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Gubarkova E, Potapov A, Moiseev A, Kiseleva E, Krupinova D, Shatilova K, Karabut M, Khlopkov A, Loginova M, Radenska-Lopovok S, Gelikonov G, Grechkanev G, Gladkova N, Sirotkina M. Depth-Resolved Attenuation Mapping of the Vaginal Wall under Prolapse and after Laser Treatment Using Cross-Polarization Optical Coherence Tomography: A Pilot Study. Diagnostics (Basel) 2023; 13:3487. [PMID: 37998623 PMCID: PMC10670580 DOI: 10.3390/diagnostics13223487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Vaginal wall prolapse is the most common type of pelvic organ prolapse and is mainly associated with collagen bundle changes in the lamina propria. Neodymium (Nd:YAG) laser treatment was used as an innovative, minimally invasive and non-ablative procedure for the treatment of early-stage vaginal wall prolapse. The purpose of this pilot study was to assess connective tissue changes in the vaginal wall under prolapse without treatment and after Nd:YAG laser treatment using cross-polarization optical coherence tomography (CP OCT) with depth-resolved attenuation mapping. A total of 26 freshly excised samples of vaginal wall from 26 patients with age norm (n = 8), stage I-II prolapses without treatment (n = 8) and stage I-II prolapse 1-2 months after Nd:YAG laser treatment (n = 10) were assessed. As a result, for the first time, depth-resolved attenuation maps of the vaginal wall in the B-scan projection in the co- and cross-polarization channels were constructed. Two parameters within the lamina propria were target calculated: the median value and the percentages of high (≥4 mm-1) and low (<4 mm-1) attenuation coefficient values. A significant (p < 0.0001) decrease in the parameters in the case of vaginal wall prolapse compared to the age norm was identified. After laser treatment, a significant (p < 0.0001) increase in the parameters compared to the normal level was also observed. Notably, in the cross-channel, both parameters showed a greater difference between the groups than in the co-channel. Therefore, using the cross-channel achieved more reliable differentiation between the groups. To conclude, attenuation coefficient maps allow visualization and quantification of changes in the condition of the connective tissue of the vaginal wall. In the future, CP OCT could be used for in vivo detection of early-stage vaginal wall prolapse and for monitoring the effectiveness of treatment.
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Affiliation(s)
- Ekaterina Gubarkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
| | - Arseniy Potapov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Alexander Moiseev
- Institute of Applied Physics of the Russian Academy of Sciences, 603950 Nizhny Novgorod, Russia
| | - Elena Kiseleva
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Darya Krupinova
- Department of Obstetrics and Gynecology, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Nizhny Novgorod Regional Oncologic Hospital, 603126 Nizhny Novgorod, Russia
| | | | - Maria Karabut
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | | | - Maria Loginova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
| | - Stefka Radenska-Lopovok
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Institute of Clinical Morphology and Digital Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Grigory Gelikonov
- Institute of Applied Physics of the Russian Academy of Sciences, 603950 Nizhny Novgorod, Russia
| | - Gennady Grechkanev
- Department of Obstetrics and Gynecology, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Natalia Gladkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Marina Sirotkina
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
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