3.03] Optical coherence tomography as a non-invasive imaging technique for examination of cervical tissue

Abstract

Objective Optical coherence tomography (OCT) is a non-invasive high-resolution real-time imaging technique that permits delineation of features up to 2 mm in depth. The purpose of this study was to examine the capabilities of OCT in characterizing cancerous and precancerous lesions of the uterine cervix. Patients and methods We conducted a single-institution, review board-approved, prospective study on the use of OCT as an adjunct to standard colposcopy and biopsy in 25 women with suspected cervical intraepithelial neoplasia (CIN). OCT images of suspicious areas were obtained before biopsy, interpreted in real time and subsequently compared with the corresponding histology. Results We obtained 47 images with corresponding histology in 25 women undergoing colposcopy for suspected CIN. In total 35 of the 37 histologically proven CIN lesions were diagnosed correctly by OCT with a sensitivity of 95%. Five of ten biopsy sites with histologically no dysplasia were misinterpreted by OCT thereby suggesting CIN. However, there were inflammatory changes in 3 of these specimens which were possibly the cause of the misinterpretations and the low specificity of 50%. Conclusion OCT is a rapid, easy-to-use modality that provides real-time microarchitectural information. With further experience we expect to overcome the present difficulties in distinguishing between early precancerous lesions and inflammatory disorders. On the basis of the above findings, we believe that this technology has the potential to improve the management of cervical dysplasia.