Raman spectroscopy and multivariate analysis for the non invasive diagnosis of clinically inconclusive vulval lichen sclerosus.
Royal Society of Chemistry
© The Royal Society of Chemistry 2017
Reason for embargo
Vulval lichen sclerosus (LS) is a common inflammatory condition associated with an increased risk of developing vulval carcinoma. Diagnosis is usually clinical although biopsy is necessary if the diagnosis is uncertain or if there is a failure to respond to adequate initial treatment. Raman spectroscopy has the potential to be applied in vivo for near real time objective non-invasive optical diagnosis, avoiding the need for invasive tissue biopsies. The aim of this study was to evaluate the diagnostic performance of Raman spectroscopy for differentiating LS from other vulval conditions in fresh vulval biopsies. Biopsies were analysed from 27 women with suspected LS in whom the attending gynaecologist could not establish the diagnosis on clinical presentation alone. Spectral variance was explored using principal component analysis and in conjunction with the histological diagnoses was used to develop and test a multivariate linear discriminant classification model. This model was validated with leave one sample out cross validation and the diagnostic performance of the technique assessed in comparison with the pathology gold standard. After cross validation the technique was able to correctly differentiate LS from other inflammatory vulval conditions with a sensitivity of 91% and specificity of 80%. This study demonstrates Raman spectroscopy has potential as a technique for in vivo non-invasive diagnosis of vulval skin conditions. Applied in the clinical setting this technique may reduce the need for invasive tissue biopsy. Further in vivo study is needed to assess the ability of Raman spectroscopy to diagnose other vulval conditions before clinical application.
We acknowledge the British Society for the Study of Vulval Disease and the Gloucestershire Hospitals NHS Foundation Trust Research and Innovation Forum for financial support. We thank Jo Motte and the team at the Gloucestershire Hospitals NHS Foundation Trust histopathology department for the preparation of the tissue sections. The study was supported by the NIHR Exeter Clinical Research Facility. The interpretations of data in the paper are those of the authors and not of NIHR or the Department of Health.
This is the author accepted manuscript. The final version is available from Royal Society of Chemistry via the DOI in this record.
First published online 03 Nov 2016
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