Optical Coherence Tomography as a Tool in Reproductive Gynecology

The objective of the investigation was to show the advisability of using optical coherence tomography (OCT) for noninvasive diagnostics and monitoring of treatments in gynecological practice for female patients of reproductive age.

Materials and Methods. OCT studies were performed during standard gynecological procedures like laparoscopy and colposcopy, as well as in course of pelvic inflammatory diseases of cervical neoplasia, with the use of an OKT1300U (BioMedTech, Russia). 330 patients of reproductive age (aged 18–45) were examined. The methods used for numeric processing of the OCT images were based on an analysis of histograms and on calculation of the first derivative of the OCT signal over depth.

Results. The use of OCT with numeric processing of the images increases the sensitivity of laparoscopy diagnosis of latent chronic salpingitis from 43.5 to 96.0%. In the case of minimal endometriosis, OCT can be used as a substitute for excisional biopsy for the visualization and verification of endometrioid heterotopias. The use of OCT in the case of cervical neoplasia in female patients of reproductive age enables a considerable decrease in surgical aggression during the diagnosis and treatment of cervical intraepithelial neoplasia and early forms of cancer.

Conclusion. The use of OCT helps to maximize individualization and organ preservation during the diagnosis and treatment of gynecological pathology, and therefore to preserve the reproductive potential of young female patients.

1. Kamath M.S., Bhattacharya S. Demographics of infertility and management of unexplained infertility. Best Pract Res Clin Obstet Gynaecol 2012 Dec; 26(6): 729–738,http://dx.doi.org/10.1016/j.bpobgyn.2012.08.001.
2. Gleicher N., Barad D. Unexplained infertility: does it really exist? Hum Reprod 2006 Aug; 21(8): 1951–1955, http://dx.doi.org/10.1093/humrep/del135.
3. Siristatidis C., Bhattacharya S. Unexplained infertility: does it really exist? Does it matter? Hum Reprod 2007 Aug; 22(8): 2084–2087, http://dx.doi.org/10.1093/humrep/dem117.
4. Molander P., Finne P., Sjöberg J., Sellors J., Paavonen J. Observer agreement with laparoscopic diagnosis of pelvic inflammatory disease using photographs. Obstet Gynecol 2003; 101(5 Pt 1): 875–880, http://dx.doi.org/10.1016/s0029-7844(03)00013-9.
5. Tsuji I., Ami K., Miyazaki A., Hujinami N., Hoshiai H. Benefit of diagnostic laparoscopy for patients with unexplained infertility and normal hysterosalpingography findings. Tohoku J Exp Med 2009 Sep; 219(1): 39–42, http://dx.doi.org/10.1620/tjem.219.39.
6. Merviel P., Lourdel E., Brzakowski M., Garriot B., Mamy L., Gagneur O., Nasreddine A. Should a laparoscopy be necessary in case of infertility with normal tubes at hysterosalpingography? Gynecol Obstet Fertil 2011 Sep; 39(9): 504–508, http://dx.doi.org/10.1016/j.gyobfe.2011.07.008.
7. Ascencio M., Collinet P., Cosson M., Mordon S. The role and value of optical coherence tomography in gynecology. J Gynecol Obstet Biol Reprod (Paris) 2007 Dec; 36(8): 749–755,http://dx.doi.org/10.1016/j.jgyn.2007.07.005.
8. Kirillin М., Panteleeva O., Yunusova E., Donchenko E., Shakhova N. Criteria for pathology recognition in OCT of fallopian tubes. J Biomed Opt 2012 Aug; 17(8): 1411–1415,http://dx.doi.org/10.1117/1.JBO.17.8.081413.
9. Eskander R.N., Randall L.M., Berman M.L., Tewari K.S., Disaia P.J., Bristow R.E. Fertility preserving options in patients with gynecologic malignancies. Am J Obstet Gynecol 2011 Aug; 205(2): 103–110, http://dx.doi.org/10.1016/j.ajog.2011.01.025.
10. Kuznetsova I.A., Shakhova N.M., Kachalina T.S., Yunusova E.E., Kiseleva E.B., Karabut M.M. Specific features of colposcopic evidence during optical coherence tomography. Akusherstvo i ginekologiya 2011; 5: 64–67.
11. Gallwas J.K., Turk L., Stepp H., Mueller S., Ochsenkuehn R., Friese K., Dannecker C. Optical coherence tomography for the diagnosis of cervical intraepithelial neoplasia. Lasers Surg Med 2011 Mar; 43(3): 206–212, http://dx.doi.org/10.1002/lsm.21030.
12. Soergel P, Hillemanns P. Photodynamic therapy for intraepithelial neoplasia of the lower genital tract. Photodiagnosis Photodyn Ther 2010 Mar; 7(1): 10–14, http://dx.doi.org/10.1016/j.pdpdt.2009.12.007.
13. Li Z., Shen J.H., Kozub J.A., Prasad R., Lu P., Joos K.M. Miniature forward-imaging B-scan optical coherence tomography probe to guide real-time laser ablation. Lasers Surg Med 2014 Mar; 46(3): 193–202, http://dx.doi.org/10.1002/lsm.22214.
14. Kuznetsova I.A., Gladkova N.D., Gelikonov V.M., Belinson J.L., Shakhova N.M., Feldchtein F.I. OCT in gyne­co­logy. In: Optical coherence tomography: technology and applications. Ed. by Drexler W., Fujimoto J.G. Springer Berlin Heidelberg; 2008; p. 1211–1240, http://dx.doi.org/10.1007/978-3-540-77550-8_39.
15. Panteleeva O.G., Shakhov B.E., Yunusova K.E., Kirillin M.Yu., Shakhova N.M. Optical introscopy is a new diagnostic technique in reproductive medicine. Vestnik rentgenologii i radiologii 2012; 4: 50–55.
16. Panteleeva O.G., Shakhova N.M., Monakhov A.G. OCT laparoscopy in the diagnosis of “minor forms” of endometriosis. Sovremennye tehnologii v medicine 2011; 2: 92–95.
17. Panteleeva O.G., Zinov’ev A.N., Yunusova K.E., Kirillin M.Yu., Shakhova N.M. Diagnostic possibilities of optical introscopy in revealing the causes of impaired reproductive health in women. Rossiyskiy vestnik akushera-ginekologa 2013; 5: 53–57.
18. Chamié L.P., Blasbalg R., Pereira R.M.A., Warmbrand G., Serafini P.C. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics 2011 Jul–Aug; 31(4): E77–Е100, http://dx.doi.org/10.1148/rg.314105193.
19. Rogovskaia S.I., Badalova L.A. Evaluation of the clinical and economic efficiency of diagnostic methods for cervical neoplasias. Rossiyskiy vestnik akushera-ginekologa 2011; 4: 39–43.
20. Shakhova N., Kuznetsova I., Yunusova K., Kiseleva E. Diagnosis of neoplastic processes in the uterine cervix. Part 2. Photonics for health care. In: Handbook of biophotonics. Ed. by Popp J., Tuchin V.V., Chiou A., Heinemann S. Wiley-VCH; 2012; p. 877–884, http://dx.doi.org/10.1002/9783527643981.bphot065.
21. Agostinis P., Berg K., Cengel K.A., Foster T.H., Girotti A.W., Gollnick S.O., Hahn S.M., Hamblin M.R., Juzeniene A., Kessel D., Korbelik M., Moan J., Mroz P., Nowis D., Piette J., Wilson B.C., Golab J. Photodynamic therapy of cancer: an update. CA Cancer J Clin 2011 Jul–Aug; 61(4): 250–281, http://dx.doi.org/10.3322/caac.20114.
22. Wang Y., Gu Y., Liao X., Chen R., Ding H. Fluorescence monitoring of a photosensitizer and prediction of the therapeutic effect of photodynamic therapy for port wine stains. Exp Biol Med 2010 Feb; 235(2): 175–180, http://dx.doi.org/10.1258/ebm.2009.009294.
23. Jarvi M.T., Patterson M.S., Wilson B.C. Insights into photodynamic therapy dosimetry: simultaneous singlet oxygen luminescence and photosensitizer photobleaching measurements. Biophys J 2012 Feb; 102(3): 661–671, http://dx.doi.org/10.1016/j.bpj.2011.12.043.
24. Tyrrell J., Thorn C., Shore A., Campbell S., Curnow A. Oxygen saturation and perfusion changes during dermatological methylaminolaevulinate photodynamic therapy. Br J Dermatol 2011 Dec; 165(6): 1323–1331, http://dx.doi.org/10.1111/j.1365-2133.2011.10554.x.
25. Mariampillai A., Leung M.K., Jarvi M., Standish B.A., Lee K., Wilson B.C., Vitkin A., Yang V.X.D. Optimized speckle variance OCT imaging of microvasculature. Opt Lett 2010 Apr; 35(8): 1257–1259, http://dx.doi.org/10.1364/OL.35.001257.

Panteleeva O.G., Kuznetsova I.A., Kachalina O.V., Eliseeva D.D., Grebenkina Е.V., Gamayunov S.V., Kuznetsov S.S., Yunusova E.E., Gubarkova E.V., Kirillin M.Yu., Shakhova N.М. Optical Coherence Tomography as a Tool in Reproductive Gynecology. Sovremennye tehnologii v medicine 2015; 7(1): 89, https://doi.org/10.17691/stm2015.7.1.12