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Artificial Intelligence in Health Early detection of CIN/cervicitis using ML

The most common symptoms reported by patients could detect subtle cellular changes that might be missed
enrolled in the study (Table A1) were abdominal pain and by human experts. ML-powered digital diagnosis and
abnormal bleeding. Fewer patients had spotting, abnormal ML-based screening would enable remote diagnosis in
discharge, and irregular menstrual cycles. The presence of low-resource settings with limited access to specialists.
blood or moisture in the cervix could affect the DR image In this study, an overall diagnostic accuracy of 94%
ratio values. These cervical conditions may cause light to was achieved using the DR image ratio R610/R540
reflect off the surface, resulting in specular reflection. The algorithm for the discrimination of malignant tissues from
resulting ratio values from specular reflection can distort normal tissues. However, the data derived using collagen
DR measurements. Therefore, when a patient has bleeding fluorescence could not lead to a confirmative diagnosis.
or experiences bleeding on touch, the DR ratio values Alternative markers relying on protoporphyrin IX
may be misleading. This limitation can be minimized by fluorescence with excitation at 405 nm could be utilized, as
cleaning the cervix before imaging. Another limitation of in OralScan, to improve screening accuracy. Furthermore,
this study is the low number of malignant cases. Further the intensity and uniformity of illumination could be
multicenter studies are planned to improve the algorithm enhanced by the addition of more LEDs.
and develop a grade-specific classification.
The mortality rates due to cervical cancer could be
During conventional cervical check-ups, most women minimized by utilizing CerviScan in large-scale screening
who undergo a Pap smear test do not return to collect the programs across the country. We believe that early
reports, which are usually available in 2 weeks for further detection of cervical cancer would reduce healthcare costs
follow-up. The non-availability of real-time screening and minimize the number of patients lost during follow-up,
results is a significant drawback for screening modalities as often occurs with traditional screening methods such as
such as Pap smears or colposcopy-directed biopsies. The Pap smear and HPV deoxyribonucleic acid tests, which
ability of the multimodal imaging system (CerviScan) to require a waiting period of 1 week to get the screening
provide real-time results, with the help of an ML algorithm, results. The potential of the device to screen and detect
presents a strong rationale for adopting this novel cervical cancers at the point-of-care in real time, along
technology in screening women above 30 years of age. with its capability for biopsy guidance – without the need
CerviScan can help to identify, locate, and treat CIN, while for visual inspection with acetic acid/visual inspection with
minimizing its possibility to progress to higher grades of Lugol’s iodine staining – will improve patient compliance
CIN and reducing mortality. In addition, the capability and its effectiveness as a novel modality for the early
of CerviScan to locate the most malignant site for biopsy direction of cervical cancers.
enhances its value by providing a more accurate pathology.
The real-time image ratio (R610/R545 and R610/R575) Acknowledgments
analytics and PCM display of autofluorescence, as well as
HbO absorption maps, help in the speedy assessment of The authors are grateful to acknowledge the support
2
malignant status and/or cervicitis. received from the Ethics Committee at the Kasturba
Medical College (KMC), Manipal, India. The authors
5. Conclusion would like to thank Prof. Dr. Stanley Mathew, Department
of Surgery, KMC, for his invaluable guidance and advice.
Quantitative detection of cervical malignancies The cooperation and support received from the enrolled
without the need for tissue incision holds great clinical patients was commendable.
significance. The algorithm developed for non-invasive
multispectral widefield imaging using CerviScan provides Funding
an opportunity to objectively screen and detect cervical
cancer in real time, while also assisting the gynecologist The project was partially supported through a grant received
in locating the malignant site for biopsy. The cloud- under the ELEVATE 100 program of the Government of
based platform approach will present a more accessible Karnataka in 2017.
and cost-effective solution for cervical cancer screening. Conflict of interest
The data from different centers, including patients with
diverse age groups, menstrual phases, and gynecological The authors declare that they have no competing interests.
histories, would refine the algorithm over time. As there Author contributions
are changes in the cervical anatomy during the menstrual
span of women, age-specific algorithms would enhance Conceptualization: Subhash Narayanan
the diagnostic accuracy. ML algorithms can outdo the Formal analysis: Phebe George, Rinoy Suvarnadas
interobserver variability among cytology results and Investigation: Phebe George, Rekha Upadhya

Volume 2 Issue 3 (2025) 133 doi: 10.36922/aih.8527