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The aim of this study was to compare the histological diagnosis of colposcopic\u2010directed biopsies (CDB) with that of DSI\u2010directed biopsies in women undergoing conization, using the histological diagnosis of the conization specimen as gold standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Women referred for colposcopy were included in a prospective cohort study at Randers Regional Hospital, Denmark, from January 2016 to February 2019. All women had four cervical punch biopsies taken. The first biopsy was taken from the area that appeared most abnormal by conventional colposcopy (ie, CDB) and the second biopsy from the area that appeared most abnormal using the DSI map. An additional two biopsies were taken either from other visible lesions or as random biopsies. Biopsies were analyzed separately. If any biopsies revealed cervical dysplasia of such a degree that excisional treatment was recommended, the patient was referred for conization. Subsequently, we compared the histological diagnosis of CDB and DSI\u2010directed biopsies with that of the cone biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 573 women were enrolled, 170 of which underwent conization. In women with an adequate colposcopy and representative biopsies (n\u00a0=\u00a0124) there was an overall agreement rate between the worst biopsy diagnosis (of any four) and the conization diagnosis in 95.2% (95% CI 89.8\u201098.2) of women. CDB diagnosis agreed with the cone diagnosis in 80.6% (95% CI 72.6\u201087.2) of women. DSI\u2010directed biopsy agreed with the cone diagnosis in 83.9% (95% CI 76.2\u201089.9) of women. The difference in detection rate between the CDB and the DSI\u2010directed biopsy was, however, not significant (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.54). Taking four biopsies increases the detection rate of cervical dysplasia to 95.2%, which was a significant increase from both CDB alone (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0008) and DSI\u2010directed biopsy alone (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0053).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no significant difference in the ability to identify the cervical dysplasia grade between CDB and DSI\u2010directed biopsies. A higher detection rate of cervical dysplasia was achieved with four biopsies than with one CDB biopsy or one DSI\u2010directed biopsy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13832","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T16:32:20Z","timestamp":1582821140000},"page":"1064-1070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Accuracy of colposcopy\u2010directed biopsy vs dynamic spectral imaging directed biopsy in correctly identifying the grade of cervical dysplasia in women undergoing conization: A methodological study"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9134-804X","authenticated-orcid":false,"given":"Berit Bargum","family":"Booth","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Gynecology and Obstetrics Randers Regional Hospital Randers Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone Kjeld","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Odense University Hospital Odense Denmark"},{"name":"OPEN Open Patient data Explorative Network University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Blaakaer","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Odense University Hospital Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonje","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Pathology Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Mertz","sequence":"additional","affiliation":[{"name":"Department of Pathology Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Randers Regional Hospital Randers Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Patobanken\u2014The Danish Pathology Data Bank (Danish only).http:\/\/www.patobank.dk"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00128360-200501000-00007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000281665.63550.8f"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000220505.18525.85"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-111504"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3181fb4547"},{"key":"e_1_2_10_8_1","unstructured":"Danish Society of Obstetrics and Gynaecology Guideline.Udredning behandling og kontrol af cervikal dysplasi. 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