{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:57:02Z","timestamp":1774933022493,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,20]],"date-time":"2024-10-20T00:00:00Z","timestamp":1729382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: While human papillomavirus (HPV) is well known for its role in cervical cancer, it also affects vaginal cancers. Although colposcopy offers a comprehensive examination of the female genital tract, its diagnostic accuracy remains suboptimal. Integrating artificial intelligence (AI) could enhance the cost-effectiveness of colposcopy, but no AI models specifically differentiate low-grade (LSILs) and high-grade (HSILs) squamous intraepithelial lesions in the vagina. This study aims to develop and validate an AI model for the differentiation of HPV-associated dysplastic lesions in this region. Methods: A convolutional neural network (CNN) model was developed to differentiate HSILs from LSILs in vaginoscopy (during colposcopy) still images. The AI model was developed on a dataset of 57,250 frames (90% training\/validation [including a 5-fold cross-validation] and 10% testing) obtained from 71 procedures. The model was evaluated based on its sensitivity, specificity, accuracy and area under the receiver operating curve (AUROC). Results: For HSIL\/LSIL differentiation in the vagina, during the training\/validation phase, the CNN demonstrated a mean sensitivity, specificity and accuracy of 98.7% (IC95% 96.7\u2013100.0%), 99.1% (IC95% 98.1\u2013100.0%), and 98.9% (IC95% 97.9\u201399.8%), respectively. The mean AUROC was 0.990 \u00b1 0.004. During testing phase, the sensitivity was 99.6% and 99.7% for both specificity and accuracy. Conclusions: This is the first globally developed AI model capable of HSIL\/LSIL differentiation in the vaginal region, demonstrating high and robust performance metrics. Its effective application paves the way for AI-powered colposcopic assessment across the entire female genital tract, offering a significant advancement in women\u2019s healthcare worldwide.<\/jats:p>","DOI":"10.3390\/cancers16203540","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T08:53:11Z","timestamp":1729500791000},"page":"3540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Artificial Intelligence and Colposcopy: Automatic Identification of Vaginal Squamous Cell Carcinoma Precursors"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0830","authenticated-orcid":false,"given":"Miguel","family":"Mascarenhas","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4150-180 Porto, Portugal"}]},{"given":"In\u00eas","family":"Alenco\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Santo Ant\u00f3nio University Hospital, 4099-001 Porto, Portugal"}]},{"given":"Maria Jo\u00e3o","family":"Carinhas","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Santo Ant\u00f3nio University Hospital, 4099-001 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0484-4804","authenticated-orcid":false,"given":"Miguel","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"}]},{"given":"Tiago","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5890-7049","authenticated-orcid":false,"given":"Francisco","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9427-5635","authenticated-orcid":false,"given":"Pedro","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4150-180 Porto, Portugal"}]},{"given":"Maria Jo\u00e3o","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"}]},{"given":"Joana","family":"Mota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8523-874X","authenticated-orcid":false,"given":"Joana","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Faculty of Engineering, University of Porto, 4150-180 Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Faculty of Engineering, University of Porto, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"WGO Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4150-180 Porto, Portugal"}]},{"given":"Teresa","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Gynecology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"}]},{"given":"Rosa","family":"Zulmira","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Santo Ant\u00f3nio University Hospital, 4099-001 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.16.1.1-17.2003","article-title":"Human papillomavirus and cervical cancer","volume":"16","author":"Burd","year":"2003","journal-title":"Clin. 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