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Park J, Seo B, Jeong Y, Park I. A Review of Recent Advancements in Sensor-Integrated Medical Tools. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2307427. [PMID: 38460177 PMCID: PMC11132050 DOI: 10.1002/advs.202307427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/26/2023] [Indexed: 03/11/2024]
Abstract
A medical tool is a general instrument intended for use in the prevention, diagnosis, and treatment of diseases in humans or other animals. Nowadays, sensors are widely employed in medical tools to analyze or quantify disease-related parameters for the diagnosis and monitoring of patients' diseases. Recent explosive advancements in sensor technologies have extended the integration and application of sensors in medical tools by providing more versatile in vivo sensing capabilities. These unique sensing capabilities, especially for medical tools for surgery or medical treatment, are getting more attention owing to the rapid growth of minimally invasive surgery. In this review, recent advancements in sensor-integrated medical tools are presented, and their necessity, use, and examples are comprehensively introduced. Specifically, medical tools often utilized for medical surgery or treatment, for example, medical needles, catheters, robotic surgery, sutures, endoscopes, and tubes, are covered, and in-depth discussions about the working mechanism used for each sensor-integrated medical tool are provided.
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Affiliation(s)
- Jaeho Park
- Department of Mechanical EngineeringKorea Advanced Institute of Science and Technology (KAIST)Daejeon34141South Korea
| | - Bokyung Seo
- Department of Mechanical EngineeringKorea Advanced Institute of Science and Technology (KAIST)Daejeon34141South Korea
| | - Yongrok Jeong
- Department of Mechanical EngineeringKorea Advanced Institute of Science and Technology (KAIST)Daejeon34141South Korea
- Radioisotope Research DivisionKorea Atomic Energy Research Institute (KAERI)Daejeon34057South Korea
| | - Inkyu Park
- Department of Mechanical EngineeringKorea Advanced Institute of Science and Technology (KAIST)Daejeon34141South Korea
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Ton C, Salehi S, Abasi S, Aggas JR, Liu R, Brandacher G, Guiseppi-Elie A, Grayson WL. Methods of ex vivo analysis of tissue status in vascularized composite allografts. J Transl Med 2023; 21:609. [PMID: 37684651 PMCID: PMC10492401 DOI: 10.1186/s12967-023-04379-x] [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: 05/05/2023] [Accepted: 07/21/2023] [Indexed: 09/10/2023] Open
Abstract
Vascularized composite allotransplantation can improve quality of life and restore functionality. However, the complex tissue composition of vascularized composite allografts (VCAs) presents unique clinical challenges that increase the likelihood of transplant rejection. Under prolonged static cold storage, highly damage-susceptible tissues such as muscle and nerve undergo irreversible degradation that may render allografts non-functional. Skin-containing VCA elicits an immunogenic response that increases the risk of recipient allograft rejection. The development of quantitative metrics to evaluate VCAs prior to and following transplantation are key to mitigating allograft rejection. Correspondingly, a broad range of bioanalytical methods have emerged to assess the progression of VCA rejection and characterize transplantation outcomes. To consolidate the current range of relevant technologies and expand on potential for development, methods to evaluate ex vivo VCA status are herein reviewed and comparatively assessed. The use of implantable physiological status monitoring biochips, non-invasive bioimpedance monitoring to assess edema, and deep learning algorithms to fuse disparate inputs to stratify VCAs are identified.
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Affiliation(s)
- Carolyn Ton
- Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
- Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
| | - Sara Salehi
- Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
- Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
| | - Sara Abasi
- Department of Biomedical Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA
- Department of Electrical and Computer Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA
- Media and Metabolism, Wildtype, Inc., 2325 3rd St., San Francisco, CA, 94107, USA
| | - John R Aggas
- Department of Biomedical Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA
- Department of Electrical and Computer Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA
- Test Development, Roche Diagnostics, 9115 Hague Road, Indianapolis, IN, 46256, USA
| | - Renee Liu
- Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
- Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Reconstructive Transplantation Program, Center for Advanced Physiologic Modeling (CAPM), Johns Hopkins University, Ross Research Building/Suite 749D, 720 Rutland Avenue, Baltimore, MD, 21205, USA.
| | - Anthony Guiseppi-Elie
- Department of Biomedical Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA.
- Department of Electrical and Computer Engineering, Center for Bioelectronics, Biosensors and Biochips (C3B®), Texas A&M University, Emerging Technologies Building 3120, 101 Bizzell St, College Station, TX, 77843, USA.
- Department of Cardiovascular Sciences, Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX, USA.
- ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA, USA.
| | - Warren L Grayson
- Department of Biomedical Engineering, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA.
- Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA.
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.
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Emran S, Jokinen N, Laitinen K, Lappalainen R, Myllymaa S. Novel 3D printed probe for bioimpedance spectroscopic measurement of oral mucosa: design and testing with ex vivo porcine oral tissues. MEASUREMENT SCIENCE AND TECHNOLOGY 2023; 34:095704. [DOI: 10.1088/1361-6501/acd658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Three-dimensional (3D) printing has a high potential in various biomedical applications. We hypothesize that 3D printing could be a viable option to construct novel bioimpedance spectroscopic (BIS) sensors suitable for electrochemical characterization of oral mucosal tissues. Previous BIS studies have relied on hand-made probes possessing significant limitations related to their single patient disposable use, large inter-probe differences, and weak reproducibility of measurement. There is also uncertainty related to the effect of varying loading pressure between the probe and biological tissue. Here, we introduce three differently sized rectangular shaped 3D printed probes and test those using a four-terminal measurement principle on various porcine oral tissue samples. We find that constructing a fully 3D printed probe is a challenging task, prone to issues relating to short-circuiting or electrochemical corrosion. However, our final prototype version, constructed with silver-coated copper electrodes, showed favorable characteristics in BIS experiments. All three differently sized probes were able to differentiate between different tissue types with excellent reproducibility. The effect of loading pressure was found to be almost negligible when using small- and medium-sized probes. However, further studies are needed to measure tissues with uneven surfaces, such as palatinum, and to avoid manual or (electro)chemical surface-finishing steps.
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Liu J, Atmaca Ö, Pott PP. Needle-Based Electrical Impedance Imaging Technology for Needle Navigation. Bioengineering (Basel) 2023; 10:bioengineering10050590. [PMID: 37237660 DOI: 10.3390/bioengineering10050590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/30/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Needle insertion is a common procedure in modern healthcare practices, such as blood sampling, tissue biopsy, and cancer treatment. Various guidance systems have been developed to reduce the risk of incorrect needle positioning. While ultrasound imaging is considered the gold standard, it has limitations such as a lack of spatial resolution and subjective interpretation of 2D images. As an alternative to conventional imaging techniques, we have developed a needle-based electrical impedance imaging system. The system involves the classification of different tissue types using impedance measurements taken with a modified needle and the visualization in a MATLAB Graphical User Interface (GUI) based on the spatial sensitivity distribution of the needle. The needle was equipped with 12 stainless steel wire electrodes, and the sensitive volumes were determined using Finite Element Method (FEM) simulation. A k-Nearest Neighbors (k-NN) algorithm was used to classify different types of tissue phantoms with an average success rate of 70.56% for individual tissue phantoms. The results showed that the classification of the fat tissue phantom was the most successful (60 out of 60 attempts correct), while the success rate decreased for layered tissue structures. The measurement can be controlled in the GUI, and the identified tissues around the needle are displayed in 3D. The average latency between measurement and visualization was 112.1 ms. This work demonstrates the feasibility of using needle-based electrical impedance imaging as an alternative to conventional imaging techniques. Further improvements to the hardware and the algorithm as well as usability testing are required to evaluate the effectiveness of the needle navigation system.
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Affiliation(s)
- Jan Liu
- Institute of Medical Device Technology, University of Stuttgart, 70569 Stuttgart, Germany
| | - Ömer Atmaca
- Institute of Medical Device Technology, University of Stuttgart, 70569 Stuttgart, Germany
- Institute of Applied Optics, University of Stuttgart, 70569 Stuttgart, Germany
| | - Peter Paul Pott
- Institute of Medical Device Technology, University of Stuttgart, 70569 Stuttgart, Germany
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Nazari H, Shrestha J, Naei VY, Bazaz SR, Sabbagh M, Thiery JP, Warkiani ME. Advances in TEER measurements of biological barriers in microphysiological systems. Biosens Bioelectron 2023; 234:115355. [PMID: 37159988 DOI: 10.1016/j.bios.2023.115355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/10/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
Biological barriers are multicellular structures that precisely regulate the transport of ions, biomolecules, drugs, cells, and other organisms. Transendothelial/epithelial electrical resistance (TEER) is a label-free method for predicting the properties of biological barriers. Understanding the mechanisms that control TEER significantly enhances our knowledge of the physiopathology of different diseases and aids in the development of new drugs. Measuring TEER values within microphysiological systems called organ-on-a-chip devices that simulate the microenvironment, architecture, and physiology of biological barriers in the body provides valuable insight into the behavior of barriers in response to different drugs and pathogens. These integrated systems should increase the accuracy, reproducibility, sensitivity, resolution, high throughput, speed, cost-effectiveness, and reliable predictability of TEER measurements. Implementing advanced micro and nanoscale manufacturing techniques, surface modification methods, biomaterials, biosensors, electronics, and stem cell biology is necessary for integrating TEER measuring systems with organ-on-chip technology. This review focuses on the applications, advantages, and future perspectives of integrating organ-on-a-chip technology with TEER measurement methods for studying biological barriers. After briefly reviewing the role of TEER in the physiology and pathology of barriers, standard techniques for measuring TEER, including Ohm's law and impedance spectroscopy, and commercially available devices are described. Furthermore, advances in TEER measurement are discussed in multiple barrier-on-a-chip system models representing different organs. Finally, we outline future trends in implementing advanced technologies to design and fabricate nanostructured electrodes, complicated microfluidic chips, and membranes for more advanced and accurate TEER measurements.
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Affiliation(s)
- Hojjatollah Nazari
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia
| | - Jesus Shrestha
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia
| | - Vahid Yaghoubi Naei
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia
| | - Sajad Razavi Bazaz
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia
| | - Milad Sabbagh
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia
| | | | - Majid Ebrahimi Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, 2007, New South Wales, Australia; Institute of Molecular Medicine, Sechenov University, 119991, Moscow, Russia.
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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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Goyal K, Borkholder DA, Day SW. A biomimetic skin phantom for characterizing wearable electrodes in the low-frequency regime. SENSORS AND ACTUATORS. A, PHYSICAL 2022; 340:113513. [PMID: 35493959 PMCID: PMC9053740 DOI: 10.1016/j.sna.2022.113513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Advances in the integration of wearable devices in our daily life have led to the development of new electrode designs for biopotential monitoring. Historically, the development and testing of wearable electrodes for the acquisition of biopotential signals has been empirical, relying on experiments on human volunteers. However, the lack of explicit control on human variables, the intra-, and inter-subject variability complicates the understanding of the performance of these wearable electrodes. Herein, phantom mimicking the electrical properties of the skin in the low-frequency range (1 Hz-1000 Hz), which has the potential to be used as a platform for controlled benchtop experiments for testing electrode functionality, is demonstrated. The fabricated phantom comprises two layers representing the deeper tissues and stratum corneum. The lower layer of the phantom mimicking deeper tissues was realized using polyvinyl alcohol cryogel (PVA-c) prepared with 0.9% W/W saline solution by a freeze-thaw technique. The properties of the upper layer representing the stratum corneum were simulated using a 100μm thick layer fabricated by spin-coating a mixture of polydimethylsiloxane (PDMS), 2.5% W/W carbon black (CB) for conductance, and 40% W/W barium titanate (BaTiO3) as a dielectric. The hydration of the stratum corneum was modeled in a controlled way by varying porosity of the phantom's upper layer. Impedance spectroscopy measurements were carried out to investigate the electrical performance of the fabricated phantom and validated against the impedance response obtained across a physiological skin impedance range of five human subjects. The results indicated that the Bode plot depicting the impedance response obtained on the phantom was found to lie in the human skin range. Moreover, it was observed that the change of porosity provides control over the hydration and the phantom can be tuned as per the skin ranges among different individuals. Also, the phantom was able to mimic the impact of dry and hydrated skin on a simulated ECG signal in the time domain. The developed skin phantom is affordable, fairly easy to manufacture, stable over time, and can be used as a platform for benchtop testing of new electrode designs.
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Affiliation(s)
- Krittika Goyal
- Department of Microsystems Engineering, Rochester Institute of Technology, Rochester, NY, 14623, USA
| | - David A. Borkholder
- Department of Microsystems Engineering, Rochester Institute of Technology, Rochester, NY, 14623, USA
| | - Steven W. Day
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, NY, 14623, USA
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Halonen S, Ovissi A, Boyd S, Kari J, Kronström K, Kosunen J, Lauren H, Numminen K, Sievänen H, Hyttinen J. Human in vivoliver and tumor bioimpedance measured with biopsy needle. Physiol Meas 2022; 43. [PMID: 35051907 DOI: 10.1088/1361-6579/ac4d38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
Objective:Liver biopsy is an essential procedure in cancer diagnostics but targeting the biopsy to the actual tumor tissue is challenging. Aim of this study was to evaluate the clinical feasibility of a novel bioimpedance biopsy needle system in liver biopsy and simultaneously to gatherin vivobioimpedance data from human liver and tumor tissues.Approach:We measured human liver and tumor impedance datain vivofrom 26 patients who underwent diagnostic ultrasound-guided liver biopsy. Our novel 18G core biopsy needle tip forms a bipolar electrode that was used to measure bioimpedance during the biopsy in real-time with frequencies from 1 kHz to 349 kHz. The needle tip location was determined by ultrasound. Also, the sampled tissue type was determined histologically.Main results:The bioimpedance values showed substantial variation between individual cases, and liver and tumor data overlapped each other. However, Mann-Whitney U test showed that the median bioimpedance values of liver and tumor tissue are significantly (p<0.05) different concerning the impedance magnitude at frequencies below 25 kHz and the phase angle at frequencies below 3 kHz and above 30 kHz.Significance:This study uniquely employed a real-time bioimpedance biopsy needle in clinical liver biopsies and reported the measured humanin vivoliver and tumor impedance data. Impedance is always device-dependent and therefore not directly comparable to measurements with other devices. Although the variation in tumor types prevented coherent tumor identification, our study provides preliminary evidence that tumor tissue differs from liver tissuein vivoand this association is frequency-dependent.
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Affiliation(s)
- Sanna Halonen
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | - Ali Ovissi
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Sonja Boyd
- HUS Diagnostic Center, Helsinki University Hospital Pathology, PB 340, Helsinki, 00029, FINLAND
| | - Juho Kari
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | | | - Juhani Kosunen
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Hanna Lauren
- Department of Radiology, Helsinki University Central Hospital Comprehensive Cancer Center, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Kirsti Numminen
- Department of Radiology, Meilahti Hospital, Haartmaninkatu 4, Helsinki, Uusimaa, 00029, FINLAND
| | - Harri Sievänen
- R&D Department, Injeq, Biokatu 8, Tampere, 33520, FINLAND
| | - Jari Hyttinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere, Pirkanmaa, 33520, FINLAND
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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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Study of needle punctures into soft tissue through audio and force sensing: can audio be a simple alternative for needle guidance? Int J Comput Assist Radiol Surg 2021; 16:1683-1697. [PMID: 34652603 PMCID: PMC8580960 DOI: 10.1007/s11548-021-02479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/10/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Percutaneous needle insertion is one of the most common minimally invasive procedures. The clinician's experience and medical imaging support are essential to the procedure's safety. However, imaging comes with inaccuracies due to artifacts, and therefore sensor-based solutions were proposed to improve accuracy. However, sensors are usually embedded in the needle tip, leading to design limitations. A novel concept was proposed for capturing tip-tissue interaction information through audio sensing, showing promising results for needle guidance. This work demonstrates that this audio approach can provide important puncture information by comparing audio and force signal dynamics during insertion. METHODS An experimental setup for inserting a needle into soft tissue was prepared. Audio and force signals were synchronously recorded at four different insertion velocities, and a dataset of 200 recordings was acquired. Indicators related to different aspects of the force and audio were compared through signal-to-signal and event-to-event correlation analysis. RESULTS High signal-to-signal correlations between force and audio indicators regardless of the insertion velocity were obtained. The force curvature indicator obtained the best correlation performances to audio with more than [Formula: see text] of the correlations higher than 0.6. The event-to-event correlation analysis shows that a puncture event in the force is generally identifiable in audio and that their intensities firmly related. CONCLUSIONS Audio contains valuable information for monitoring needle tip/tissue interaction. Significant dynamics obtained from a well-known sensor as force can also be extracted from audio, regardless of insertion velocities.
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Holm S, Holm T, Martinsen ØG. Simple circuit equivalents for the constant phase element. PLoS One 2021; 16:e0248786. [PMID: 33770096 PMCID: PMC7997031 DOI: 10.1371/journal.pone.0248786] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/05/2021] [Indexed: 12/05/2022] Open
Abstract
The constant phase element (CPE) is a capacitive element with a frequency-independent negative phase between current and voltage which interpolates between a capacitor and a resistor. It is used extensively to model the complexity of the physics in e.g. the bioimpedance and electrochemistry fields. There is also a similar element with a positive phase angle, and both the capacitive and inductive CPEs are members of the family of fractional circuit elements or fractance. The physical meaning of the CPE is only partially understood and many consider it an idealized circuit element. The goal here is to provide alternative equivalent circuits, which may give rise to better interpretations of the fractance. Both the capacitive and the inductive CPEs can be interpreted in the time-domain, where the impulse and step responses are temporal power laws. Here we show that the current impulse responses of the capacitive CPE is the same as that of a simple time-varying series RL-circuit where the inductor’s value increases linearly with time. Similarly, the voltage response of the inductive CPE corresponds to that of a simple parallel RC circuit where the capacitor’s value increases linearly with time. We use the Micro-Cap circuit simulation program, which can handle time-varying circuits, for independent verification. The simulation corresponds exactly to the expected response from the proposed equivalents within 0.1% error. The realization with time-varying components correlates with known time-varying properties in applications, and may lead to a better understanding of the link between CPE and applications.
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Affiliation(s)
- Sverre Holm
- Department of Physics, University of Oslo, Oslo, Norway
- * E-mail:
| | - Thomas Holm
- Institute for Energy Technology, Kjeller, Norway
| | - Ørjan Grøttem Martinsen
- Department of Physics, University of Oslo, Oslo, Norway
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
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Sanchez B, Martinsen OG, Freeborn TJ, Furse CM. Electrical impedance myography: A critical review and outlook. Clin Neurophysiol 2020; 132:338-344. [PMID: 33450556 DOI: 10.1016/j.clinph.2020.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/31/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022]
Abstract
Electrical impedance myography (EIM) technology is finding application in neuromuscular disease research as a tool to assess muscle health. Correlations between EIM outcomes, functional, imaging and histological data have been established in a variety of neuromuscular disorders; however, an analytical discussion of EIM is lacking. This review presents an explanation for clinicians and others who are applying EIM and interpreting impedance outcomes. The background of EIM is presented, including the relation between EIM, volume conduction properties, tissue structure, electrode configuration and conductor volume. Also discussed are technical considerations to guide the reader to critically evaluate EIM and understand its limitations and strengths.
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Affiliation(s)
- Benjamin Sanchez
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112, USA.
| | - Orjan G Martinsen
- Department of Physics, University of Oslo, 0371 Oslo, Norway; Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo 0372, Norway
| | - Todd J Freeborn
- Department of Electrical and Computer Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Cynthia M Furse
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112, USA
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13
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Biopsy needle integrated with multi-modal physical/chemical sensor array. Biosens Bioelectron 2020; 148:111822. [DOI: 10.1016/j.bios.2019.111822] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/16/2019] [Accepted: 10/23/2019] [Indexed: 12/19/2022]
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14
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Gelenkerhaltende Eingriffe zur Therapie der Sprunggelenkarthrose. ARTHROSKOPIE 2020. [DOI: 10.1007/s00142-019-00332-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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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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16
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Kim J, Abbasi MA, Kim T, Park KD, Cho S. Lock-in Amplifier-Based Impedance Detection of Tissue Type Using a Monopolar Injection Needle. SENSORS 2019; 19:s19214614. [PMID: 31652819 PMCID: PMC6864682 DOI: 10.3390/s19214614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/01/2019] [Accepted: 10/22/2019] [Indexed: 01/02/2023]
Abstract
For successful intra-articular injection therapy, it is essential to accurately position the tip of the injection needle into the target joint area while administering the drug into the affected tissue. In this study, we investigated the feasibility of a monopolar injection needle and lock-in amplifier (LIA)-based impedance measurement system for detecting the tissue type where the needle tip is located. After positioning the monopolar injection needle tip into the dermis, hypodermis, or muscle layer of pork tissue, the electrical impedance was measured in the frequency range of 10 Hz to 10 kHz. We observed a difference in the results based on the tissue type where the needle was positioned (p-value < 0.01). Therefore, the monopolar injection needle with electrical impedance measurement can be used to improve intra-articular injection therapy through non-destructive and real-time monitoring of the needle position in the tissues.
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Affiliation(s)
- Junsub Kim
- Gachon Advanced Institute for Health Science & Technology, Gachon University, Incheon 21999, Korea.
| | - Muhammad Aitzaz Abbasi
- Department of Electronic Engineering, Gachon University, 1342 Seongnamdaero, Seongnam-si, Gyeonggi-do 13120, Korea.
| | - Tahee Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju 27376, Korea.
| | - Ki Deok Park
- Department of Rehabilitation Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea.
| | - Sungbo Cho
- Gachon Advanced Institute for Health Science & Technology, Gachon University, Incheon 21999, Korea.
- Department of Electronic Engineering, Gachon University, 1342 Seongnamdaero, Seongnam-si, Gyeonggi-do 13120, Korea.
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17
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Electrical Characterization of Pork Tissue Measured by a Monopolar Injection Needle and Discrete Fourier Transform based Impedance Measurement. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9194049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ultrasonography or fluoroscopy-guided needle injection has been used for intra-articular injection therapy against adhesive capsulitis and joint diseases. To improve the image-guided intra-articular injection therapy, electrical impedance measurement based positioning of the needle tip in the target tissue can be applied. The feasibility of the discrimination for the tissue layer at which the disposable monopolar injection needle tip position was investigated using the discrete Fourier transform (DFT)-based impedance measurement system and the ultrasound imaging device. The electrical impedance spectra of the pork tissue measured in the frequency range of 200 Hz to 50 kHz were characterized by designed equivalent circuit modeling analysis. The normalized impedance data of the tissue layers (dermis, hypodermis, and muscle) were significantly different from each other (p-value < 0.001). The DFT-based impedance measurement system with a monopolar injection needle can be complementary to the image-guided intra-articular injection therapy.
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18
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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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19
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Riveros-Perez E, Albo C, Jimenez E, Cheriyan T, Rocuts A. Color your epidural: color flow Doppler to confirm labor epidural needle position. Minerva Anestesiol 2019; 85:376-383. [DOI: 10.23736/s0375-9393.18.13175-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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O'Donnell BD, Loughnane F. Novel nerve imaging and regional anesthesia, bio-impedance and the future. Best Pract Res Clin Anaesthesiol 2019; 33:23-35. [DOI: 10.1016/j.bpa.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/20/2019] [Accepted: 02/22/2019] [Indexed: 11/24/2022]
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21
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Tronstad C, Strand-Amundsen R. Possibilities in the Application of Machine Learning on Bioimpedance Time-series. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2019; 10:24-33. [PMID: 33584879 PMCID: PMC7531209 DOI: 10.2478/joeb-2019-0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 05/16/2023]
Abstract
The relation between a biological process and the changes in passive electrical properties of the tissue is often non-linear, in which developing prediction models based on bioimpedance spectra is not trivial. Relevant information on tissue status may also lie in characteristic developments in the bioimpedance spectra over time, often neglected by conventional methods. The aim of this study was to explore possibilities in machine learning methods for time series of bioimpedance spectra, where we used organ ischemia as an example. Based on published data on the development of the bioimpedance spectrum during liver ischemia, a simulation model was made and used to generate sets of synthetic data with different levels of organ-to-organ variation, measurement noise and drift. Three types of artificial neural networks were employed in learning to predict the ischemic duration, based on the simulated datasets. The simulated prediction performance was very dependent on the amount of training examples, the organ-to-organ variation and the selection of input variables from the bioimpedance spectrum. The performance was also affected by noise and drift in the measurement, but a recurrent neural network with long short-term memory units could obtain good predictions even on noisy and drifting measurements. This approach may be relevant for further exploration on several applications of bioimpedance having the purpose of predicting a biological state based on spectra measured over time.
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Affiliation(s)
- Christian Tronstad
- Department of Clinical and Biomedical Engineering, Oslo University Hospital - Rikshospitalet, Oslo, Norway
- E-mail:
| | - Runar Strand-Amundsen
- Department of Clinical and Biomedical Engineering, Oslo University Hospital - Rikshospitalet, Oslo, Norway
- Sensocure AS, Skoppum, Norway
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22
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Halonen S, Kari J, Ahonen P, Kronström K, Hyttinen J. Real-Time Bioimpedance-Based Biopsy Needle Can Identify Tissue Type with High Spatial Accuracy. Ann Biomed Eng 2018; 47:836-851. [DOI: 10.1007/s10439-018-02187-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
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23
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Ewalefo SO, Dombrowski M, Hirase T, Rocha JL, Weaver M, Kline A, Carney D, Hogan MV. Management of Posttraumatic Ankle Arthritis: Literature Review. Curr Rev Musculoskelet Med 2018; 11:546-557. [PMID: 30327933 PMCID: PMC6220012 DOI: 10.1007/s12178-018-9525-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Trauma is the principle cause of osteoarthritis in the ankle, which is associated with significant morbidity. This review highlights the current literature for the purpose of bringing the reader up-to-date on the management of posttraumatic ankle arthritis, describing treatment efficacy, indications, contraindications, and complications. RECENT FINDINGS Recent studies on osteoarthritis have demonstrated variability among anatomic locations regarding the mechanisms and rates of development for posttraumatic osteoarthritis, which are attributed to newly discovered biological differences intrinsic to each joint. Regarding surgical management of posttraumatic ankle arthritis, osteochondral allograft transplantation of the talus, and supramalleolar osteotomies have demonstrated promising results. Additionally, the outpatient setting was found to be appropriate for managing pain following total ankle arthroplasty, associated with low complication rates and no readmission. Management for posttraumatic ankle arthritis is generally progressive. Initial treatment entails nonpharmacologic options with surgery reserved for posttraumatic ankle arthritis refractory to conservative treatment. Patient demographics and lifestyles should be carefully considered when formulating a management strategy, as outcomes are dependent upon the satisfaction of each set of respective criteria. Ultimately, the management of posttraumatic ankle arthritis should be individualized to satisfy the needs and desires, which are specific to each patient.
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Affiliation(s)
- Samuel O Ewalefo
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Texas A&M College of Medicine, Bryan, TX, USA.
| | - Malcolm Dombrowski
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Takashi Hirase
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Jorge L Rocha
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mitchell Weaver
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alex Kline
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dwayne Carney
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - MaCalus V Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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24
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Concentric Ring Probe for Bioimpedance Spectroscopic Measurements: Design and Ex Vivo Feasibility Testing on Pork Oral Tissues. SENSORS 2018; 18:s18103378. [PMID: 30308986 PMCID: PMC6210762 DOI: 10.3390/s18103378] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/19/2018] [Accepted: 10/03/2018] [Indexed: 11/17/2022]
Abstract
Many oral diseases, such as oral leukoplakia and erythroplakia, which have a high potential for malignant transformations, cause abnormal structural changes in the oral mucosa. These changes are clinically assessed by visual inspection and palpation despite their poor accuracy and subjective nature. We hypothesized that non-invasive bioimpedance spectroscopy (BIS) might be a viable option to improve the diagnostics of potentially malignant lesions. In this study, we aimed to design and optimize the measurement setup and to conduct feasibility testing on pork oral tissues. The contact pressure between a custom-made concentric ring probe and tissue was experimentally optimized. The effects of loading time and inter-electrode spacing on BIS spectra were also clarified. Tissue differentiation testing was performed for ex vivo pork oral tissues including palatinum, buccal mucosa, fat, and muscle tissue samples. We observed that the most reproducible results were obtained by using a loading weight of 200 g and a fixed time period under press, which was necessary to allow meaningful quantitative comparison. All studied tissues showed their own unique spectra, accompanied by significant differences in both impedance magnitude and phase (p ≤ 0.014, Kruskal-Wallis test). BIS shows promise, and further studies are warranted to clarify its potential to detect specific pathological tissue alterations.
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25
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Illanes A, Boese A, Maldonado I, Pashazadeh A, Schaufler A, Navab N, Friebe M. Novel clinical device tracking and tissue event characterization using proximally placed audio signal acquisition and processing. Sci Rep 2018; 8:12070. [PMID: 30104613 PMCID: PMC6089924 DOI: 10.1038/s41598-018-30641-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/02/2018] [Indexed: 11/24/2022] Open
Abstract
We propose a new and complementary approach to image guidance for monitoring medical interventional devices (MID) with human tissue interaction and surgery augmentation by acquiring acoustic emission data from the proximal end of the MID outside the patient to extract dynamical characteristics of the interaction between the distal tip and the tissue touched or penetrated by the MID. We conducted phantom based experiments (n = 955) to show dynamic tool/tissue interaction during tissue needle passage (a) and vessel perforation caused by guide wire artery perforation (b). We use time-varying auto-regressive (TV-AR) modelling to characterize the dynamic changes and time-varying maximal energy pole (TV-MEP) to compute subsequent analysis of MID/tissue interaction characterization patterns. Qualitative and quantitative analysis showed that the TV-AR spectrum and the TV-MEP indicated the time instants of the needle path through different phantom objects (a) and clearly showed a perforation versus other generated artefacts (b). We demonstrated that audio signals acquired from the proximal part of an MID could provide valuable additional information to surgeons during minimally invasive procedures.
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Affiliation(s)
- Alfredo Illanes
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany.
| | - Axel Boese
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany
| | - Iván Maldonado
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany
| | - Ali Pashazadeh
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany
| | - Anna Schaufler
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany
| | - Nassir Navab
- Technische Universität München, Fakultät für Informatik, München, Germany
| | - Michael Friebe
- Otto-von-Guericke-Universität, INKA Intelligente Katheter, Magdeburg, Germany
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26
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Anso J, Balmer TW, Jegge Y, Kalvoy H, Bell BJ, Dur C, Calvo EM, Williamson TM, Gerber N, Ferrario D, Forterre F, Buchler P, Stahel A, Caversaccio MD, Weber S, Gavaghan KA. Electrical Impedance to Assess Facial Nerve Proximity During Robotic Cochlear Implantation. IEEE Trans Biomed Eng 2018; 66:237-245. [PMID: 29993441 DOI: 10.1109/tbme.2018.2830303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reported studies pertaining to needle guidance suggest that tissue impedance available from neuromonitoring systems can be used to discriminate nerve tissue proximity. In this pilot study, the existence of a relationship between intraoperative electrical impedance and tissue density, estimated from computer tomography (CT) images, is evaluated in the mastoid bone of in vivo sheep. In five subjects, nine trajectories were drilled using an image-guided surgical robot. Per trajectory, five measurement points near the facial nerve were accessed and electrical impedance was measured (≤1 KHz) using a multipolar electrode probe. Micro-CT was used postoperatively to measure the distances from the drilled trajectories to the facial nerve. Tissue density was determined from coregistered preoperative CT images and, following sensitivity field modeling of the measuring tip, tissue resistivity was calculated. The relationship between impedance and density was determined for 29 trajectories passing or intersecting the facial nerve. A monotonic decrease in impedance magnitude was observed in all trajectories with a drill axis intersecting the facial nerve. Mean tissue densities intersecting with the facial nerve (971-1161 HU) were different (p <0.01) from those along safe trajectories passing the nerve (1194-1449 HU). However, mean resistivity values of trajectories intersecting the facial nerve (14-24 Ωm) were similar to those of safe passing trajectories (17-23 Ωm). The determined relationship between tissue density and electrical impedance during neuromonitoring of the facial nerve suggests that impedance spectroscopy may be used to increase the accuracy of tissue discrimination, and ultimately improve nerve safety distance assessment in the future.
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27
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Cheng Z, Davies BL, Caldwell DG, Mattos LS. A New Venous Entry Detection Method Based on Electrical Bio-impedance Sensing. Ann Biomed Eng 2018; 46:1558-1567. [PMID: 29675812 DOI: 10.1007/s10439-018-2025-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/07/2018] [Indexed: 10/17/2022]
Abstract
Peripheral intravenous catheterization (PIVC) is frequently required for various medical treatments. Over 1 billion PIVC operations are performed per year in the United States alone. However, this operation is characterized by a very low success rate, especially amongst pediatric patients. Statistics show that only 53% of first PIVC attempts are successful in pediatric patients. Since their veins are small and readily rupture, multiple attempts are commonly required before successfully inserting the catheter into the vein. This article presents and evaluates a novel venous entry detection method based on measuring the electrical bio-impedance of the contacting tissue at the tip of a concentric electrode needle (CEN). This detection method is then implemented in the design of a clinical device called smart venous entry indicator (SVEI), which lights up a LED to indicate the venous entry when the measured value is within the range of blood. To verify this detection method, two experiments are conducted. In the first experiment, we measured the bio-impedance during the insertion of a CEN into a rat's tail vein with different excitation frequencies. Then three classifiers are tested to discriminate blood from surrounding tissues. The experimental results indicate that with 100 kHz excitation frequency the blood bio-impedance can be identified with accuracy nearly 100%, demonstrating the feasibility and reliability of the proposed method for venous entry detection. The second experiment aims to assess the impact of SVEI on PIVC performance. Ten naive subjects were invited to catheterize a realistic baby arm phantom. The subjects are equally divided into two groups, where one group does PIVC with SVEI and the other group uses an ordinary IV catheter. The results show that subjects using SVEI can achieve much higher success rates (86%) than those performing PIVC in a conventional way (12%). Also, all subjects assisted by SVEI succeeded in their first trials while no one succeed in their first attempt using the conventional unassisted system. These results demonstrate the proposed detection method has great potential to improve pediatric PIVC performance, especially for non-expert clinicians. This supports further investment towards clinical validation of the technology.
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Affiliation(s)
- Zhuoqi Cheng
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163, Genoa, Italy.
| | - Brian L Davies
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163, Genoa, Italy.,Mechanical Engineering Department, Imperial College London, London, SW7 2AZ, UK
| | - Darwin G Caldwell
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163, Genoa, Italy
| | - Leonardo S Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, 16163, Genoa, Italy
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28
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Bicen AO, West LL, Cesar L, Inan OT. Toward Non-Invasive and Automatic Intravenous Infiltration Detection: Evaluation of Bioimpedance and Skin Strain in a Pig Model. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2018; 6:4100207. [PMID: 29692956 PMCID: PMC5912429 DOI: 10.1109/jtehm.2018.2815539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/05/2018] [Accepted: 02/27/2018] [Indexed: 11/06/2022]
Abstract
Intravenous (IV) therapy is prevalent in hospital settings, where fluids are typically delivered with an IV into a peripheral vein of the patient. IV infiltration is the inadvertent delivery of fluids into the extravascular space rather than into the vein (and requires urgent treatment to avoid scarring and severe tissue damage), for which medical staff currently needs to check patients periodically. In this paper, the performance of two non-invasive sensing modalities, electrical bioimpedance (EBI), and skin strain sensing, for the automatic detection of IV infiltration was investigated in an animal model. Infiltrations were physically simulated on the hind limb of anesthetized pigs, where the sensors for EBI and skin strain sensing were co-located. The obtained data were used to examine the ability to distinguish between infusion into the vein and an infiltration event using bioresistance and bioreactance (derived from EBI), as well as skin strain. Skin strain and bioresistance sensing could achieve detection rates greater than 0.9 for infiltration fluid volumes of 2 and 10 mL, respectively, for a given false positive, i.e., false alarm rate of 0.05. Furthermore, the fusion of multiple sensing modalities could achieve a detection rate of 0.97 with a false alarm rate of 0.096 for 5mL fluid volume of infiltration. EBI and skin strain sensing can enable non-invasive and real-time IV infiltration detection systems. Fusion of multiple sensing modalities can help to detect expanded range of leaking fluid volumes. The provided performance results and comparisons in this paper are an important step towards clinical translation of sensing technologies for detecting IV infiltration.
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Affiliation(s)
- A. Ozan Bicen
- Inan Research Laboratory, School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Leanne L. West
- Pediatric Technology CenterGeorgia Institute of TechnologyAtlantaGA30332USA
| | | | - Omer T. Inan
- Inan Research Laboratory, School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGA30332USA
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29
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Biopsy Needle Integrated with Electrical Impedance Sensing Microelectrode Array towards Real-time Needle Guidance and Tissue Discrimination. Sci Rep 2018; 8:264. [PMID: 29321531 PMCID: PMC5762724 DOI: 10.1038/s41598-017-18360-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 12/10/2017] [Indexed: 01/28/2023] Open
Abstract
A biopsy needle with electrical impedance sensor array based on stainless steel microelectrodes (EIS needle) was developed for real-time four electrode measurement and multi-spot sensing of tissues during the biopsy process. The sensor performance was characterized by using saline solutions with various concentrations, which proved accurate, stable and reliable electrical impedance measurement. The capability of impedance-based tissue sensing was verified by the conductivity measurement of agarose hydrogel based phantom mimicking cancer tissue. Furthermore, multi-spot impedance sensing during needle insertion was demonstrated using porcine meat with muscle and fat layers, which exhibited a clear discrimination between different types of tissues. Also, the electrical impedance difference between normal and fatty livers of mouse model was measured by the EIS needle. We could successfully demonstrate that the EIS needle can provide localized and accurate characterization of biological tissues at the needle tip.
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30
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Amini M, Hisdal J, Kalvøy H. Applications of Bioimpedance Measurement Techniques in Tissue Engineering. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2018; 9:142-158. [PMID: 33584930 PMCID: PMC7852004 DOI: 10.2478/joeb-2018-0019] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Indexed: 05/19/2023]
Abstract
Rapid development in the field of tissue engineering necessitates implementation of monitoring methods for evaluation of the viability and characteristics of the cell cultures in a real-time, non-invasive and non-destructive manner. Current monitoring techniques are mainly histological and require labeling and involve destructive tests to characterize cell cultures. Bioimpedance measurement technique which benefits from measurement of electrical properties of the biological tissues, offers a non-invasive, label-free and real-time solution for monitoring tissue engineered constructs. This review outlines the fundamentals of bioimpedance, as well as electrical properties of the biological tissues, different types of cell culture constructs and possible electrode configuration set ups for performing bioimpedance measurements on these cell cultures. In addition, various bioimpedance measurement techniques and their applications in the field of tissue engineering are discussed.
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Affiliation(s)
- M. Amini
- Department of Physics, University of Oslo, Oslo, Norway
| | - J. Hisdal
- Vascular Investigations and Circulation lab, Aker Hospital, Oslo University Hospital, Oslo, Norway
| | - H. Kalvøy
- Department of Clinical and Biomedical Engineering, Rikshospitalet, Oslo University Hospital, Oslo, Norway
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31
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Kalvoy H, Tronstad C, Ullensvang K, Steinfeldt T, Sauter AR. Detection of needle to nerve contact based on electric bioimpedance and machine learning methods. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:9-12. [PMID: 29059798 DOI: 10.1109/embc.2017.8036750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In an ongoing project for electrical impedance-based needle guidance we have previously showed in an animal model that intraneural needle positions can be detected with bioimpedance measurement. To enhance the power of this method we in this study have investigated whether an early detection of the needle only touching the nerve also is feasible. Measurement of complex impedance during needle to nerve contact was compared with needle positions in surrounding tissues in a volunteer study on 32 subjects. Classification analysis using Support-Vector Machines demonstrated that discrimination is possible, but that the sensitivity and specificity for the nerve touch algorithm not is at the same level of performance as for intra-neuralintraneural detection.
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Cheng Z, Davies BL, Caldwell DG, Barresi G, Xu Q, Mattos LS. A hand-held robotic device for peripheral intravenous catheterization. Proc Inst Mech Eng H 2017; 231:1165-1177. [DOI: 10.1177/0954411917737328] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intravenous catheterization is frequently required for numerous medical treatments. However, this process is characterized by a high failure rate, especially when performed on difficult patients such as newborns and infants. Very young patients have small veins, and that increases the chances of accidentally puncturing the catheterization needle directly through them. In this article, we present the design, development and experimental evaluation of a novel hand-held robotic device for improving the process of peripheral intravenous catheterization by facilitating the needle insertion procedure. To our knowledge, this design is the first hand-held robotic device for assisting in the catheterization insertion task. Compared to the other available technologies, it has several unique advantages such as being compact, low-cost and able to reliably detect venipuncture. The system is equipped with an electrical impedance sensor at the tip of the catheterization needle, which provides real-time measurements used to supervise and control the catheter insertion process. This allows the robotic system to precisely position the needle within the lumen of the target vein, leading to enhanced catheterization success rate. Experiments conducted to evaluate the device demonstrated that it is also effective to deskill the task. Naïve subjects achieved an average catheterization success rate of 88% on a 1.5 mm phantom vessel with the robotic device versus 12% with the traditional unassisted system. The results of this work prove the feasibility of a hand-held assistive robotic device for intravenous catheterization and show that such device has the potential to greatly improve the success rate of these difficult operations.
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Affiliation(s)
- Zhuoqi Cheng
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Brian L Davies
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
- Department of Mechanical Engineering, Imperial College London, London, UK
| | - Darwin G Caldwell
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Giacinto Barresi
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Qinqi Xu
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Leonardo S Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
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Kwon H, Rutkove SB, Sanchez B. Recording characteristics of electrical impedance myography needle electrodes. Physiol Meas 2017; 38:1748-1765. [PMID: 28721951 DOI: 10.1088/1361-6579/aa80ac] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Neurologists and physiatrists need improved tools for the evaluation of skeletal muscle condition. Here we evaluate needle electrical impedance myography (EIM), a new minimally invasive approach to determine muscle status that could ultimately become a bedside tool for the assessment of neuromuscular disorders. APPROACH We design and study the recording characteristics of tetrapolar EIM needle electrodes combining theory and finite-element model simulations. We then use these results to build and pilot in vivo an EIM needle electrode in the rat gastrocnemius muscle ([Formula: see text]). The dielectric properties of muscle are reported (mean ± standard deviation). RESULTS The numerical simulations show that the contribution of subcutaneous fat and muscle tissues to needle EIM data is <3% and >97%, respectively, and the sensed volume is [Formula: see text] cm3. Apparent resistivity [Formula: see text] [Formula: see text] cm and relative permittivity [Formula: see text] (dimensionless) measured at 10 kHz are in good agreement with in vivo dielectric properties reported in the literature. SIGNIFICANCE The results presented show the feasibility of measuring muscle impedivity in vivo using a needle electrode from 10 kHz to 1 MHz. The development of needle EIM technology can open up a new field of study in electrodiagnostic medicine, with potential applications to both disease diagnosis and biomarker assessment of therapy.
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Affiliation(s)
- H Kwon
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215-5491, United States of America
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Development of multi-spot impedance sensing biopsy needle based on attachable and flexible sensor film. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:4788-4791. [PMID: 28269341 DOI: 10.1109/embc.2016.7591798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We demonstrate the biopsy needle capable of multi-spot impedance sensing based on attachable and flexible sensor film. In order to directly integrate sensor electrodes into curved surface of biopsy needle, attachable and thin polyimide substrate was used. Sensor electrodes were easily manipulated due to advantage of conventional microfabrication technique and this enable capability of multi-spot impedance sensing. To verify validity of proposed method, attachability of sensor film and real-time response of multi-spot sensing of fabricated biopsy needle was investigated.
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Sharp J, Bouazza-Marouf K, Noronha D, Gaur A. Tissue type determination by impedance measurement: A bipolar and monopolar comparison. Saudi J Anaesth 2017; 11:15-20. [PMID: 28217047 PMCID: PMC5292845 DOI: 10.4103/1658-354x.197334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: In certain medical applications, it is necessary to be able to determine the position of a needle inside the body, specifically with regards to identifying certain tissue types. By measuring the electrical impedance of specific tissue types, it is possible to determine the type of tissue the tip of the needle (or probe) is at. Materials and Methods: Two methods have been investigated for electric impedance detection; bipolar and monopolar. Commercially available needle electrodes are of a monopolar type. Although many patents exist on the bipolar setups, these have not as yet been commercialized. This paper reports a comparison of monopolar and bipolar setups for tissue type determination. In vitro experiments were carried out on pork to compare this investigation with other investigations in this field. Results: The results show that both monopolar and bipolar setups are capable of determining tissue type. However, the bipolar setup showed slightly better results; the difference between the different soft tissue type impedances was greater compared to the monopolar method. Conclusion: Both monopolar and bipolar electrical impedance setups work very similarly in inhomogeneous volumes such as biological tissue. There is a clear potential for clinical applications with impedance-based needle guidance, with both the monopolar and bipolar setups. It is, however, worth noting that the bipolar setup is more versatile.
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Affiliation(s)
- Jack Sharp
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Kaddour Bouazza-Marouf
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Dorita Noronha
- Department of Anaesthesia, University Hospitals of Leicester NHS Trust, Leicester, Leicestershire LE1 5WW, UK
| | - Atul Gaur
- Department of Anaesthesia, University Hospitals of Leicester NHS Trust, Leicester, Leicestershire LE1 5WW, UK
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Elsharkawy H, Sonny A, Chin KJ. Localization of epidural space: A review of available technologies. J Anaesthesiol Clin Pharmacol 2017; 33:16-27. [PMID: 28413269 PMCID: PMC5374826 DOI: 10.4103/0970-9185.202184] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results. After careful review of abstracts and full texts, 42 articles were selected to be included. Newer techniques for localization of EDS can be broadly classified into techniques that (1) guide the needle to the EDS, (2) identify needle entry into the EDS, and (3) confirm catheter location in EDS. An ideal method should be easy to learn and perform, easily reproducible with high sensitivity and specificity, identifies inadvertent intrathecal and intravascular catheter placements with ease, feasible in perioperative setting and have a cost-benefit advantage. Though none of them in their current stages of development qualify as an ideal method, many show tremendous potential. Some techniques are useful in patients with difficult spinal anatomy and infants, and thus are complementary to traditional methods. In addition to improving the existing technology, future research should aim at proving the superiority of these techniques over traditional methods, specifically regarding successful EDS localization, better safety profile, and a favorable cost-benefit ratio.
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Affiliation(s)
- Hesham Elsharkawy
- Department of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Abraham Sonny
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ki Jinn Chin
- Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
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Pettersen FJ, Martinsen ØG, Høgetveit JO, Kalvøy H, Odland HH. Bioimpedance measurements of temporal changes in beating hearts. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/6/065015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Yang L, Zhang G, Song J, Dai M, Xu C, Dong X, Fu F. Ex-Vivo Characterization of Bioimpedance Spectroscopy of Normal, Ischemic and Hemorrhagic Rabbit Brain Tissue at Frequencies from 10 Hz to 1 MHz. SENSORS 2016; 16:s16111942. [PMID: 27869707 PMCID: PMC5134601 DOI: 10.3390/s16111942] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
Stroke is a severe cerebrovascular disease and is the second greatest cause of death worldwide. Because diagnostic tools (CT and MRI) to detect acute stroke cannot be used until the patient reaches the hospital setting, a portable diagnostic tool is urgently needed. Because biological tissues have different impedance spectra under normal physiological conditions and different pathological states, multi-frequency electrical impedance tomography (MFEIT) can potentially detect stroke. Accurate impedance spectra of normal brain tissue (gray and white matter) and stroke lesions (ischemic and hemorrhagic tissue) are important elements when studying stroke detection with MFEIT. To our knowledge, no study has comprehensively measured the impedance spectra of normal brain tissue and stroke lesions for the whole frequency range of 1 MHz within as short as possible an ex vivo time and using the same animal model. In this study, we established intracerebral hemorrhage and ischemic models in rabbits, then measured and analyzed the impedance spectra of normal brain tissue and stroke lesions ex vivo within 15 min after animal death at 10 Hz to 1 MHz. The results showed that the impedance spectra of stroke lesions significantly differed from those of normal brain tissue; the ratio of change in impedance of ischemic and hemorrhagic tissue with regard to frequency was distinct; and tissue type could be discriminated according to its impedance spectra. These findings further confirm the feasibility of detecting stroke with MFEIT and provide data supporting further study of MFEIT to detect stroke.
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Affiliation(s)
- Lin Yang
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Ge Zhang
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Jiali Song
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Meng Dai
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Canhua Xu
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Xiuzhen Dong
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
| | - Feng Fu
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an 710032, China.
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In-Vivo Electrical Impedance Measurement in Mastoid Bone. Ann Biomed Eng 2016; 45:1122-1132. [PMID: 27830489 DOI: 10.1007/s10439-016-1758-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Nerve monitoring is a safety mechanism to detect the proximity between surgical instruments and important nerves during surgical bone preparation. In temporal bone, this technique is highly specific and sensitive at distances below 0.1 mm, but remains unreliable for distances above this threshold. A deeper understanding of the patient-specific bone electric properties is required to improve this range of detection. A sheep animal model has been used to characterize bone properties in vivo. Impedance measurements have been performed at low frequencies (<1 kHz) between two electrodes placed inside holes drilled into the sheep mastoid bone. An electric circuit composed of a resistor and a Fricke constant phase element was able to accurately describe the experimental measurements. Bone resistivity was shown to be linearly dependent on the inter-electrode distance and the local bone density. Based on this model, the amount of bone material between the electrodes could be predicted with an error of 0.7 mm. Our results indicate that bone could be described as an ideal resistor while the electrochemical processes at the electrode-tissue interface are characterized by a constant phase element. These results should help increasing the safety of surgical drilling procedures by better predicting the distance to critical nerve structures.
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Detection of spine structures with Bioimpedance Probe (BIP) Needle in clinical lumbar punctures. J Clin Monit Comput 2016; 31:1065-1072. [DOI: 10.1007/s10877-016-9915-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
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41
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Meroni D, Bovio D, Frisoli PA, Aliverti A. Measurement of electrical impedance in different ex-vivo tissues. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:2311-2314. [PMID: 28268788 DOI: 10.1109/embc.2016.7591192] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bioimpedance allows living tissues characterization and detection of pathological states. Although in previous years several methods have been proposed to assess bioimpedance, many instruments used in studies of living tissues characterization are commercial devices designed for the measurement of components or electronic circuits and therefore the measurement of biological tissues can be affected by electrical polarization. In order to test if electrical impedance spectroscopy may be helpful in providing further information about the structure and the properties of tissues, an impedance meter for living-tissues, able to avoid polarization, was developed. Subsequently, ex-vivo impedance measurements were performed by placing a needle-probe into 6 tissues (heart, kidney, lung, muscle, liver and fat) of 3 rabbits. Impedance was analyzed in terms of modulus and phase. In the range 2-10 kHz, considering both modulus and phase, it was possible to discriminate each tissue with statistical significance. In the lower considered range of frequencies (i.e., 10-100 Hz and 200-1000 Hz) this was not always the case. We conclude that the detailed analysis of modulus and phase in the frequency range of 2-10 kHz, by using an ad-hoc device able to avoid electrical polarization, allows to discriminate between several healthy living tissues.
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Halonen S, Kankaanpää E, Kari J, Parmanne P, Relas H, Kronström K, Luosujärvi R, Peltomaa R. Synovial fluid detection in intra-articular injections using a bioimpedance probe (BIP) needle-a clinical study. Clin Rheumatol 2016; 36:1349-1355. [PMID: 26873101 DOI: 10.1007/s10067-016-3210-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
Intra-articular glucocorticoid injections are the recommended treatment for active arthritis, but accurate positioning of the needle may be challenging. Inexperienced physicians might decide not to inject because an unsuccessful injection impairs clinical outcome and may lead to complications; however, choosing not to inject may impair or delay the best possible treatment. Here, we address this problem by introducing a novel Bioimpedance Probe (BIP) Needle-guidance method that was tested in a clinical study. The BIP Needle was utilized for detection of synovial fluid. It measures real-time bioimpedance spectra and identifies when the needle tip is in contact with the synovial fluid. Injections into 80 joints with active arthritis were performed by an experienced rheumatologist using the BIP Needle. The location of the BIP Needle was ensured by aspiration of synovial fluid, absence of resistance during injection, and/or using real-time ultrasound imaging. Sensitivity and specificity of the device for synovial fluid detection were 86 % (CI 75-93 %) and 85 % (CI 74-92 %), respectively. The BIP Needles showed high spatial resolution and differentiated the synovial fluid from the surrounding tissues. However, lack of synovial fluid, anatomic variability, and intra-articular structures challenged the technology. The BIP Needles provided adequate results in intra-articular injections. Performance of the device was good even in small joints, which may be the most difficult for inexperienced physicians. Further performance improvement can be expected when more data is collected for mathematical models. Overall, this novel method showed potential to be used in real-time needle guidance.
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Affiliation(s)
| | - Eeva Kankaanpää
- Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Juho Kari
- R&D Department, Injeq Ltd., Tampere, Finland
| | - Pinja Parmanne
- Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Heikki Relas
- Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | | | - Riitta Luosujärvi
- Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Ritva Peltomaa
- Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. .,Helsinki University Central Hospital, Helsinki Triangle Hospital, Haartmaninkatu 4, PO Box 372, FI-00029 HUS, Helsinki, Finland.
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Kalvoy H, Aliau-Bonet C, Pallas-Areny R, Martinsen OG. Effects of stray capacitance to ground in three electrode monopolar needle bioimpedance measurements. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:7542-5. [PMID: 26738037 DOI: 10.1109/embc.2015.7320137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Positive phase angle is documented and analyzed in a three electrode monopolar needle measurement. Inductance equivalent behavior of the stray capacitance to ground is described as error source in a non-inductive sample measurement.
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Kang G, Yun J, Cho JS, Yoon J, Lee JH. Micro Electrical Impedance Spectroscopy (μEIS) Fabricated on the Curved Surface of a Fine Needle for Biotissue Discrimination. ELECTROANAL 2015. [DOI: 10.1002/elan.201500591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Helen L, O'Donnell BD, Moore E. Nerve localization techniques for peripheral nerve block and possible future directions. Acta Anaesthesiol Scand 2015; 59:962-74. [PMID: 25997933 DOI: 10.1111/aas.12544] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/24/2015] [Accepted: 04/05/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Ultrasound guidance is now a standard nerve localization technique for peripheral nerve block (PNB). Ultrasonography allows simultaneous visualization of the target nerve, needle, local anesthetic injectate, and surrounding anatomical structures. Accurate deposition of local anesthetic next to the nerve is essential to the success of the nerve block procedure. Due to limitations in the visibility of both needle tip and nerve surface, the precise relationship between needle tip and target nerve is unknown at the moment of injection. Importantly, nerve injury may result both from an inappropriately placed needle tip and inappropriately placed local anesthetic. The relationship between the block needle tip and target nerve is of paramount importance to the safe conduct of peripheral nerve block. METHODS This review summarizes the evolution of nerve localization in regional anesthesia, characterizes a problem faced by clinicians in performing ultrasound-guided nerve block, and explores the potential technological solutions to this problem. RESULTS To date, technology newly applied to PNB includes real-time 3D imaging, multi-planar magnetic needle guidance, and in-line injection pressure monitoring. This review postulates that optical reflectance spectroscopy and bioimpedance may allow for accurate identification of the relationship between needle tip and target nerve, currently a high priority deficit in PNB techniques. CONCLUSIONS Until it is known how best to define the relationship between needle and nerve at the moment of injection, some common sense principles are suggested.
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Affiliation(s)
- L. Helen
- Sensing and Separation Group; Chemistry Department and Life Science Interface Group; Tyndall National Institute; University College Cork; Cork Ireland
| | - B. D. O'Donnell
- Department of Anesthesia; Cork University Hospital & ASSERT for Health Centre; University College Cork; Cork Ireland
| | - E. Moore
- Sensing and Separation Group; Chemistry Department and Life Science Interface Group; Tyndall National Institute; University College Cork; Cork Ireland
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Youn SH, Sim T, Choi A, Song J, Shin KY, Lee IK, Heo HM, Lee D, Mun JH. Multi-class biological tissue classification based on a multi-classifier: Preliminary study of an automatic output power control for ultrasonic surgical units. Comput Biol Med 2015; 61:92-100. [DOI: 10.1016/j.compbiomed.2015.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 11/30/2022]
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Kalvøy H, Sauter AR. Detection of intraneural needle-placement with multiple frequency bioimpedance monitoring: a novel method. J Clin Monit Comput 2015; 30:185-92. [PMID: 25902898 PMCID: PMC4792358 DOI: 10.1007/s10877-015-9698-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 04/17/2015] [Indexed: 11/01/2022]
Abstract
Electrical impedance measurements have been used to detect intraneural needle placement, but there is still a lack of precision with this method. The purpose of the study was to develop a method for the discrimination of nerve tissue from other tissue types based on multiple frequency impedance measurements. Impedance measurements with 25 different frequencies between 1.26 and 398 kHz were obtained in eight pigs while placing the tip of a stimulation needle within the sciatic nerve and in other tissues. Various impedance variables and measurement frequencies were tested for tissue discrimination. Best tissue discrimination was obtained by using three different impedance parameters with optimal measurement frequencies: Modulus (126 kHz), Phase angle (40 kHz) and the Delta of the phase angle (between 126 and 158 kHz). These variables were combined in a Compound variable C. The area under the curve in a receiver operating characteristic was consecutively increased for the Modulus (78 %), Phase angle (86 %), Delta of the phase angle (94 %), and the Compound variable C (97 %), indicating highest specificity and sensitivity for C. An algorithm based on C was implemented in a real-time feasibility test and used in an additional test animal to demonstrate our new method. Discrimination between nerve tissue and other tissue types was improved by combining several impedance variables at multiple measurement frequencies.
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Affiliation(s)
- Håvard Kalvøy
- Department of Clinical and Biomedical Engineering, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Axel R Sauter
- Division of Emergencies and Critical Care, Department of Anaesthesiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
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48
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Bioimpedance monitoring of 3D cell culturing—Complementary electrode configurations for enhanced spatial sensitivity. Biosens Bioelectron 2015; 63:72-79. [DOI: 10.1016/j.bios.2014.07.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/04/2014] [Accepted: 07/08/2014] [Indexed: 12/20/2022]
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49
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Accurate resistivity mouse brain mapping using microelectrode arrays. Biosens Bioelectron 2014; 60:143-53. [DOI: 10.1016/j.bios.2014.03.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/11/2014] [Accepted: 03/21/2014] [Indexed: 12/19/2022]
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50
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Dai Y, Du J, Yang Q, Zhang J. Noninvasive electrical impedance sensor for in vivo tissue discrimination at radio frequencies. Bioelectromagnetics 2014; 35:385-95. [DOI: 10.1002/bem.21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 03/05/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Yu Dai
- Institute of Robotics and Automatic Information System; Tianjin Key Laboratory of Intelligent Robotics; College of Computer and Control Engineering, Nankai University; Tianjin P.R. China
| | - Jun Du
- Department of Genitourinary Oncology; Key Laboratory of Cancer Prevention and Therapy; Tianjin Medical University Cancer Institute and Hospital; Tianjin P.R. China
| | - Qing Yang
- Department of Genitourinary Oncology; Key Laboratory of Cancer Prevention and Therapy; Tianjin Medical University Cancer Institute and Hospital; Tianjin P.R. China
| | - Jianxun Zhang
- Institute of Robotics and Automatic Information System; Tianjin Key Laboratory of Intelligent Robotics; College of Computer and Control Engineering, Nankai University; Tianjin P.R. China
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