Abstract
The accuracy of colposcopic diagnosis depends on the skill and proficiency of physicians. This study evaluated the feasibility of interpreting colposcopic images with the assistance of artificial intelligence (AI) for the diagnosis of high-grade cervical intraepithelial lesions. This study included female patients who underwent colposcopy-guided biopsy in 2020 at two institutions in the Republic of Korea. Two experienced colposcopists reviewed all images separately. The Cerviray AI® system (AIDOT, Seoul, Korea) was used to interpret the cervical images. AI demonstrated improved sensitivity with comparable specificity and positive predictive value when compared with the colposcopic impressions of each clinician. The areas under the curve were greater with combined impressions (both AI and that of the two colposcopists) of high-grade lesions, when compared with the individual impressions of each colposcopist. This study highlights the feasibility of the application of an AI system in cervical cancer screening. AI interpretation can be utilized as an assisting tool in combination with human colposcopic evaluation of exocervix.
Highlights
Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that is diagnosed and categorized as CIN1, CIN2, or CIN3 [1]
The purpose of this study was to evaluate the feasibility of an artificial intelligence (AI) system as an assistant tool in diagnosing high-grade CIN lesions compared to human interpretation of cervical images
Almost half of the patients did not require any treatment; most of the patients with high-grade lesions were treated with conization or loop electrosurgical excision procedure (LEEP)
Summary
Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that is diagnosed and categorized as CIN1, CIN2, or CIN3 [1]. Genital human papillomavirus (HPV) infection is known as the critical step in the development of CIN [2]. If CIN is untreated, some patients may develop cervical cancer [3]. A diagnosis of CIN2-3 is a histological diagnosis obtained from biopsies of the suspect lesions, either with or without colposcopy, for which treatment is recommended. Screening for CIN can be achieved by cytological examination, human papillomavirus (HPV) screening, or colposcopy [4]. Primary HPV testing is the most preferred method globally [5]. Regular screening for cervical cancer may lower the lifetime risk of the disease [6]. Screening programs in low-income countries are difficult due to inaccessibility, lack of funding, lack of public policies, and high costs [7]
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