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Halter RJ, Hartov A, Poplack SP, diFlorio-Alexander R, Wells WA, Rosenkranz KM, Barth RJ, Kaufman PA, Paulsen KD. Real-time electrical impedance variations in women with and without breast cancer. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:38-48. [PMID: 25073168 PMCID: PMC4555352 DOI: 10.1109/tmi.2014.2342719] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The chaotic vascular network surrounding malignant tumors leads to pulsatile blood flow patterns that differ from those in benign regions of the breast. This study aimed to determine if high-speed electrical impedance tomography (EIT) is able to detect conductivity changes associated with cyclic blood-volume changes and to gauge the potential of using these signatures to differentiate malignant from benign regions within the breast. EIT imaging of pulsating latex membranes submerged in saline baths provided initial validation of its use for tracking temporally varying conductivities. Nineteen women (10 with cancer, nine without) were imaged with EIT over the course of several heartbeats in synchrony with pulse-oximetry acquisition. Eight parameters ( rs, ϕ(rt,max), rt,max, Plow:full, Phigh:full, Plow:high) relating the conductivity images and pulse-oximeter signatures were extracted and used as a means of comparing malignant and benign regions of the breast. Significant differences between malignant and benign regions of interest were noted in seven of the eight parameters. The maximum correlation between conductivity and pulse-oximeter signals, rt,max , was observed to be the optimal discriminating parameter with a receiver operating characteristic area under the curve of 0.8 and a specificity of 81% at a sensitivity of 77%. Assessing the dynamic conductivity of breast may provide additional clinical utility to that of standard imaging modalities, but further investigation is necessary to better understand the biophysical mechanisms leading to the observed conductivity changes.
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Affiliation(s)
- Ryan J. Halter
- Thayer School of Engineering and Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA
| | - Alex Hartov
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755 USA
| | - Steven P. Poplack
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Roberta diFlorio-Alexander
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Wendy A. Wells
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Kari M. Rosenkranz
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Richard J. Barth
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Peter A. Kaufman
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA, and also with Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766 USA
| | - Keith D. Paulsen
- Thayer School of Engineering and Geisel School of Medicine, Dartmouth College, Hanover, NH 03755 USA
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Schneble EJ, Graham LJ, Shupe MP, Flynt FL, Banks KP, Kirkpatrick AD, Nissan A, Henry L, Stojadinovic A, Shumway NM, Avital I, Peoples GE, Setlik RF. Future directions for the early detection of recurrent breast cancer. J Cancer 2014; 5:291-300. [PMID: 24790657 PMCID: PMC3982042 DOI: 10.7150/jca.8017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The main goal of follow-up care after breast cancer treatment is the early detection of disease recurrence. In this review, we emphasize the multidisciplinary approach to this continuity of care from surgery, medical oncology, and radiology. Challenges within each setting are briefly addressed as a means of discussion for the future directions of an effective and efficient surveillance plan of post-treatment breast cancer care.
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Affiliation(s)
- Erika J Schneble
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Lindsey J Graham
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Matthew P Shupe
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Frederick L Flynt
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Kevin P Banks
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Aaron D Kirkpatrick
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Aviram Nissan
- 2. Hadassah Medical Center, Kiryat Hadassah, POB 12000, Jerusalem, 91120, Israel
| | - Leonard Henry
- 3. IU Health Goshen, 200 High Park Ave., Goshen, IN 46526, USA
| | | | - Nathan M Shumway
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Itzhak Avital
- 4. Bon Secours Cancer Institute, 5855 Bremo Road, Richmond, VA 23226, USA
| | - George E Peoples
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
| | - Robert F Setlik
- 1. San Antonio Military Medical Center (SAMMC), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA
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Prasad SN, Houserkova D, Campbell J. BREAST IMAGING USING 3D ELECTRICAL IMPEDENCE TOMOGRAPHY. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2008; 152:151-4. [DOI: 10.5507/bp.2008.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Soni NK, Hartov A, Kogel C, Poplack SP, Paulsen KD. Multi-frequency electrical impedance tomography of the breast: new clinical results. Physiol Meas 2004; 25:301-14. [PMID: 15005324 DOI: 10.1088/0967-3334/25/1/034] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Electrical impedance tomography (EIT) has been used in the recent past for a number of clinical applications. In this work we present recent tomographic and spectroscopic findings for breast imaging from clinical exams completed at Dartmouth. The results presented here are based on 18 normal and 24 abnormal subjects. The participants were classified as normal or abnormal using the American College of Radiology (ACR) indexing system for mammograms. The EIT data were collected for ten discrete frequencies in the range 10 kHz-1 MHz using a single array of 16 electrodes. The finite element method was used to reconstruct the images. The images were examined visually and were compared with mammograms. The results were also analyzed based on zonal averages of property values and breast tissue radiodensities. Statistical analysis showed a significance difference between the mean conductivity and permittivity values of normal and abnormal subjects for various zones defined on the reconstructed images. Tissues with high radiodensity also had increased conductivity and permittivity.
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Affiliation(s)
- Nirmal K Soni
- Thayer School of Engineering, Dartmouth College, 8000 Cummings Hall, Hanover, NH 03755-8000, USA.
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Poplack SP, Paulsen KD, Hartov A, Meaney PM, Pogue BW, Tosteson TD, Grove MR, Soho SK, Wells WA. Electromagnetic breast imaging: average tissue property values in women with negative clinical findings. Radiology 2004; 231:571-80. [PMID: 15128998 DOI: 10.1148/radiol.2312030606] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Representative data are provided for three electromagnetic breast imaging techniques-near-infrared spectroscopy, electrical impedance spectroscopy, and microwave imaging spectroscopy-to serve as potential benchmarks for future investigation. The breasts of 23 women without clinical or mammographic findings of disease were imaged in the coronal plane with nonionizing radiation of varying frequencies. Average electromagnetic property values were reconstructed at each frequency on the basis of computational models of light diffusion, current flow, and microwave propagation. Electromagnetic properties were correlated with subject characteristics and between techniques. Each technique yielded information on breast tissue features (eg, conductivity, permittivity, light scattering, and absorption) that had not previously all been measured in the same individuals.
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Affiliation(s)
- Steven P Poplack
- Department of Radiology, Dartmouth Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756, USA.
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Hope TA, Iles SE. Technology review: the use of electrical impedance scanning in the detection of breast cancer. Breast Cancer Res 2003; 6:69-74. [PMID: 14979909 PMCID: PMC400648 DOI: 10.1186/bcr744] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The present paper focuses on electrical impedance scanning. The basic science behind the new modality, measurements of breast tissue impedance in vivo and in vitro, and the studies performed with a newly available commercial machine are discussed. Electrical impedance scanning has been generating interest for several reasons, including comfort to the patient, the relatively low cost, and studies suggest that it may be effective in detecting disease in mammographically dense breasts.
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Affiliation(s)
- Tyna A Hope
- Department of Electrical and Computer Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.
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Abstract
Some evidence has been found that malignant breast tumors have lower electrical impedance than surrounding normal tissues. Although the separation of malignant tumors from benign lesions based on impedance measurements needs further investigation, electrical impedance could be used as an indicator for breast cancer detection. In this paper, we provide a systematic technical review of the existing electrical impedance techniques proposed for breast cancer detection, with an emphasis on noninvasive impedance imaging techniques. The electrical impedance of human breast tissue is first introduced, with tabulation of previous in vitro impedance measurement results on cancerous and normal breast tissues, and a brief description on the limited in vivo impedance measurements completed with invasive, or noninvasive, non-imaging techniques. A detailed review on noninvasive impedance imaging techniques for breast cancer detection, such as electrical impedance tomography (EIT) and electrical impedance mapping (EIM), is then presented. We suggest that for better breast cancer detection, an invasive impedance technique may be enhanced by combination with other cancer indicators. 3D EIT should be improved through collective efforts. EIM using a pair of electrode arrays is a viable method with great potential. Magnetic induction tomography and other magnetic induction based impedance imaging for breast cancer detection are promising and merit further exploration as well.
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Affiliation(s)
- Y Zou
- Department of Electrical and Computer Engineering, The George Washington University, 801 22nd Street NW, Washington, DC 20052, USA.
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Kerner TE, Paulsen KD, Hartov A, Soho SK, Poplack SP. Electrical impedance spectroscopy of the breast: clinical imaging results in 26 subjects. IEEE TRANSACTIONS ON MEDICAL IMAGING 2002; 21:638-645. [PMID: 12166860 DOI: 10.1109/tmi.2002.800606] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Electrical impedance spectroscopy (EIS) is a potential, noninvasive technique to image women for breast cancer. Studies have shown characteristic frequency dispersions in the electrical conductivity and permittivity of malignant versus normal tissue. Using a multifrequency EIS system, we imaged the breasts of 26 women. All patients had mammograms ranked using the American College of Radiology (ACR) BIRADS system. Of the 51 individual breasts imaged, 38 were ACR 1 negative, six had ACR 4-5 suspicious lesions, and seven had ACR 2 benign findings such as fibroadenomas or calcifications. A radially translatable circular array of 16 Ag/AgCl electrodes was placed around the breast while the patient lay prone. We applied trigonometric voltage patterns at ten frequencies between 10 and 950 kHz. Anatomically coronal images were reconstructed from this data using nonlinear partial differential equation methods. Typically, ACR 1-rated breasts were interrogated in a single central plane whereas ACR 2-5-rated breasts were imaged in multiple planes covering the region of suspicion. In general, a characteristic homogeneous image emerged for mammographically normal cases while focal inhomogeneities were observed in images from women with malignancies. Using a specific visual criterion, EIS images identified 83% of the ACR 4-5 lesions while 67% were detected using a numerical criterion. Overall, multifrequency electrical impedance imaging appears promising for detecting breast malignancies, but improvements must be made before the method reaches its full potential.
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Affiliation(s)
- Todd E Kerner
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
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