Near real-time confocal microscopy of amelanotic tissue: detection of dysplasia in ex vivo cervical tissue.

Rationale And Objectives: The authors performed this study to determine whether images of ex vivo tissue obtained with a near real-time confocal microscope can be used to differentiate between normal and dysplastic tissue.

Materials And Methods: Biopsy specimens of colposcopically normal and abnormal cervical tissue were obtained from 19 patients and imaged at various depths with a confocal microscope. Nuclear morphologic features were extracted from the confocal images; in addition, a group of reviewers examined the images and attempted to identify whether the specimen contained high-grade dysplasia. Results of both analyses were compared with the histopathologic findings of the same specimens provided by a board-certified pathologist with expertise in gynecologic pathology.

Results: The morphologic feature measurements compared well with the findings at pathologic examination. The use of the nuclear-cytoplasmic ratio to determine the presence of dysplasia resulted in a sensitivity of 100% and a specificity of 91%. The untrained reviewers had an average sensitivity of 95% and an average specificity of 69% in the determination of dysplasia.

Conclusion: The results indicate the clinical potential of in vivo confocal imaging in the detection of dysplasia.