Okawa Kiguna Sei, Okawa Shinpei, Sasa Hidenori, Ishihara Miya
Department of Obstetrics and Gynecology, Seirei Hamamatsu General Hospital, 2-1212 Sumiyoshi, Chuo-ku, Hamamatsu, Shizuoka, Japan.
Department of Medical Engineering, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, Japan.
J Med Ultrason (2001). 2025 Jan;52(1):119-129. doi: 10.1007/s10396-024-01501-4. Epub 2024 Oct 3.
Early diagnosis of a precursor lesion in the uterine cervix is an essential factor in uterine cervical cancer prevention. Although colposcopy is an established procedure for detecting high-risk patients, its accuracy and reproducibility are relatively low. Some supportive or alternative techniques to improve the early diagnosis of a precursor lesion have been studied, and correct diagnosis with high reliability using a minimally invasive, cost-effective technique has been pursued. This study aimed to examine the possibility of using photoacoustic (PA) imaging as a supportive technique to improve the accuracy of early diagnosis of cervical precursor lesions.
A PA imaging system for microvessels was used to detect angiogenesis in severe lesions. A total of 21 patients who underwent surgical treatment and 114 outpatients who visited our colposcopy clinic were examined. A retrospective evaluation of PA images was performed as follows: (i) pathological assessment of the specific PA findings and (ii) retrospective evaluation of the severe lesion detection rate through PA.
PA image evaluation and pathological findings showed dense angiogenesis in a severe precursor lesion appearing as a "hot spot" in the PA image. A comparison with colposcopy findings was performed for accuracy evaluation, and the detection rate of severe lesions using PA was relatively high (positive predictive value, 84.5%; negative predictive value, 82.1%).
Our results indicate the possibility of using PA imaging for early diagnosis of severe cervical precursor lesions. With its ability to yield quantitative information, PA imaging can improve ultrasound diagnosis.
子宫颈前体病变的早期诊断是预防子宫颈癌的关键因素。虽然阴道镜检查是检测高危患者的既定方法，但其准确性和可重复性相对较低。已经研究了一些支持性或替代性技术以改善前体病变的早期诊断，并一直在寻求使用微创、经济高效的技术进行高可靠性的正确诊断。本研究旨在探讨使用光声（PA）成像作为支持性技术来提高宫颈前体病变早期诊断准确性的可能性。
使用用于微血管的PA成像系统检测严重病变中的血管生成。共检查了21例接受手术治疗的患者和114例到我们阴道镜诊所就诊的门诊患者。对PA图像进行回顾性评估如下：（i）对特定PA表现进行病理评估，以及（ii）通过PA对严重病变检测率进行回顾性评估。
PA图像评估和病理结果显示，严重前体病变中血管生成密集，在PA图像中表现为“热点”。为进行准确性评估，将其与阴道镜检查结果进行了比较，使用PA检测严重病变的比率相对较高（阳性预测值，84.5%；阴性预测值，82.1%）。
我们的结果表明，使用PA成像对严重宫颈前体病变进行早期诊断具有可能性。PA成像能够提供定量信息，可改善超声诊断。
