[Colpophotography using a large scale camera].

OBJECTIVE: Colposcopy is the reference standard for a visual inspection device in terms of illumination, optics, and clinical performance. A hand-held magnification device such as the AviScope, developed as an alternative to naked eye visual inspection with acetic acid, is also of interest as a low-cost, more portable alternative to a colposcope in low-resource settings within the context of cervical cancer prevention programs and for microbicides research. DESIGN: A performance comparison of the AviScope, visual inspection with acetic acid, and three colposcopes. METHODS: An analysis was carried out of the optics and illumination of the colposcopes and the AviScope prototype and of the evidence for the reproducibility and clinical accuracy of visual methods for histologically confirmed high-grade cervical intraepithelial neoplasia. Using the findings, the feasibility of increasing the performance and reducing the cost of a hand-held scope was examined. RESULTS: Published studies have found the AviScope to have slightly higher sensitivity than visual inspection with acetic acid (60.7 versus 55.7%, P < 0.05) without loss of specificity. Despite the variability among the colposcopes, the field of view, resolution, depth of field, magnification, and quality of the illumination beam pattern and spectral output exceeded that of the AviScope. The clinical sensitivity and specificity of colposcopy were higher than that of the AviScope. The availability of improved materials for optics and illumination suggests that a hand-held scope with enhanced performance is feasible. CONCLUSION: Although the performance of the AviScope prototype was suboptimal compared with the colposcopes, it appears possible to design a hand-held magnification device at a reasonable price with better optics and illumination.

Colposcopes↗

PubMed2002

[A comparative study of digital colposcope and optical colposcope in the diagnosis of early lesions of uterine cervix].

OBJECTIVE: To evaluate the clinical value of domestically manufactured digital colposcope system (SLC-2000) in the detection of early cervical lesions. METHODS: During a follow-up study of patients in Xiangyuan county, Shanxi, a high risk area for cervical cancer, a digital colposcope and an optical colposcope were randomly used for diagnosis, with pathology as the gold standard. RESULTS: In 163 cervical biopsy specimens, 103 were diagnosed as chronic inflammation by histologic examination. Among 60 specimens which gave abnormal pathology, there were papilloma 1, cervical intra-epithelial neoplasia (CIN) I 37, CIN II 18 and CIN III 4. In 33 endocervical curettage specimens, 3 were pathologically positive. Comparing the digital and optical colposcope in diagnosing the positive lesions of > or = CIN I, the sensitivity of the former and latter were 83.3% and 95.0%, the difference without being statistically significant (P = 0.075). The specificity, positive predictive value, and accuracy of these two instruments were 61.2%, 21.4%, 55.6% and 41.3%, 69.3% 48.5%, with significant difference (P = 0.000, P = 0.035, and P = 0.000). In diagnosing > or = CIN II cervical lesions, these three results of the two instruments did not show any significant difference either. The negative predictive value of the digital and optical colposcope were 86.3% and 88.0%, also showing no significant difference (P = 0.075). CONCLUSION: The specificity, positive predictive value, and accuracy of the digital colposcope in diagnosing cervical lesions > or = CIN I are all superior to those of the traditional optical colposcope, even though the sensitivity of the latter is higher. There is no difference between the two instruments in diagnosing lesions > or = CIN II. Not only is domestic digital colposcope (SLC-2000) effective, but feasible and practical in the diagnosis, research and follow-up of cervical lesions.

Colposcopes↗