Bertelsen Vibe Munk, Booth Berit Bargum, Tranberg Mette, Kristensen Christina Blach, Bennetsen Mary Holten, Petersen Lone Kjeld, Bor Pinar
Department of Gynaecology and Obstetrics, Randers Regional Hospital, Department of Clinical Medicine, Aarhus University and University Research Clinic for Cancer Screening, Department of Public Health Programmes Central Denmark Region, Denmark.
Department of Gynaecology and Obstetrics, Randers Regional Hospital and Department of Gynaecology and Obstetrics, Odense University Hospital, Denmark.
J Low Genit Tract Dis. 2025 Oct 1;29(4):335-341. doi: 10.1097/LGT.0000000000000910. Epub 2025 Aug 28.
Dynamic Spectral Imaging colposcopy (DSI), an AI-driven technology, may improve cervical cancer diagnostics. This study aimed to evaluate the cervical intraepithelial neoplasia grade 2 or worse (CIN2+) sensitivity of DSI compared to regular colposcopy in individuals referred due to human papillomavirus (HPV)-positive and/or low-grade cytology.
This multicenter comparative cross-sectional study included individuals aged ≥18 years referred for colposcopy due to HPV positivity and/or low-grade cytology. Participants underwent either DSI or regular colposcopy. Colposcopists first identified the most suspicious area; in the DSI group, this was done before reviewing the DSI color map. The worst colored area was then selected, followed by additional biopsies. All participants had 4 cervical biopsies taken, with the most severe diagnosis as the gold standard. The primary outcome was CIN2+ detection sensitivity comparison between groups using a chi-square test.
A total of 411 individuals underwent examination with DSI and 308 had regular colposcopy. The sensitivity for detecting CIN2+ with DSI was 69.3% (95% CI = 61.2-76.7) with an average of 1.3 biopsies, comparable to the sensitivity of the regular group when 2 biopsies were taken (68.3%, 95% CI = 58.3-77.2). No significant sensitivity differences were observed between groups when 3 or 4 biopsies were combined.
The DSI color map did not show a clinically significant improvement in CIN2+ detection sensitivity compared to regular colposcopy. However, multiple biopsies enhanced sensitivity and remained superior for CIN2+ detection in both colposcopy groups.
动态光谱成像阴道镜检查（DSI）是一种人工智能驱动的技术，可能会改善宫颈癌的诊断。本研究旨在评估在因人乳头瘤病毒（HPV）阳性和/或低级别细胞学检查而转诊的个体中，与常规阴道镜检查相比，DSI对2级或更高级别宫颈上皮内瘤变（CIN2+）的检测敏感性。
这项多中心比较性横断面研究纳入了因HPV阳性和/或低级别细胞学检查而转诊进行阴道镜检查的18岁及以上个体。参与者接受了DSI或常规阴道镜检查。阴道镜检查人员首先确定最可疑区域；在DSI组中，这是在查看DSI彩色图之前完成的。然后选择颜色最差的区域，随后进行额外活检。所有参与者均进行了4次宫颈活检，以最严重的诊断作为金标准。主要结局是使用卡方检验比较两组之间CIN2+检测敏感性。
共有411名个体接受了DSI检查，308名接受了常规阴道镜检查。DSI检测CIN2+的敏感性为69.3%（95%CI=61.2-76.7），平均活检1.3次，与常规组进行2次活检时的敏感性（68.3%，95%CI=58.3-77.2）相当。当合并3次或4次活检时，两组之间未观察到显著的敏感性差异。
与常规阴道镜检查相比，DSI彩色图在CIN2+检测敏感性方面未显示出临床上的显著改善。然而，多次活检提高了敏感性，并且在两个阴道镜检查组中，对于CIN2+检测仍然更具优势。
