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Detection of Cervical Intraepithelial Neoplasias and Cancers in Cervical Tissue by In Vivo Light Scattering

Mourant, Judith R. PhD1; Bocklage, Thérese J. MD2; Powers, Tamara M. AS1; Greene, Heather M. BS3; Dorin, Maxine H. MD4; Waxman, Alan G. MD4; Zsemlye, Meggan M. MD4; Smith, Harriet O. MD5

Journal of Lower Genital Tract Disease: October 2009 - Volume 13 - Issue 4 - p 216-223
doi: 10.1097/LGT.0b013e318195d91b
Original Articles

Objective. This study aimed to examine the utility of in vivo elastic light scattering measurements, to identify cervical intraepithelial neoplasias 2,3 and cancers in women undergoing colposcopy, and to determine the effects of patient characteristics such as menstrual status on the elastic light scattering spectroscopic measurements.

Materials and Methods. A fiber optic probe was used to measure light transport in the cervical epithelium of patients undergoing colposcopy. Spectroscopic results from 151 patients were compared with histopathology of the measured and biopsied sites. A method of classifying the measured sites into 2 clinically relevant categories was developed and tested using 5-fold cross-validation.

Results. Statistically significant effects by age at diagnosis, menopausal status, timing of the menstrual cycle, and oral contraceptive use were identified, and adjustments based on these measurements were incorporated in the classification algorithm. A sensitivity of 77% ± 5% and a specificity of 62% ± 2% were obtained for separating cervical intraepithelial neoplasia 2,3 and cancer from other pathologies and normal tissue.

Conclusions. The effects of both menstrual status and age should be taken into account in the algorithm for classifying tissue sites based on elastic light scattering spectroscopy. When this is done, elastic light scattering spectroscopy shows good potential for real-time diagnosis of cervical tissue at colposcopy. Guiding biopsy location is one potential near-term clinical application area, whereas facilitating "see and treat" protocols is a longer term goal. Improvements in accuracy are essential.

Menstrual status was found to significantly affect the spectroscopic measurements in this study where in vivo light scattering showed potential for diagnosing cervical intraepithelial neoplasia.

1Bioscience Division, Los Alamos National Laboratory, Los Alamos, 2Pathology Department, University of New Mexico Health Science Center, Camino de Salud, 3Division of Gynecologic Oncology and 4General Gynecology Division, Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM; and 5Department of Obstetrics and Gynecology and Women's Health, Division of Gynecologic Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY

Reprint requests to: Judith R. Mourant, PhD, MS E535, Los Alamos National Laboratory, Los Alamos, NM 87544. E-mail:

Funding: This work was funded by National Institutes of Health grant CA71898.

©2009The American Society for Colposcopy and Cervical Pathology