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

Invasive carcinoma of the uterine cervix is preceded by a number of morphological intraepithelial changes. Real-time confocal microscopy has been demonstrated to be successful in imaging subcellular detail in-vivo. The purpose of this pilot study is to image ex-vivo tissue using a near real time confocal microscope and determine whether the images can be used to distinguish between normal and dysplastic tissue. Biopsies from 19 patients were imaged at various depths with our confocal microscope. Nuclear morphologic features were extracted from the confocal images. The morphologic feature measurements compare well with the pathologic examination. Discriminating the images for the presence of dysplasia using morphologic feature detection resulted in a sensitivity and specificity of 100% and 91%, respectively.