J Gynecol Oncol.  2014 Oct;25(4):282-286. 10.3802/jgo.2014.25.4.282.

Performance of a low cost magnifying device, magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix

• Singh V
• Parashari
• Gupta S
• Sodhani P
• Sehgal A

• KMID: 2130115
• DOI: http://doi.org/10.3802/jgo.2014.25.4.282

Abstract

OBJECTIVE
To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix.
METHODS
A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5% acetic acid (VIA), and VIA under magnification (VIAM) with the Magnivisualizer. All women, independently of test results, were referred for colposcopic examination. Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.
RESULTS
The detection rate for VIA positive lesions was 12% (134/659), while it was 29% for VIAM positive lesions (191/659). The sensitivities of detection of cervical intraepithelial neoplasia (CIN) 2 and higher lesions were 61.7% for VIA, 88.3% for VIAM, and 86.7% for colposcopy, with a specificity of 58.5% for VIA, 55.8% for VIAM, and 90.4% for colposcopy. The performance of colposcopy and VIAM was moderate (kappa, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (kappa, 0.87; 95% CI, 0.82 to 0.94) for detection of CIN 2 and higher lesions.
CONCLUSION
In low resource settings, where colposcopic facilities are not available at the community level, a simple low-cost, handheld Magnivisualizer can be considered a valid option for detection of cervical precancerous and cancerous lesions. However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.

Keyword

Ambulatory care facilities; Colposcopy; Sensitivity and Specificity; Uterine cervical dysplasia; Uterine cervical neoplasms

MeSH Terms

Acetic Acid/diagnostic use
Adult
Aged
Biopsy/methods
*Colposcopes
Colposcopy
Early Detection of Cancer/*instrumentation/methods
Equipment Design
Female
Humans
Middle Aged
Neoplasm Grading
Optical Imaging/*instrumentation/methods
Outpatient Clinics, Hospital
Reproducibility of Results
Uterine Cervical Dysplasia/*diagnosis/pathology
Uterine Cervical Neoplasms/*diagnosis/pathology
Acetic Acid

Figure

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  Fig. 1 Flow chart of study.

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