: SpectroLive Medical Device for Skin In Vivo Optical Biopsy

“…Optical spectroscopy has been thoroughly studied over the past years to characterize its diagnostic accuracy in diagnosing microcirculation disorders [19] or cancer on a wide variety of organs such as liver [20,21], breast [13], colon [9,22], skin [3,23,24], cervix [25,26], esophagus [27] or bronchi [28]. Those research teams decided either to use off-the shelf devices, or to develop their own devices.…”