Optical coherence tomography as a non-invasive imaging technique for preinvasive and invasive neoplasia of the uterine cervix

Objective Optical coherence tomography (OCT) is a non-invasive high-resolution imaging technique that permits characterization of microarchitectural features of tissue up to 2 mm in depth in real time. The purpose of this study was to evaluate the feasibility of OCT for the identification of precancerous (cervical intraepithelial neoplasia (CIN)) and cancerous lesions of the uterine cervix. Methods We conducted a prospective study on the use of OCT in women with suspected CIN. OCT images were obtained on colposcopy from non-suspicious and suspicious areas, and were evaluated independently by two investigators and later compared with the corresponding histology. The sensitivity, specificity, negative and positive predictive values and accuracy of the new technique in identifying CIN or carcinoma were calculated. Results Of a total of 610 OCT images, 97 from suspicious areas in 60 women were compared with the corresponding histology. Sixty-three of 67 CIN lesions and four invasive carcinomas were diagnosed correctly on evaluation of the OCT images by the first observer. There were 69 true-positive, 11 true-negative, 13 false-positive and four false-negative results, giving a sensitivity of 95% and a specificity of 46%. Conclusion OCT is a rapid, easy-to-use modality that provides real-time, microarchitectural information of the cervical epithelium. Further refinement of this technology will lead to OCT systems with a significantly higher resolution and may result in better differentiation of cancerous and precancerous lesions. Copyright (C) 2010 ISUOG. Published by John Wiley & Sons, Ltd.