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. 2023 Nov 14;13(11):1605.
doi: 10.3390/jpm13111605.

Analysis of New Colposcopy Techniques in the Diagnosis and Evolution of SIL/CIN: Comparison of Colposcopy with the DSI System (COLPO-DSI Study)

Virginia González González  1 , María Del Mar Ramírez Mena  2 , Javier Calvo Torres  2 , Miguel Ángel Herráiz Martínez  2 , Irene Serrano García  3 , Pluvio Coronado  2
Affiliations

Analysis of New Colposcopy Techniques in the Diagnosis and Evolution of SIL/CIN: Comparison of Colposcopy with the DSI System (COLPO-DSI Study)

Virginia González González et al. J Pers Med. .

Abstract

Compared with conventional colposcopy, colposcopy assisted by DSI-map increases the detection of HSIL/CIN2+ and might help to identify the lesions more likely to regress.

Introduction: Comparison of the performance of colposcopy assisted by dynamic spectral imaging (C-DSI) with that of conventional colposcopy (CC) in the diagnosis of cervical intraepithelial neoplasia (HSIL/CIN2 or CIN3).

Materials and methods: A total of 1655 women were referred for colposcopy between 2012 and 2020 and included in the study. Of that total, 973 were examined by the same colposcopist with C-DSI, and 682 with CC. Comparisons between CC and C-DSI were made by using the histological diagnosis performed with a punch biopsy or loop electrosurgical excision procedure (LEEP) as the gold standard. A follow-up study was conducted until 2021 to detect progression to HSIL/CIN2 at 6, 12 and 24 months after first examination.

Results: C-DSI provided higher sensitivity for the diagnosis of HSIL/CIN2 or CIN 3 than CC (sensitivity of 76.8% and 86.6% vs. 54.2% and 72.2%, respectively). In negative or ASCUS/LSIL Pap smear results, C-DSI showed higher sensitivity than CC (sensitivity of 66.7% and 61.5% vs. 21.4% and 33.3%, respectively). In contrast, these differences were not observed in high-grade Pap smears. The sensitivity of C-DSI in cases with HPV16/18 infection was stronger than that of CC (73.53% vs. 56.67%). The sensitivity of C-DSI to detect the progression to HSIL/CIN2+ during follow-up was 30, 17.6 and 35.7% at 6, 12 and 24 months, respectively.

Conclusions: The present study shows that C-DSI in women referred for colposcopy increases the HSIL/CIN 2-3 detection rate compared to conventional colposcopy. Nevertheless, C-DSI does not seem to be an important tool to predict the evolution of the lesions during follow-up.

Keywords: cervical intraepithelial neoplasia; colposcopy; dynamic spectral imaging; dysis; hpv; human papillomavirus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Conventional colposcopy performed with acetic acid application. White arrows point to the areas with higher acetic acid absorption. (b) Colposcopy after obtaining the corresponding DySIS map of the cervix. Biopsies were taken from red, yellow and white areas. Histology confirmed a CIN2–3 lesion.
Figure 2
Figure 2
(a) Conventional colposcopy after acetowhitening. Notice acetowhitening process occurs in the anterior section of the cervix. (b) After performing DySIS-assisted colposcopy, green areas can be observed in the anterior section. Final biopsy result showed an LSIL/CIN 1 lesion.
Figure 3
Figure 3
Flow chart of patients included and excluded. (A) Patients of C-DSI group. (B) Patients of CC group.
See this image and copyright information in PMC

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