Tan Jeffrey, Delaney Peter, McLaren Wendy J
Royal Women's Hospital, Carlton, Victoria, Australia.
Expert Rev Med Devices. 2007 Nov;4(6):863-71. doi: 10.1586/17434440.4.6.863.
Optical imaging technologies, such as reflectance and fluorescence spectroscopy, have shown the potential to provide enhanced detection of changes in the uterine cervix at clinical examination. This review focuses on fluorescence confocal endomicroscopy that enables in vivo microscopic imaging of the cervical epithelium in histological detail in real time. The microscopic imaging technique may permit 'see-and-treat' workflows in colposcopy through high-resolution fluorescence imaging of cellular and subcellular detail from the surface and subepithelial layers of the cervical mucosa. The device may be used in conjunction with a conventional colposcope. Preliminary data from clinical studies suggest that the device can be used to visualize features of the cervical epithelium including the squamo-columnar junction, dermal papillae and endocervical glands. Moreover, the technique has the ability to detect and grade precancerous changes of the cervical epithelium in conditions, such as cervical intraepithelial neoplasia, where prediction using colposcopy may be problematic. The early detection and diagnosis of gynecological abnormalities through the collection of 'optical' biopsies or targeted mucosal excisional biopsies have the potential to improve patient management through early therapeutic intervention and 'see-and-treat' strategies.
光学成像技术，如反射光谱和荧光光谱，已显示出在临床检查中增强子宫颈变化检测的潜力。本综述聚焦于荧光共聚焦内镜检查，它能够实时对子宫颈上皮进行组织学细节的体内显微成像。这种显微成像技术可能通过对子宫颈黏膜表面和上皮下层细胞及亚细胞细节的高分辨率荧光成像，在阴道镜检查中实现“所见即治疗”的工作流程。该设备可与传统阴道镜结合使用。临床研究的初步数据表明，该设备可用于可视化子宫颈上皮的特征，包括鳞柱交界、真皮乳头和子宫颈管腺。此外，该技术有能力在诸如子宫颈上皮内瘤变等情况下检测子宫颈上皮的癌前变化并进行分级，而在这些情况下，使用阴道镜进行预测可能存在问题。通过采集“光学”活检或靶向黏膜切除活检来早期检测和诊断妇科异常，有可能通过早期治疗干预和“所见即治疗”策略改善患者管理。
