Comparison of the AV Magnivisualizer device with colposcopy to detect cervical intraepithelial neoplasia using the Swede scoring system

Abstract

Objective: To compare the AV Magnivisualizer with colposcopy to detect cervical intraepithelial neoplasia (CIN) using the Swede scoring system.

Methods: Cross-sectional study conducted in a tertiary care hospital from May 2017 to March 2018. One hundred women with positive results at visual inspection with acetic acid underwent cervical inspection using the Magnivisualizer followed by a colposcope. Biopsies were taken if the Swede score was greater than 4. Pregnant women, women with an obvious cervical growth, acute cervicitis, or prior cervical surgery were excluded. Diagnostic accuracy of the Magnivisualizer and colposcope was calculated for high-grade lesions (CIN 2/CIN 2+) and agreement was compared between the two modalities.

Results: The sensitivity, specificity, and positive and negative predictive values of the Magnivisualizer were 88.2%, 70.0%, 50.0%, and 94.6%, respectively, to detect high-grade lesions at a Swede score cutoff of 5 or more. The area under the curve for the Magnivisualizer was 0.80 (95% CI, 0.67-0.92), which was comparable with colposcopy (AUC 0.86; 95% CI, 0.76-0.96). There was very good agreement between the Magnivisualizer and colposcopy (κ=0.865, P<0.001) for high-grade lesions.

Conclusion: The Magnivisualizer had high diagnostic accuracy to detect high-grade CIN in screen-positive women, which was comparable with colposcopy.

Keywords: AV Magnivisualizer; Cervical cancer; Cervical intraepithelial neoplasia; Colposcopy; India; Low-resource setting; Screening.