Detecting cryoablation with EIT and the benefit of including ice front imaging data

Measurement of corneal endothelial impedance with non-invasive external electrodes--a theoretical study

The corneal endothelial cell layer function is critical for the maintenance of hydration and transparency of the cornea. Recent advances in corneal lamellar transplantation point to the need for reliable, non-invasive and rapid endothelial function assessment. Findings using an invasive electrode in an experimental animal model have suggested an association between bioimpedance parameters and endothelial cell function. Currently, however there is no clinical device that allows for non-invasive measurements of endothelial layer electrical impedance. This report is a finite element simulation study that models the human eye. It evaluates the feasibility of using external non-invasive electrodes to detect changes in endothelial layer electrical properties as a function of electrode location and measurement frequencies. The findings show that the ratio between the potential recorded at low and high frequencies is sensitive to changes in endothelial resistivity as well as endothelial capacitance. Moreover, the optimal electrode configuration yielding the highest sensitivity is one where the current injecting electrodes are oppose to each other and the voltage recording electrodes are adjacent to the current injecting electrodes. This first-order theoretical study suggests that a non-invasive device which measures electrical properties of the endothelial layer from the exterior of the eye could be developed. Clearly further animal and human studies are required to develop a reliable clinical tool.

Current status of ablative therapies for renal tumors

The increase in detection of small (≤ 4 cm) renal cortical neoplasms has made nephron-sparing surgery the new standard of care for T1a renal lesions. Advances in minimally invasive surgery have improved the surgical approach to these lesions to include laparoscopic partial nephrectomy and renal ablative therapies. In this review, we discuss the indications, outcomes, and potential complications of the commonly used ablative modalities in urologic practice. We will expand on renal cryoablation and review the mechanism of action, surgical approaches, and evidence based medicine using this modality.

Imaging cryosurgery with EIT: tracking the ice front and post-thaw tissue viability

Cryosurgery employs freezing for targeted destruction of undesirable tissues such as cancer. Ice front imaging has made controlled treatment of deep body tumors possible. One promising method, recently explored for this task, is EIT, which recovers images of electrical impedance from measurements made at boundary electrodes. However, since frozen tissue near the ice front survives, ice front imaging is insufficient. Monitoring treatment effect would enable iterative cryosurgery, where extents of ablation and need for further treatment are assessed upon thawing. Since lipid bilayers are strong barriers to low frequency electrical current and cell destruction implies impaired membranes, EIT should be able to detect the desired effect of cryosurgery: cell death. Previous work has tested EIT for ice front imaging with tank studies while others have simulated EIT in detecting cryoablation, but in vivo tests have not been reported in either case. To address this, we report 3D images of differential conductivity throughout the freeze-thaw cycle in a rat liver model in vivo with histological validation, first testing our system for ice front imaging in a gel and for viability imaging post-thaw in a raw potato slice.

Multiple biopsy probe sampling enabled minimally invasive electrical impedance tomography

Biopsies are a reliable method for examining tissues and organs inside the body, in particular for detection of tumors. However, a single biopsy produces only limited information on the site from which it is taken. Therefore, tumor detection now employs multiple biopsy samplings to examine larger volumes of tissue. Nevertheless, even with multiple biopsies, the information remains discrete, while the costs of biopsy increase. Here we propose and evaluate the feasibility of using minimally invasive medical imaging as a means to overcome the limitations of discrete biopsy sampling. The minimally invasive medical imaging technique employs the biopsy probe as electrodes for measurements of electrical impedance tomography relevant data during each biopsy sampling. The data from multiple samplings are combined and used to produce an EIT image of the tissue. Two- and three-dimensional mathematical simulations confirm that the minimally invasive medical imaging technique can produce electrical impedance tomography images of the tissues between the biopsy probe insertion sites. We show that these images can detect tumors that would be missed with multiple biopsy samplings only, and that the technique may facilitate the detection of tumors with fewer biopsies, thereby reducing the cost of cancer detection.