Mueller Polarimetric Imaging for Cervical Intraepithelial Neoplasia Detection

Cervical cancer is one of the leading causes of death in women worldwide due to its high incidence in low-resource countries, where regular and reliable screening is unavailable. In developed countries, women with an abnormal smear are referred for colposcopy, which involves examining the cervix using a low-magnification microscope (the colposcope) to guide biopsy and detect precancerous lesions. However, due to the poor detection performance of colposcopy, multiple visits and biopsies are required, which delays patient management and makes this screening approach expensive and not applicable in low-resource countries. Therefore, a new, more effective, and affordable imaging technique is needed for improving the performance of colposcopy to reduce the cost and time of diagnosis and patient management in developed countries significantly, as well as to design and build a low-cost system that could be part of an economically viable “screen and treat” approach in low-resource countries. Imaging Mueller polarimetry has shown great promise in this regard. This optical modality allows the effective detection of precancerous cervical lesions. Furthermore, it can be implemented with a macroscopic field of view, which is essential for clinical applications, using low-cost optics and patient-friendly light sources. In this chapter, we summarize and discuss the milestones we have achieved in demonstrating the ability of imaging Mueller polarimetry to improve cervical cancer diagnosis, from preliminary ex vivo tests to the first in vivo feasibility study. The results obtained so far pave the way for a clinical trial (currently in preparation) that will evaluate the performance of Mueller polarimetric imaging for cervical cancer screening on a cohort of patients under real-life conditions of blood perfusion and mechanical stress.