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Cervical Epithelial Brightness by Optical Coherence Tomography Can Determine Histological Grades of Cervical Neoplasia

Belinson, Suzanne E. PhD1; Ledford, Katy BA2; Rasool, Nabila MD3; Rollins, Andrew PhD4; Wilan, Na MD5; Wang, Chun MD5; Rong, Xuan MD5; Zhang, Wei MD5; Zhu, Yasha MD5; Tresser, Nancy PhD6; Wu, RuiFang MD5; Belinson, Jerome L. MD1,3

Journal of Lower Genital Tract Disease: April 2013 - Volume 17 - Issue 2 - p 160–166
doi: 10.1097/LGT.0b013e31825d7bf0
Original Articles

Objective The study aimed to determine if the difference in cervical epithelium brightness, as measured by optical coherence tomography (OCT), has potential as a distinguishing characteristic of normal, low-grade, high-grade (cervical intraepithelial neoplasia 2+), and cancer histological findings.

Materials and Methods Information from 476 women was available for analysis. Demographic information was collected through in-person interview. All participants were human papillomavirus positive and/or had abnormal cytological finding and underwent colposcopy or unaided visual inspection and examination by OCT by quadrant. All women had a minimum of 4 OCT-matched cervical biopsies and endocervical curettage. Two sample t tests were used to measure differences in OCT image brightness by histological grades.

Results Mean OCT image brightness differed significantly between each preinvasive histological grade and invasive cancer (p < .01 for all comparisons). Brightness as measured by OCT was also able to differentiate between squamous metaplasia and cervical intraepithelial neoplasia 3/cancer; p values were .004 and .003, respectively.

Conclusions Epithelial brightness is an important component of cervical epithelium diagnosis by OCT, and we plan to add it to our diagnostic mathematical algorithm in all future versions of OCT software.

A quantitative optical imaging method was found to be effective in identifying high-grade preinvasive and early invasive cervical carcinoma.

1Preventive Oncology International, Inc., Cleveland Heights; 2University of Toledo, Toledo; 3Department of Obstetrics and Gynecology, Women’s Health Institute, Cleveland Clinic, Cleveland; and 4Case Western Reserve University, Cleveland, OH; 5Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China; and 6Imalux Corporation, Cleveland, OH

Reprint requests to: Nancy Tresser, PhD, Imalux, 11000 Cedar Ave, Suite 250, Cleveland, OH 44106. E-mail:

Dr. Suzanne Belinson was supported by the US Public Health Service grant R25 CA100600 from the National Cancer Institute.

Nancy Tresser is an employee of Imalux Corporation. The other authors do not have any conflicts of interest to disclose.

©2013The American Society for Colposcopy and Cervical Pathology