Ludwig Maximilians University Munich, Grosshadern Medical Campus, Department of Obstetrics and Gynecology, Marchioninistrasse 15, 81377 Munich, Germany.
Ludwig-Maximilians University Munich, Innenstadt Medical Campus, Department of Surgery, Nussbaumstrasse 20, 80336 Munich, Germany.
J Biomed Opt. 2017 Jan 1;22(1):16013. doi: 10.1117/1.JBO.22.1.016013.
Optical coherence tomography (OCT) is a noninvasive high-resolution imaging technique that permits the detection of cancerous and precancerous lesions of the uterine cervix. The purpose of this study was to evaluate a new system that integrates an OCT device into a microscope. OCT images were taken from loop electrosurgical excision procedure (LEEP) specimens under microscopic guidance. The images were blinded with respect to their origin within the microscopic image and analyzed independently by two investigators using initially defined criteria and later compared to the corresponding histology. Sensitivity and specificity were calculated with respect to the correct identification of high-grade squamous intraepithelial lesions (HSIL). The interinvestigator agreement was assessed by using Cohen’s kappa statistics. About 160 OCT images were obtained from 20 LEEP specimens. Sixty randomly chosen images were used to define reproducible criteria for evaluation. The assessment of the remaining 100 images showed a sensitivity of 88% (second investigator 84%) and a specificity of 69% (65%) in detecting HSIL. Surgical microscopy-guided OCT appears to be a promising technique for immediate assessment of microanatomical changes. In the gynecological setting, the combination of OCT with a colposcope may improve the detection of high-grade squamous intraepithelial lesions.
光学相干断层扫描（OCT）是一种非侵入性的高分辨率成像技术，可用于检测子宫颈的癌变和癌前病变。本研究旨在评估一种将 OCT 设备集成到显微镜中的新系统。在显微镜引导下，从环形电切术（LEEP）标本中获取 OCT 图像。这些图像在微观图像内的来源方面是盲目的，并由两位研究人员独立使用最初定义的标准进行分析，然后与相应的组织学进行比较。根据正确识别高级别鳞状上皮内病变（HSIL）来计算敏感性和特异性。使用 Cohen's kappa 统计来评估研究人员之间的一致性。从 20 个 LEEP 标本中获得了大约 160 个 OCT 图像。随机选择 60 张图像用于定义可重复的评估标准。对其余 100 张图像的评估显示，在检测 HSIL 方面，敏感性为 88%（第二位研究人员为 84%），特异性为 69%（65%）。手术显微镜引导的 OCT 似乎是一种很有前途的即时评估微观解剖变化的技术。在妇科环境中，OCT 与阴道镜的结合可能会提高对高级别鳞状上皮内病变的检测。
