The early detection of cervical dysplasia enables early treatment, a critical factor in cancer prevention. In the United States, cervical cancer screening is age-based and includes cervical cytology with human papilloma virus (HPV) testing with referral to colposcopy for abnormal results. Colposcopy is used to visualize changes in the appearance of the transformation zone to direct biopsies which can confirm a diagnosis of dysplasia or cancer. Directed biopsies can be limited in detection of abnormalities because they represent a small area of the transformation zone and can be limited by provider expertise. Additionally, biopsies contribute to patient discomfort and anxiety awaiting for results.
We recently reported the first in vivo cervical data from angle-resolved low-coherence interferometry (a/LCI), an optical technique that measures nuclear size as a biomarker for dysplasia, which is well-suited for screening due to its high sensitivity and specificity and its non-invasive utilization. However, in order to target the single-point measurements of the a/LCI instrument, we aimed to construct a probe capable of mapping the cervical epithelium to identify the transformation zone between the ectocervical and endocervical epithelia, the location at which dysplasia is most likely to develop.
We termed this complementary technology multiplexed low-coherence interferometer (m/LCI). Thirty-six parallel fiber-optic interferometers were constructed to obtain optical depth profiles using spectral-domain LCI. Light from each channel is delivered to the cervix via a 6x6 fiber-optic bundle and a custom endoscopic probe. The depth-profile from each optical channel enables the identification of the ectocervix and endocervix.
A pilot study at Duke University (n=5) was followed by an ongoing clinical study at New York City Health + Hospitals/Jacobi (Bronx, New York) (current n=20, target n=50). We present the results from these first studies to demonstrate the feasibility of m/LCI as a means of identifying the transformation zone for screening of dysplasia.