In-vivo assessment of acetic acid-cervical tissue interaction using quantitative imaging of backscattered light: its potential use for in-vivo cervical cancer detection grading and mapping

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Abstract
Topical application of acetic acid solution is routinely used as a marker for the clinical diagnosis of cervical cancer and more specifically to direct biopsy sampling. Abnormal areas are visualized as transient white patches and there are several evidences that acetic acid-tissue interaction kinetics is correlated with the malignancy grade. The visual assessment of this interaction can not be effective and therefore the obtained diagnostic information is limited. In this paper a new method and a multi-spectral imaging system are presented, capable to enhance the contrast between normal and acetic acid responsive tissue areas and to assess quantitatively the kinetics of acetic acid-tissue interaction. The former is achieved by cutting-off the regular reflection, in combination with the selection of the appropriate imaging spectral band. The second is achieved with the dynamic measurement of the intensity of the back-scattered light in any spatial point of the image, after acetic acid application. The obtained quantitative data provide a means for the early detection, and more accurate grading and mapping of the lesion. This method was experimentally implemented to colposcopy and a remarkable improvement of the sensitivity specificity and reproducibility was demonstrated during in initial clinical trials.

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