This study aimed to evaluate a novel real-time rotational optical coherence tomography (OCT) imaging system (OCTIS) with a fiber-optic probe to look at endometrium and to correlate the OCTIS images with standard histology. OCT could obtain real-time images resembling histological examination. With recent development of customized probes, it allows OCT to be used in the field of gynecology.This is a pilot, prospective, ex-vivo and observational study. Women underwent hysterectomy for various gynecological conditions were recruited and OCTIS images were obtained from endometrium of 15 fresh uterus specimens immediately after hysterectomy. The excised uterus was cut open and OCTIS imaging was obtained. The scanned region of endometrium was excised for histological examination and OCTIS images were precisely compared to corresponding histological images and ultrasound images. Blinded qualitative analysis on OCTIS images was performed by 2 assessors to determine inter-rating reliability on the histopathological diagnosis.Epithelium, glands, cysts, and stroma of endometrium were clearly seen by the OCTIS. Different phases of menstrual cycle of normal endometrium could be differentiated and pathological condition such as hyperplastic and dysplasic endometrium, which corresponded well with histological findings, could be identified. The inter-rater reliability between assessors on overall OCTIS endometrium and neoplastic OCTIS endometrium was moderate (Kendall τb of 0.58) and substantial (Kendall τb of 0.76), respectively.OCTIS can provide real-time, high-resolution and rotational imaging modality to view endometrial structure with high consistency with histological examination and satisfactory agreement between observers. It has a great potential to be developed in the clinical use of endometrial assessment for gynecological applications.

译文

这项研究旨在评估一种新型的实时旋转光学相干断层扫描 (OCT) 成像系统 (OCTIS),该系统具有光纤探针,可观察子宫内膜并将OCTIS图像与标准组织学相关联。OCT可以获得类似于组织学检查的实时图像。随着定制探针的最新发展,它使OCT可以用于妇科领域。这是一项试点,前瞻性,离体和观察性研究。招募了因各种妇科疾病而接受子宫切除术的妇女,并在子宫切除术后立即从15个新鲜子宫标本的子宫内膜中获得了OCTIS图像。切开切除的子宫并获得OCTIS成像。切除子宫内膜的扫描区域进行组织学检查,并将OCTIS图像与相应的组织学图像和超声图像进行精确比较。2名评估人员对OCTIS图像进行盲化定性分析,以确定组织病理学诊断的相互评估可靠性。OCTIS清楚地看到子宫内膜的上皮,腺体,囊肿和间质。可以区分正常子宫内膜月经周期的不同阶段,并可以识别出增生和发育不良的子宫内膜等病理状况,这与组织学结果非常吻合。评估人员对整个OCTIS子宫内膜和肿瘤性OCTIS子宫内膜的评估间可靠性分别为中等 (0.58的Kendall τ b) 和实质性 (0.76的Kendall τ b)。OCTIS可以提供实时,高分辨率和旋转成像方式,以与组织学检查高度一致的方式观察子宫内膜结构,并在观察者之间达成令人满意的协议。在妇科应用子宫内膜评估的临床应用中具有很大的开发潜力。

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