Value of colposcopy with dynamic spectral imaging in the detection and evolution of high-grade cervical lesions

Abstract

ABSTRACT Objective To analyze the performance of colposcopy assisted with dynamic spectral imaging (CC-DSI) compared to conventional colposcopy (CC) in diagnosing cervical intraepithelial neoplasia 2+ (CIN2+). Methods In total, 973 consecutive women were referred for colposcopy between 2012 and 2016 and were examined simultaneously by CC and CC-DSI; 877 were eligible. Comparisons between CC and CC-DSI were performed against the histological diagnosis performed by either punch biopsy or loop electrosurgical excision procedure (LEEP). Results In final histology, 494 women had no CIN, 250 had CIN1 and 133 had CIN2+. The sensitivity to identify women with CIN2+ was significantly higher for CC-DSI compared to CC for the entire group and in the subgroup of 675 women referred with ASCUS or LSIL. In women with HPV16/18 infections, the sensitivity of CC increased with the addition of DSI from 53% to 79% (p < 0.001). Using a multivariant Cox regression model, CC-DSI was an independent factor for progression of the cervical lesions (HR: 2.29, 95% CI 1.07–4.90). Other predictive factors were the number of sexual partners (HR: 1.05, 95% CI: 1.01–1.09) and anal intercourse (HR: 2.45, 95% CI 1.23–5.02). Conclusion CC-DSI improves the ability to detect cervical lesions compared to CC and could help predict their potential to progress.