Can Dynamic Spectral Imaging System colposcopy replace conventional colposcopy in the detection of high-grade cervical lesions?

The sensitivity of conventional colposcopy for the detection of high-grade cervical lesions (cervical intraepithelial neoplasia stage 2 or above; CIN2+) is poor. We aimed to investigate if a Dynamic Spectral Imaging System (DySIS) can enhance or replace conventional colposcopy in clinical practice. From 3 December 2013 to 29 January 2014 a total of 239 women were included. All women were referred to the Department of Obstetrics and Gynecology, Aarhus, Denmark because of an abnormal cytology result. Every woman had three to five cervical punch biopsies taken; two biopsies were taken following DySIS recommendations. Subsequent biopsies were taken following the clinician's assessment or randomly. DySIS allowed detection of five CIN2+ cases (7.4%) that would not have been detected otherwise, but it failed to detect 46 of CIN2+ cases (67.6%). The sensitivity and specificity of DySIS for detecting CIN2+ was 32.4 and 83.0%, respectively. DySIS colposcopy seemed inferior to conventional colposcopy in detecting high-grade lesions and cannot replace conventional colposcopy with random biopsies.