Journal Highlight: Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia: Testing a device as an adjunct to colposcopy

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  • Published: Apr 11, 2011
  • Channels: UV/Vis Spectroscopy
thumbnail image: Journal Highlight: Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia: Testing a device as an adjunct to colposcopy

Accuracy of optical spectroscopy for the detection of cervical intraepithelial neoplasia: Testing a device as an adjunct to colposcopy

International Journal of Cancer 2011, 128, 1151-1168
Scott B. Cantor, Jose-Miguel Yamal, Martial Guillaud, Dennis D. Cox, E. Neely Atkinson, John L. Benedet, Dianne Miller, Thomas Ehlen, Jasenka Matisic, Dirk van Niekerk, Monique Bertrand, Andrea Milbourne, Helen Rhodes, Anais Malpica, Gregg Staerkel, Shahla Nader-Eftekhari, Karen Adler-Storthz, Michael E. Scheurer, Karen Basen-Engquist, Eileen Shinn, Loyd A. West, Anne-Therese Vlastos, Xia Tao, J. Robert Beck, Calum MacAulay, Michele Follen

Abstract: Testing emerging technologies involves the evaluation of biologic plausibility, technical efficacy, clinical effectiveness, patient satisfaction, and cost-effectiveness. The objective of this study was to select an effective classification algorithm for optical spectroscopy as an adjunct to colposcopy and obtain preliminary estimates of its accuracy for the detection of CIN 2 or worse. We recruited 1,000 patients from screening and prevention clinics and 850 patients from colposcopy clinics at two comprehensive cancer centers and a community hospital. Optical spectroscopy was performed, and 4,864 biopsies were obtained from the sites measured, including abnormal and normal colposcopic areas. The gold standard was the histologic report of biopsies, read 2 to 3 times by histopathologists blinded to the cytologic, histopathologic, and spectroscopic results. We calculated sensitivities, specificities, receiver operating characteristic (ROC) curves, and areas under the ROC curves. We identified a cutpoint for an algorithm based on optical spectroscopy that yielded an estimated sensitivity of 1.00 [95% confidence interval (CI) = 0.92-1.00] and an estimated specificity of 0.71 [95% CI = 0.62-0.79] in a combined screening and diagnostic population. The positive and negative predictive values were 0.58 and 1.00, respectively. The area under the ROC curve was 0.85 (95% CI = 0.81-0.89). The per-patient and per-site performance were similar in the diagnostic and poorer in the screening settings. Like colposcopy, the device performs best in a diagnostic population. Alternative statistical approaches demonstrate that the analysis is robust and that spectroscopy works as well as or slightly better than colposcopy for the detection of CIN 2 to cancer.

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An effective classification algorithm was derived for optical spectroscopy as an adjunct to colposcopy and preliminary estimates of its accuracy were obtained for the detection of cervical intraepithelial neoplasia or worse 

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