Measurement of electrical impedance in different ex-vivo tissues

Electric Bioimpedance Sensing for the Detection of Head and Neck Squamous Cell Carcinoma

The early detection of head and neck squamous cell carcinoma (HNSCC) is essential to improve patient prognosis and enable organ and function preservation treatments. The objective of this study is to assess the feasibility of using electrical bioimpedance (EBI) sensing technology to detect HNSCC tissue. A prospective study was carried out analyzing tissue from 46 patients undergoing surgery for HNSCC. The goal was the correct identification of pathologic tissue using a novel needle-based EBI sensing device and AI-based classifiers. Considering the data from the overall patient cohort, the system achieved accuracies between 0.67 and 0.93 when tested on tissues from the mucosa, skin, muscle, lymph node, and cartilage. Furthermore, when considering a patient-specific setting, the accuracy range increased to values between 0.82 and 0.95. This indicates that more reliable results may be achieved when considering a tissue-specific and patient-specific tissue assessment approach. Overall, this study shows that EBI sensing may be a reliable technology to distinguish pathologic from healthy tissue in the head and neck region. This observation supports the continuation of this research on the clinical use of EBI-based devices for early detection and margin assessment of HNSCC.

Towards Real-time Multiplexed Bioimpedance Tumour-Tissue Margin Analysis

Bioimpedance varies with physical tissue characteristics. As such it can be used for real-time tissue discrimination. This has led to its application as a surgical mapping tool to differentiate between healthy and abnormal tissue intraoperatively during tumour resection. Here, we build on previous work implementing a probe-based tetrapolar bioimpedance systems demonstrator, now extracting additional information for margin analysis with imperfect bioimpedance visibility. Through finite element analysis, we show preliminary findings using a single measurement with a multiplexed tetrapolar bioimpedance probe for identifying tissue boundaries, applied to porcine tissue as a surrogate for a tumour-tissue interface.

Differentiation using minimally-invasive bioimpedance measurements of healthy and pathological lung tissue through bronchoscopy

Purpose

To use minimally-invasive transcatheter electrical impedance spectroscopy measurements for tissue differentiation among healthy lung tissue and pathologic lung tissue from patients with different respiratory diseases (neoplasm, fibrosis, pneumonia and emphysema) to complement the diagnosis at real time during bronchoscopic procedures.

Methods

Multi-frequency bioimpedance measurements were performed in 102 patients. The two most discriminative frequencies for impedance modulus (|Z|), phase angle (PA), resistance (R) and reactance (Xc) were selected based on the maximum mean pair-wise Euclidean distances between paired groups. One-way ANOVA for parametric variables and Kruskal-Wallis for non-parametric data tests have been performed with post-hoc tests. Discriminant analysis has also been performed to find a linear combination of features to separate among tissue groups.

Results

We found statistically significant differences for all the parameters between: neoplasm and pneumonia (p < 0.05); neoplasm and healthy lung tissue (p < 0.001); neoplasm and emphysema (p < 0.001); fibrosis and healthy lung tissue (p ≤ 0.001) and pneumonia and healthy lung tissue (p < 0.01). For fibrosis and emphysema (p < 0.05) only in |Z|, R and Xc; and between pneumonia and emphysema (p < 0.05) only in |Z| and R. No statistically significant differences (p > 0.05) are found between neoplasm and fibrosis; fibrosis and pneumonia; and between healthy lung tissue and emphysema.

Conclusion

The application of minimally-invasive electrical impedance spectroscopy measurements in lung tissue have proven to be useful for tissue differentiation between those pathologies that leads increased tissue and inflammatory cells and those ones that contain more air and destruction of alveolar septa, which could help clinicians to improve diagnosis.

Concentric Ring Probe for Bioimpedance Spectroscopic Measurements: Design and Ex Vivo Feasibility Testing on Pork Oral Tissues

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.

An electrical impedance tomography (EIT) multi-electrode needle-probe device for local assessment of heterogeneous tissue impeditivity

Electrical Impedance Tomography (EIT) is an image reconstruction technique applied in medicine for the electrical imaging of living tissues. In literature there is the evidence that a large resistivity variation related to the differences of the human tissues exists. As a result of this interest for the electrical characterization of the biological samples, recently the attention is also focused on the identification and characterization of the human tissue, by studying the homogeneity of its structure. An 8 electrodes needle-probe device has been developed with the intent of identifying the structural inhomogeneities under the surface layers. Ex-vivo impeditivity measurements, by placing the needle-probe in 5 different patterns of fat and lean porcine tissue, were performed, and impeditivity maps were obtained by EIDORS open source software for image reconstruction in electrical impedance. The values composing the maps have been analyzed, pointing out a good tissue discrimination, and the conformity with the real images. We conclude that this device is able to perform impeditivity maps matching to reality for position and orientation. In all the five patterns presented is possible to identify and replicate correctly the heterogeneous tissue under test. This new procedure can be helpful to the medical staff to completely characterize the biological sample, in different unclear situations.

In-vivo Measurements of Tissue Impeditivity by Electrical Impedance Spectroscopy

The electrical properties of biological tissues differ depending on their structural characteristics. In literature, a lot of study have been carried out with the intent of taking advantage of bioimpedance analysis. Unfortunately, many apparatuses used during these evaluations were not always designed for measurements on living tissues. As a consequence, data could be affected by electrode polarization. In 2016, we presented a new impedance meter, developed for measurements on living tissues. Initially, it was tested only on ex-vivo rabbit's tissues with promising results. As a continuation, this device has been tested on in-vivo samples by placing a needle-probe into 3 tissues (liver, spleen, ovary) of 2 female dogs. Furthermore, was evaluated also the bioimpedance signal of the ovary explanted, comparing it with the in-vivo data. Bioimpedance was analyzed in terms of modulus and phase along a broad spectrum of frequencies (10Hz - 10kHz).Data obtained confirm the possibility of discriminating among the 3 tested tissues, at high frequencies for modulus and at low for phase. Confirmation that values on in-vivo and exvivo tissues are comparable if detected within few minutes after the explant, is also reported. We conclude that this clinical evaluation confirmed, also in-vivo, the good performance of the device previously tested on ex-vivo tissues, and provide more information about the tissue properties and characteristics.

A bioimpedance sensing system for in-vivo cancer tissue identification: Design and preliminary evaluation

Bioimpedance evaluation can provide useful information for biological tissue characterization and potentially allows the identification of pathological areas within a tissue in-vivo. In this study a new needle-based bioimpedance sensing system was designed and developed to provide such capability considering intra-operative detection of cancerous tissue in the larynx as the primary specific application. The system is small, low-power, fully embedded in a printed circuit board and based on a disposable concentric electrode needle. These characteristics make it appropriate for the envisioned clinical use. In addition, the device operates in real-time and offers functionalities allowing the tuning of its properties to maximize its sensing capabilities for different applications. This includes the possibility to perform bioimpedance measurements using a sweep of excitation frequencies or a single frequency. Here, the first functionality was used to evaluate the instrument's tissue discrimination performance at different frequencies and consequently identify the best frequency for such task. The second functionality was used to evaluate the performance of the system by obtaining repeated measurements on different locations of specific biological tissues. This was done using six different ex-vivo animal tissues and an ex-vivo porcine larynx. The bioimpedance measurements acquired were then investigated in terms of magnitude and phase. Combined analysis of these two terms suggests that it is indeed possible to discriminate between different tissues using the developed instrument. This is a highly motivating preliminary result that demonstrates the potential of the technology and justify the investment of further efforts towards a clinically usable system.