{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:14:49Z","timestamp":1791292489550,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["UH2\/UH3 CA189910"],"award-info":[{"award-number":["UH2\/UH3 CA189910"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01 CA251911"],"award-info":[{"award-number":["R01 CA251911"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2021,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We conducted a prospective evaluation of the diagnostic performance of high\u2010resolution microendoscopy (HRME) to detect cervical intraepithelial neoplasia (CIN) in women with abnormal screening tests. Study participants underwent colposcopy, HRME and cervical biopsy. The prospective diagnostic performance of HRME using an automated morphologic image analysis algorithm was compared to that of colposcopy using histopathologic detection of CIN as the gold standard. To assess the potential to further improve performance of HRME image analysis, we also conducted a retrospective analysis assessing performance of a multi\u2010task convolutional neural network to segment and classify HRME images. One thousand four hundred eighty\u2010six subjects completed the study; 435 (29%) subjects had CIN Grade 2 or more severe (CIN2+) diagnosis. HRME with morphologic image analysis for detection of CIN Grade 3 or more severe diagnoses (CIN3+) was similarly sensitive (95.6% vs 96.2%, <jats:italic>P<\/jats:italic>\u00a0=\u2009.81) and specific (56.6% vs 58.7%, <jats:italic>P<\/jats:italic>\u00a0=\u2009.18) as colposcopy. HRME with morphologic image analysis for detection of CIN2+ was slightly less sensitive (91.7% vs 95.6%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.01) and specific (59.7% vs 63.4%, <jats:italic>P<\/jats:italic>\u00a0=\u2009.02) than colposcopy. Images from 870 subjects were used to train a multi\u2010task convolutional neural network\u2010based algorithm and images from the remaining 616 were used to validate its performance. There were no significant differences in the sensitivity and specificity of HRME with neural network analysis vs colposcopy for detection of CIN2+ or CIN3+. Using a neural network\u2010based algorithm, HRME has comparable sensitivity and specificity to colposcopy for detection of CIN2+. HRME could provide a low\u2010cost, point\u2010of\u2010care alternative to colposcopy and biopsy in the prevention of cervical cancer.<\/jats:p>","DOI":"10.1002\/ijc.33543","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T16:12:20Z","timestamp":1617466340000},"page":"431-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Cervical lesion assessment using real\u2010time microendoscopy image analysis in Brazil: The <scp>CLARA<\/scp> study"],"prefix":"10.1002","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1143-7668","authenticated-orcid":false,"given":"Brady","family":"Hunt","sequence":"first","affiliation":[{"name":"Department of Bioengineering Rice University  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Humberto Tavares Guerreiro","family":"Fregnani","sequence":"additional","affiliation":[{"name":"Research and Education Institute, Barretos Cancer Hospital  Barretos Brazil"},{"name":"Superintendence of Education, A.C. 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C\u00e9sar","family":"Possati\u2010Resende","sequence":"additional","affiliation":[{"name":"Department of Prevention Barretos Cancer Hospital  Barretos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio","family":"Antoniazzi","sequence":"additional","affiliation":[{"name":"Department of Prevention Barretos Cancer Hospital  Barretos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"de Oliveira Fonseca","sequence":"additional","affiliation":[{"name":"Department of Prevention Barretos Cancer Hospital  Barretos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iara Viana Vidigal","family":"Santana","sequence":"additional","affiliation":[{"name":"Department of Pathology Barretos Cancer Hospital  Barretos Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziela","family":"de Mac\u00eado Matsushita","sequence":"additional","affiliation":[{"name":"Department of Pathology 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