[Optical coherence tomography: preliminary results with a new noninvasive technique for evaluating uterine cervical tissue and vulvar epithelium]. / La tomografia a coerenza ottica, una nuova tecnica non invasiva per valutare il tessuto cervicale uterino e l'epitelio vulvare. Risultati preliminari.

ABSTRACT

AIM: Optical coherence tomography (OCT) is a noninvasive diagnostic imaging technique that captures high-definition real-time images at near-microscopic resolution (1-2 mm below the surface) of biological tissue morphology. The aim of this study was to define the characteristics of uterine cervical and vulvar pathologies by means of OCT and to compare OCT findings versus histopathological features. MATERIALS AND METHODS: This prospective single-center study was approved by the regional ethical committee. The OCT scans were performed in women with suspected cervical intraepithelial neoplasia (CIN) or vulvar intraepithelial neoplasia (VIN). The suspicious lesions were identified using colposcopy, visualized by OCT, and then biopsied. The OCT scans were evaluated by two independent examiners. The results were then compared with the histopathological findings. The sensitivity and specificity of OCT were calculated. RESULTS: Overall, 50 of the 54 CIN and 2 carcinomas confirmed on histology were correctly diagnosed with OCT, yielding a sensitivity of 93%; specificity was 33%, with 8 false positives and 4 true negatives. In 10 patients with suspected VIN, 19 OCT images were compared with the corresponding biopsies. Three states of tissue structure could be distinguished, with typical features of normal tissue and tissue altered by neoplastic transformation. CONCLUSION: OCT is a noninvasive, fast and simple technique to obtain real-time information on tissue microstructure. Further study is needed to assess its use in routine diagnostic imaging; however, these preliminary results indicate its high sensitivity.