Diagnostic efficacy of backscattering intensity measurements in optical coherence tomography of cervical intraepithelial dysplasia
Version of Record online: 3 JAN 2012
Copyright © 2012 Wiley Periodicals, Inc.
Lasers in Surgery and Medicine
Volume 44, Issue 1, pages 11–19, January 2012
How to Cite
Gallwas, J., Mortensen, U., Gaschler, R., Stepp, H., Friese, K. and Dannecker, C. (2012), Diagnostic efficacy of backscattering intensity measurements in optical coherence tomography of cervical intraepithelial dysplasia. Lasers Surg. Med., 44: 11–19. doi: 10.1002/lsm.21146
- Issue online: 13 JAN 2012
- Version of Record online: 3 JAN 2012
- Manuscript Accepted: 30 OCT 2011
- Muenchener Medizinische Wochenschrift
Vol. 44, Issue 7, 598, Version of Record online: 7 JUN 2012
- optical coherence tomography (OCT);
- epithelial brightness;
- intraepithelial cervical dysplasia;
- statistical analysis of diagnostic judgments
Background and Objectives
The aim of this study was to determine the diagnostic efficacy of backscattering intensity measurements in optical coherence tomography in identifying different grades of cervical intraepithelial dysplasia.
Study Design/Materials and Methods
OCT images were taken from 153 unsuspicious and suspicious areas of 30 fresh conisation and hysterectomy specimens, evaluated by two blinded investigators using a six-grade classification (normal, inflammation, CIN1, CIN2, CIN3, squamous carcinoma) and later compared to the corresponding histology. Differences between judgments based on either the histology or the OCT images were investigated employing Correspondence Analysis (CA). Further, we explored the extent as to which backscattering intensity profiles of OCT images contained the essential information required for a reliable and valid diagnosis, using Linear Discriminant Analysis (LDA).
The CA of histology- and OCT-based judgments suggests that the diagnostic process may be characterized in terms of two stochastically independent underlying (“latent”) variables, the first of them reflecting the definiteness with which CIN classes are identified, the second reflecting a bias towards diagnosing inflammation on the side of the OCT-based judgments. This finding is supported by the results of LDAs, where histology and OCT categorizations differ in particular with respect to the positions of inflammation and CIN1. Possibly, a second canonical variable has to be assumed accounting for the evaluation of carcinoma.
The systematic differences between histology-based and OCT-based diagnoses suggest that the use of available information is influenced by perceptual and/or cognitive biases. Apart from this it seems that the profiles appear to provide a remarkably large amount of information determining the main course of the diagnostic process. Lasers Surg. Med. 44:11–19, 2012. © 2012 Wiley Periodicals, Inc.