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Hirata I, Mazzotta A, Makvandi P, Cesini I, Brioschi C, Ferraris A, Mattoli V. Sensing Technologies for Extravasation Detection: A Review. ACS Sens 2023; 8:1017-1032. [PMID: 36912628 PMCID: PMC10043935 DOI: 10.1021/acssensors.2c02602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 03/14/2023]
Abstract
Peripheral intravenous catheters are administered for various purposes, such as blood sampling or the infusion of contrast agents and drugs. Extravasation happens when the catheter is unintentionally directed outside of the vein due to movement of the intravascular catheter, enhanced vascular permeability, or occlusion of the upstream vein. In this article, extravasation and its mechanism are discussed. Subsequently, the sensorized devices (e.g., single sensor and multimodal detection) to identify the extravasation phenomena are highlighted. In this review article, we have shed light on both physiological and engineering points of view of extravasation and its detection approaches. This review provides an overview on the most recent and relevant technologies that can help in the early detection of extravasation.
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Affiliation(s)
- Ikue Hirata
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Arianna Mazzotta
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
- The
Biorobotics Institute, Scuola Superiore
Sant’Anna, Pontedera 56025, Italy
| | - Pooyan Makvandi
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Ilaria Cesini
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Chiara Brioschi
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Andrea Ferraris
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Virgilio Mattoli
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
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Chen B, Shi Y, Li J, Zhai J, Liu L, Liu W, Hu L, Zhao Y. Tissue Recognition Based on Electrical Impedance Classified by Support Vector Machine in Spinal Operation Area. Orthop Surg 2022; 14:2276-2285. [PMID: 35913262 PMCID: PMC9483044 DOI: 10.1111/os.13406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE One of the major difficulties in spinal surgery is the injury of important tissues caused by tissue misclassification, which is the source of surgical complications. Accurate recognization of the tissues is the key to increase safety and effect as well as to reduce the complications of spinal surgery. The study aimed at tissue recognition in the spinal operation area based on electrical impedance and the boundaries of electrical impedance between cortical bone, cancellous bone, spinal cord, muscle, and nucleus pulposus. METHODS Two female white swines with body weight of 40 kg were used to expose cortical bone, cancellous bone, spinal cord, muscle, and nucleus pulposus under general anesthesia and aseptic conditions. The electrical impedance of these tissues at 12 frequencies (in the range of 10-100 kHz) was measured by electrochemical analyzer with a specially designed probe, at 22.0-25.0°C and 50%-60% humidity. Two types of tissue recognition models - one combines principal component analysis (PCA) and support vector machine (SVM) and the other combines combines SVM and ensemble learning - were constructed, and the boundaries of electrical impedance of the five tissues at 12 frequencies of current were figured out. Linear correlation, two-way ANOVA, and paired T-test were conducted to analyze the relationship between the electrical impedance of different tissues at different frequencies. RESULTS The results suggest that the differences of electrical impedance mainly came from tissue type (p < 0.0001), the electrical impedance of five kinds of tissue was statistically different from each other (p < 0.0001). The tissue recognition accuracy of the algorithm based on principal component analysis and support vector machine ranged from 83%-100%, and the overall accuracy was 95.83%. The classification accuracy of the algorithm based on support vector machine and ensemble learning was 100%, and the boundaries of electrical impedance of five tissues at various frequencies were calculated. CONCLUSION The electrical impedance of cortical bone, cancellous bone, spinal cord, muscle, and nucleus pulposus had significant differences in 10-100 kHz frequency. The application of support vector machine realized the accurate tissue recognition in the spinal operation area based on electrical impedance, which is expected to be translated and applied to tissue recognition during spinal surgery.
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Affiliation(s)
- Bingrong Chen
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongwang Shi
- MD Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiahao Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiliang Zhai
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Liu
- China Astronaut Research and Training Center, Beijing, China
| | - Wenyong Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Lei Hu
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Yu Zhao
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Smart Bio-Impedance-Based Sensor for Guiding Standard Needle Insertion. SENSORS 2022; 22:s22020665. [PMID: 35062626 PMCID: PMC8779690 DOI: 10.3390/s22020665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/10/2022]
Abstract
A venipuncture is the most common non-invasive medical procedure, and is frequently used with patients; however, a high probability of post-injection complications accompanies intravenous injection. The most common complication is a hematoma, which is associated with puncture of the uppermost and lowermost walls. To simplify and reduce complications of the venipuncture procedure, and as well as automation of this process, a device that can provide information of the needle tip position into patient’s tissues needs to be developed. This paper presents a peripheral vascular puncture control system based on electrical impedance measurements. A special electrode system was designed to achieve the maximum sensitivity for puncture identification using a traditional needle, which is usually used in clinical practice. An experimental study on subjects showed that the electrical impedance signal changed significantly once the standard needle entered the blood vessel. On basis of theoretical and experimental studies, a decision rule of puncture identification based on the analysis of amplitude-time parameters of experimental signals was proposed. The proposed method was tested on 15 test and 9 control samples, with the results showing that 97% accuracy was obtained.
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Cheng Z, Lindberg Schwaner K, Dall'Alba D, Fiorini P, Savarimuthu TR. An electrical bioimpedance scanning system for subsurface tissue detection in Robot Assisted Minimally Invasive Surgery. IEEE Trans Biomed Eng 2021; 69:209-219. [PMID: 34156935 DOI: 10.1109/tbme.2021.3091326] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In Robot Assisted Minimally Invasive Surgery, discriminating critical subsurface structures is essential to make the surgical procedure safer and more efficient. In this paper, a novel robot assisted electrical bio-impedance scanning (RAEIS) system is developed and validated using a series of experiments. The proposed system constructs a tri-polar sensing configuration for tissue homogeneity inspection. Specifically, two robotic forceps are used as electrodes for applying electric current and measuring reciprocal voltages relative to a ground electrode which is placed distal from the measuring site. Compared to the other existing electrical bioimpedance sensing technology, the proposed system is able to use miniaturized electrodes to measure a site flexibly with enhanced subsurfacial detection capability. In this paper, we present the concept, the modeling of the sensing method, the hardware design, and the system calibration. Subsequently, a series of experiments are conducted for system evaluation including finite element simulation, saline solution bath experiments and experiments based on ex vivo animal tissues. The experimental results demonstrate that the proposed system can measure the resistivity of the material with high accuracy, and detect a subsurface non-homogeneous object with 100% success rate. The proposed parameters estimation algorithm is able to approximate the resistivity and the depth of the subsurface object effectively with one fast scanning.
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Ibba P, Tronstad C, Moscetti R, Mimmo T, Cantarella G, Petti L, Martinsen ØG, Cesco S, Lugli P. Supervised binary classification methods for strawberry ripeness discrimination from bioimpedance data. Sci Rep 2021; 11:11202. [PMID: 34045542 PMCID: PMC8160339 DOI: 10.1038/s41598-021-90471-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/10/2021] [Indexed: 11/09/2022] Open
Abstract
Strawberry is one of the most popular fruits in the market. To meet the demanding consumer and market quality standards, there is a strong need for an on-site, accurate and reliable grading system during the whole harvesting process. In this work, a total of 923 strawberry fruit were measured directly on-plant at different ripening stages by means of bioimpedance data, collected at frequencies between 20 Hz and 300 kHz. The fruit batch was then splitted in 2 classes (i.e. ripe and unripe) based on surface color data. Starting from these data, six of the most commonly used supervised machine learning classification techniques, i.e. Logistic Regression (LR), Binary Decision Trees (DT), Naive Bayes Classifiers (NBC), K-Nearest Neighbors (KNN), Support Vector Machine (SVM) and Multi-Layer Perceptron Networks (MLP), were employed, optimized, tested and compared in view of their performance in predicting the strawberry fruit ripening stage. Such models were trained to develop a complete feature selection and optimization pipeline, not yet available for bioimpedance data analysis of fruit. The classification results highlighted that, among all the tested methods, MLP networks had the best performances on the test set, with 0.72, 0.82 and 0.73 for the F[Formula: see text], F[Formula: see text] and F[Formula: see text]-score, respectively, and improved the training results, showing good generalization capability, adapting well to new, previously unseen data. Consequently, the MLP models, trained with bioimpedance data, are a promising alternative for real-time estimation of strawberry ripeness directly on-field, which could be a potential application technique for evaluating the harvesting time management for farmers and producers.
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Affiliation(s)
- Pietro Ibba
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy.
| | - Christian Tronstad
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, 0315, Norway
| | - Roberto Moscetti
- Department for Innovation in Biological, Agro-Food and Forest Systems, University of Tuscia, 01100, Viterbo, Italy
| | - Tanja Mimmo
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy.,Competence Centre of Plant Health, Free University of Bolzano-Bozen, Piazza Universitá 1, 39100, Bolzano-Bozen, Italy
| | - Giuseppe Cantarella
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy
| | - Luisa Petti
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy. .,Competence Centre of Plant Health, Free University of Bolzano-Bozen, Piazza Universitá 1, 39100, Bolzano-Bozen, Italy.
| | - Ørjan G Martinsen
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, 0315, Norway
| | - Stefano Cesco
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy
| | - Paolo Lugli
- Faculty of Science and Technology, Free University of Bolzano-Bozen, 39100, Bolzano-Bozen, Italy
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Rowson B. 2020 Athanasiou ABME Student Awards. Ann Biomed Eng 2020. [DOI: 10.1007/s10439-020-02689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cheng Z, Carobbio ALC, Soggiu L, Migliorini M, Guastini L, Mora F, Fragale M, Ascoli A, Africano S, Caldwell DG, Canevari FRM, Parrinello G, Peretti G, Mattos LS. SmartProbe: a bioimpedance sensing system for head and neck cancer tissue detection. Physiol Meas 2020; 41:054003. [PMID: 32325435 DOI: 10.1088/1361-6579/ab8cb4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES This study presents SmartProbe, an electrical bioimpedance (EBI) sensing system based on a concentric needle electrode (CNE). The system allows the use of commercial CNEs for accurate EBI measurement, and was specially developed for in-vivo real-time cancer detection. APPROACH Considering the uncertainties in EBI measurements due to the CNE manufacturing tolerances, we propose a calibration method based on statistical learning. This is done by extracting the correlation between the measured impedance value |Z|, and the material conductivity σ, for a group of reference materials. By utilizing this correlation, the relationship of σ and |Z| can be described as a function and reconstructed using a single measurement on a reference material of known conductivity. MAIN RESULTS This method simplifies the calibration process, and is verified experimentally. Its effectiveness is demonstrate by results that show less than 6% relative error. An additional experiment is conducted for evaluating the system's capability to detect cancerous tissue. Four types of ex-vivo human tissue from the head and neck region, including mucosa, muscle, cartilage and salivary gland, are characterized using SmartProbe. The measurements include both cancer and surrounding healthy tissue excised from 10 different patients operated on for head and neck cancer. The measured data is then processed using dimension reduction and analyzed for tissue classification. The final results show significant differences between pathologic and healthy tissues in muscle, mucosa and cartilage specimens. SIGNIFICANCE These results are highly promising and indicate a great potential for SmartProbe to be used in various cancer detection tasks.
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Affiliation(s)
- Zhuoqi Cheng
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
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Zhu G, Zhou L, Wang S, Lin P, Guo J, Cai S, Xiong X, Jiang X, Cheng Z. Design of a Drop-in EBI Sensor Probe for Abnormal Tissue Detection in Minimally Invasive Surgery. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2020; 11:87-95. [PMID: 33584908 PMCID: PMC7851984 DOI: 10.2478/joeb-2020-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 06/12/2023]
Abstract
It is a common challenge for the surgeon to detect pathological tissues and determine the resection margin during a minimally invasive surgery. In this study, we present a drop-in sensor probe based on the electrical bioimpedance spectroscopic technology, which can be grasped by a laparoscopic forceps and controlled by the surgeon to inspect suspicious tissue area conveniently. The probe is designed with an optimized electrode and a suitable shape specifically for Minimally Invasive Surgery (MIS). Subsequently, a series of ex vivo experiments are carried out with porcine liver tissue for feasibility validation. During the experiments, impedance measured at frequencies from 1 kHz to 2 MHz are collected on both normal tissues and water soaked tissue. In addition, classifiers based on discriminant analysis are developed. The result of the experiment indicate that the sensor probe can be used to measure the impedance of the tissue easily and the developed tissue classifier achieved accuracy of 80% and 100% respectively.
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Affiliation(s)
- Guanming Zhu
- School of Automation, Guangdong University of Technology
| | - Liang Zhou
- School of Automation, Guangdong University of Technology
| | - Shilong Wang
- School of Automation, Guangdong University of Technology
| | - Pengjie Lin
- School of Automation, Guangdong University of Technology
| | - Jing Guo
- School of Automation, Guangdong University of Technology
| | - Shuting Cai
- School of Automation, Guangdong University of Technology
| | - Xiaoming Xiong
- School of Automation, Guangdong University of Technology
| | - Xiaobing Jiang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
| | - Zhuoqi Cheng
- The Mærsk Mc-Kinney Møller Institute, University of Southern Denmark
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Cheng Z, Dall’Alba D, Caldwell DG, Fiorini P, Mattos LS. Design and Integration of Electrical Bio-Impedance Sensing in a Bipolar Forceps for Soft Tissue Identification: A Feasibility Study. IFMBE PROCEEDINGS 2020. [DOI: 10.1007/978-981-13-3498-6_1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Cheng Z, Dall'Alba D, Foti S, Mariani A, Chupin T, Caldwell DG, Ferrigno G, De Momi E, Mattos LS, Fiorini P. Design and Integration of Electrical Bio-impedance Sensing in Surgical Robotic Tools for Tissue Identification and Display. Front Robot AI 2019; 6:55. [PMID: 33501070 PMCID: PMC7805990 DOI: 10.3389/frobt.2019.00055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/26/2019] [Indexed: 11/16/2022] Open
Abstract
The integration of intra-operative sensors into surgical robots is a hot research topic since this can significantly facilitate complex surgical procedures by enhancing surgical awareness with real-time tissue information. However, currently available intra-operative sensing technologies are mainly based on image processing and force feedback, which normally require heavy computation or complicated hardware modifications of existing surgical tools. This paper presents the design and integration of electrical bio-impedance sensing into a commercial surgical robot tool, leading to the creation of a novel smart instrument that allows the identification of tissues by simply touching them. In addition, an advanced user interface is designed to provide guidance during the use of the system and to allow augmented-reality visualization of the tissue identification results. The proposed system imposes minor hardware modifications to an existing surgical tool, but adds the capability to provide a wealth of data about the tissue being manipulated. This has great potential to allow the surgeon (or an autonomous robotic system) to better understand the surgical environment. To evaluate the system, a series of ex-vivo experiments were conducted. The experimental results demonstrate that the proposed sensing system can successfully identify different tissue types with 100% classification accuracy. In addition, the user interface was shown to effectively and intuitively guide the user to measure the electrical impedance of the target tissue, presenting the identification results as augmented-reality markers for simple and immediate recognition.
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Affiliation(s)
- Zhuoqi Cheng
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Diego Dall'Alba
- Altair Robotic Labs, Department of Computer Science, University of Verona, Verona, Italy
| | - Simone Foti
- NearLab, Electronic Information and Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Andrea Mariani
- NearLab, Electronic Information and Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Thibaud Chupin
- NearLab, Electronic Information and Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Darwin G. Caldwell
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Giancarlo Ferrigno
- NearLab, Electronic Information and Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Elena De Momi
- NearLab, Electronic Information and Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Leonardo S. Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Paolo Fiorini
- Altair Robotic Labs, Department of Computer Science, University of Verona, Verona, Italy
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Cheng Z, Davies BL, Caldwell DG, Mattos LS. A Hand-Held Robot for Precise and Safe PIVC. IEEE Robot Autom Lett 2019. [DOI: 10.1109/lra.2019.2892380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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13
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Kwon H, Guasch M, Nagy JA, Rutkove SB, Sanchez B. New electrical impedance methods for the in situ measurement of the complex permittivity of anisotropic skeletal muscle using multipolar needles. Sci Rep 2019; 9:3145. [PMID: 30816169 PMCID: PMC6395651 DOI: 10.1038/s41598-019-39277-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/21/2019] [Indexed: 01/24/2023] Open
Abstract
This paper provides a rigorous analysis on the measurement of the permittivity of two-dimensional anisotropic biological tissues such as skeletal muscle using the four-electrode impedance technique. The state-of-the-art technique requires individual electrodes placed at the same depth in contact with the anisotropic material, e.g. using monopolar needles. In this case, the minimum of measurements in different directions needed to estimate the complex permittivity and its anisotropy direction is 3, which translates into 12 monopolar needle insertions (i.e. 3 directions × 4 electrodes in each direction). Here, we extend our previous work and equip the reader with 8 new methods for multipolar needles, where 2 or more electrodes are spaced along the needle's shaft in contact with the tissue at different depths. Using multipolar needles, the new methods presented reduce the number of needle insertions by a factor of 2 with respect to the available methods. We illustrate the methods with numerical simulations and new experiments on ex vivo ovine skeletal muscle (n = 3). Multi-frequency longitudinal and transverse permittivity data from 30 kHz to 1 MHz is made publicly available in the supplementary material. The methods presented here for multipolar needles bring closer the application of needle electrical impedance to patients with neuromuscular diseases.
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Affiliation(s)
- H Kwon
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5491, USA. .,College of Science of & Technology, Yonsei University, Wonju, 26493, Republic of Korea.
| | - M Guasch
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5491, USA
| | - J A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5491, USA
| | - S B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5491, USA
| | - B Sanchez
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215-5491, USA.
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Schoevaerdts L, Esteveny L, Gijbels A, Smits J, Reynaerts D, Vander Poorten E. Design and evaluation of a new bioelectrical impedance sensor for micro-surgery: application to retinal vein cannulation. Int J Comput Assist Radiol Surg 2018; 14:311-320. [PMID: 30141126 DOI: 10.1007/s11548-018-1850-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Nowadays, millions of people suffer from retinal vein occlusion, a blind-making eye disease. No curative treatment currently exists for this vascular disorder. However, a promising treatment consists in injecting a thrombolytic drug directly inside the affected retinal vessel. Successfully puncturing miniature vessels with diameters between 50 and 400 [Formula: see text] remains a real challenge, amongst others due to human hand tremor, poor visualisation and depth perception. As a consequence, there is a significant risk of double-puncturing the targeted vessel. Sub-surfacic injection of thrombolytic agent could potentially lead to severe retinal damage. METHODS A new bio-impedance sensor has been developed to visually display the instant of vessel puncture. The physical working principle of the sensor has been analysed, and a representative electrical model has been derived. Based on this model, the main design parameters were derived to maximise the sensor sensitivity. A detailed characterisation and experimental validation of this concept were conducted. RESULTS Stable, repeatable and robust impedance measurements were obtained. In an experimental campaign, 35 puncture attempts on ex vivo pig eyes vessels were conducted. A confusion matrix shows a detection accuracy of 80% if there is a puncture, a double puncture or no puncture. The 20% of inaccuracy most probably comes from the limitations of the employed eye model and the experimental conditions. CONCLUSIONS The developed bio-impedance sensor has shown great promise to help in avoiding double punctures when cannulating retinal veins. Compared to other puncture detection methods, the proposed sensor is simple and therefore potentially more affordable. Future research will include validation in an in vivo situation involving vitreoretinal surgeons.
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Affiliation(s)
- Laurent Schoevaerdts
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Louvain, Belgium.
| | - Laure Esteveny
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Louvain, Belgium
| | - Andy Gijbels
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Louvain, Belgium
| | - Jonas Smits
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Louvain, Belgium
| | - Dominiek Reynaerts
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Louvain, Belgium
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