Sonia G Parra1, Ana M Rodriguez2, Katelin D Cherry1, Richard A Schwarz1, Rose M Gowen3, Laura B Guerra3, Andrea M Milbourne4, Paul A Toscano5, Susan P Fisher-Hoch5, Kathleen M Schmeler4, Rebecca R Richards-Kortum6. 1. Rice University, Department of Bioengineering, Houston, TX 77005, USA. 2. The University of Texas Medical Branch, Department of Obstetrics & Gynecology, Galveston, TX 77555, USA. 3. Su Clinica Brownsville, Brownsville, TX 78526, USA. 4. The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX 77057, USA. 5. The University of Texas Health Science Center at Houston, School of Public Health, Brownsville, TX 78520, USA. 6. Rice University, Department of Bioengineering, Houston, TX 77005, USA. Electronic address: rkortum@rice.edu.
Abstract
OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings.
OBJECTIVE:Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings.
Authors: Yubo Tang; Alex Kortum; Sonia G Parra; Imran Vohra; Andrea Milbourne; Preetha Ramalingam; Paul A Toscano; Kathleen M Schmeler; Rebecca R Richards-Kortum Journal: Biomed Opt Express Date: 2019-12-16 Impact factor: 3.732
Authors: Paula Demétrio de Souza França; Navjot Guru; Abigail R Kostolansky; Audrey Mauguen; Giacomo Pirovano; Susanne Kossatz; Sheryl Roberts; Marcio Abrahão; Snehal G Patel; Kay J Park; Thomas Reiner; Elizabeth Jewell Journal: J Nucl Med Date: 2020-11-13 Impact factor: 10.057
Authors: Brady Hunt; José Humberto Tavares Guerreiro Fregnani; David Brenes; Richard A Schwarz; Mila P Salcedo; Júlio César Possati-Resende; Márcio Antoniazzi; Bruno de Oliveira Fonseca; Iara Viana Vidigal Santana; Graziela de Macêdo Matsushita; Philip E Castle; Kathleen M Schmeler; Rebecca Richards-Kortum Journal: Int J Cancer Date: 2021-04-03 Impact factor: 7.316