AccScience Publishing / AIH / Online First / DOI: 10.36922/aih.8527
ORIGINAL RESEARCH ARTICLE

Screening and early detection of cervical intraepithelial neoplasia and cervicitis using a hemoglobin absorption map-derived machine learning algorithm

Phebe George1 Rekha Upadhya Upadhya2 Rinoy Suvarnadas1 Niranjana Sampthalia3 Subhash Narayanan1*
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1 Research and Development Division, Sascan Meditech Pvt. Ltd., TIMed, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
2 Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
3 Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
Received: 14 January 2025 | Revised: 6 March 2025 | Accepted: 10 April 2025 | Published online: 2 May 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Early and non-invasive detection of cervical malignancy holds great clinical significance. Diffuse reflectance (DR) spectroscopy has the capability to map tissue transformation at the biochemical, morphological, and cellular levels. We have developed a non-invasive, multimodal imaging system to map changes in tissue autofluorescence using DR for the screening and early detection of cervical cancer and cervical inflammation (cervicitis). The developed multispectral imaging device consists of light-emitting diodes (LED) emitting at 375, 545, 575, and 610 nm wavelengths, along with a 5-megapixel monochrome camera for image acquisition. Camera operation and image analysis are controlled using proprietary software installed on a Windows tablet. The 375 nm LED-excited autofluorescence, and the elastically backscattered light at 545, 575, and 610 nm originating from the cervix tissue are captured by the camera and processed to assess tissue abnormalities. A machine learning (ML) algorithm based on DR image intensity ratio values was developed for tissue classification. It was observed that the R610/R545 image ratio could discriminate malignant cervical sites from normal tissues, achieving a sensitivity of 100% and specificity of 93%. In comparison, cervicitis could be discriminated from normal tissues using the R610/R575 ratio, with a sensitivity of 91.6% and specificity of 94.4%. The study demonstrates the potential of DR imaging in conjunction with ML algorithm to non-invasively screen and detect cervical intraepithelial neoplasia and cervicitis in real time. As compared to the existing practice of Pap smear and colposcopy-directed biopsy, which are subjective and require a waiting period for results, objective screening using CerviScan would help reduce patient anxiety, unnecessary biopsies, and treatment costs. With increased patient screening, the accuracy of the ML algorithm would improve. When integrated into a cloud server, the system could address the needs of multiple users in a field setting.

Keywords
Cervical intraepithelial neoplasia
Cervical inflammation
Diffuse reflectance image intensity ratio
Machine learning algorithm
Funding
The project was partially supported through a grant received under the ELEVATE 100 program of the Government of Karnataka in 2017.
Conflict of interest
The authors declare that they have no competing interests.
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Artificial Intelligence in Health, Electronic ISSN: 3029-2387 Print ISSN: 3041-0894, Published by AccScience Publishing