FPGA-based voltage and current dual drive system for high frame rate electrical impedance tomography

Electrical Impedance Tomography Technical Contributions for Detection and 3D Geometric Localization of Breast Tumors: A Systematic Review

Impedance measuring acquisition systems focused on breast tumor detection, as well as image processing techniques for 3D imaging, are reviewed in this paper in order to define potential opportunity areas for future research. The description of reported works using electrical impedance tomography (EIT)-based techniques and methodologies for 3D bioimpedance imaging of breast tissues with tumors is presented. The review is based on searching and analyzing related works reported in the most important research databases and is structured according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) parameters and statements. Nineteen papers reporting breast tumor detection and location using EIT were systematically selected and analyzed in this review. Clinical trials in the experimental stage did not produce results in most of analyzed proposals (about 80%), wherein statistical criteria comparison was not possible, such as specificity, sensitivity and predictive values. A 3D representation of bioimpedance is a potential tool for medical applications in malignant breast tumors detection being capable to estimate an ap-proximate the tumor volume and geometric location, in contrast with a tumor area computing capacity, but not the tumor extension depth, in a 2D representation.

A Run-Time Reconfiguration Method for an FPGA-Based Electrical Capacitance Tomography System

A desirable feature of an electrical capacitance tomography system is the adaptation possibility to any sensor configuration and measurement mode. A run-time reconfiguration of a system for electrical capacitance tomography is presented. An original mechanism is elaborated to reconfigure, on the fly, a modular EVT4 system with multiple FPGAs installed. The outlined system architecture is based on FPGA programmable logic devices (Xilinx Spartan) and PicoBlaze soft-core processors. Soft-core processors are used for communication, measurement control and data preprocessing. A novel method of FPGA partial reconfiguration is described, in which a PicoBlaze soft-core processor is used as a reconfiguration controller. Behavioral reconfiguration of the system is obtained by providing run-time access to the program code of a soft-core control processor. The tests using EVT4 hardware and different algorithms for tomographic scanning were performed. A test object was measured using 2D and 3D sensors. The time and resources required for the examined reconfiguration procedure are evaluated.

Impact of skull sutures, spongiform bone distribution, and aging skull conductivities on the EEG forward and inverse problems

Source imaging is a principal objective for electroencephalography (EEG), the solutions of which require forward problem (FP) computations characterising the electric potential distribution on the scalp due to known sources. Additionally, the EEG-FP is dependent upon realistic, anatomically correct volume conductors and accurate tissue conductivities, where the skull is particularly important. Skull conductivity, however, deviates according to bone composition and the presence of adult sutures. The presented study therefore analyses the effect the presence of adult sutures and differing bone composition have on the EEG-FP and inverse problem (IP) solutions. Utilising a well-established head atlas, detailed head models were generated including compact and spongiform bone and adult sutures. The true skull conductivity was considered as inhomogeneous according to spongiform bone proportion and sutures. The EEG-FP and EEG-IP were solved and compared to results employing homogeneous skull models, with varying conductivities and omitting sutures, as well as using a hypothesised aging skull conductivity model. Significant localised FP errors, with relative error up to 85%, were revealed, particularly evident along suture lines and directly related to the proportion of spongiform bone. This remained evident at various ages. Similar EEG-IP inaccuracies were found, with the largest (maximum 4.14 cm) across suture lines. It is concluded that modelling the skull as an inhomogeneous layer that varies according to spongiform bone proportion and includes differing suture conductivity is imperative for accurate EEG-FP and source localisation calculations. Their omission can result in significant errors, relevant for EEG research and clinical diagnosis.

Simplifying the hardware requirements for fast neural EIT of peripheral nerves

OBJECTIVE

The main objective of this study was to assess the feasibility of lowering the hardware requirements for fast neural EIT in order to support the distribution of this technique. Specifically, the feasibility of replacing the commercial modules present in the existing high-end setup with compact and cheap customized circuitry was assessed.

APPROACH

Nerve EIT imaging was performed on rat sciatic nerves with both our standard ScouseTom setup and a customized version in which commercial benchtop current sources were replaced by custom circuitry. Electrophysiological data and images collected in the same experimental conditions with the two setups were compared. Data from the customized setup was subject to a down-sampling analysis to simulate the use of a recording module with lower specifications.

MAIN RESULTS

Compound action potentials (573±287µV and 487±279µV, p=0.28) and impedance changes (36±14µV and 31±16µV, p=0.49) did not differ significantly when measured using commercial high-end current sources or our custom circuitry, respectively. Images reconstructed from both setups showed neglibile (<1voxel, i.e. 40µm) difference in peak location and a high degree of correlation (R2=0.97). When down-sampling from 24 to 16 bits ADC resolution and from 100KHz to 50KHz sampling frequency, signal-to-noise ratio showed acceptable decrease (<-20%), and no meaningful image quality loss was detected (peak location difference <1voxel, pixel-by-pixel correlation R2=0.99).

SIGNIFICANCE

The technology developed for this study greatly reduces the cost and size of a fast neural EIT setup without impacting quality and thus promotes the adoption of this technique by the neuroscience research community.

Electrical Tomography Reconstruction Using Reconfigurable Waveforms in a FPGA

The principal objective of this research is to conceive a mobile system based on electrical tomography for subsurface imaging and monitoring in order to enable simultaneous recording of electrical potentials of cardiac and pulmonary activity. For an exploration of excitation waveforms in electrical tomography, specialized hardware is required. As the main principle of tomography is the measurement of electrical perturbations on an unknown object, it is crucial to synchronize excitation and sensing processes in a very precise way for the purpose of acquiring meaningful data. To cope with this problem, an FPGA device is used, with an architecture that allows us to trigger excitation signals and to read sensed data simultaneously via independent processes that share the same clock. In this way, waveform reconfiguration on frequency and shape can be provided and studied. The system is connected to a standard microcontroller SoC with a simple API that allows for IoT capabilities for on-line operation and tracking, given that the design is targeted for in vivo medical monitoring. As a result of the research work, a measuring device was developed, the surface data analyzed and the image was reconstructed using the selected configuration.

Phantom Studies of Fused-Data TREIT Using Only Biopsy-Probe Electrodes

Transrectal electrical impedance tomography (TREIT) is a novel imaging modality being developed for prostate biopsy guidance and cancer characterization. We describe a novel fused-data TREIT (fd-TREIT) system and approach developed to improve imaging robustness and evaluate it on challenging clinically-representative phantoms. The new approach incorporates 8 electrodes (in 2 rows) on a biopsy probe (BP) and 12 electrodes on the face of a transrectal ultrasound (TRUS) probe and includes a biopsy gun, instrument tracking, 3D-printed needle guide, and EIT hardware and software. The approach was evaluated via simulation, a series of prostate-shaped gel phantoms, and an ex vivo bovine tissue sample using only absolute reconstructions. The simulations surprisingly found that using only biopsy-probe electrode measurements, i.e. omitting TRUS-probe electrode measurements, significantly improves robustness to noise thus leading to simpler modeling and significant decreases in computational times (~13x speed-up/reconstructions in ~27 minutes). The gel phantom experiments resulted in reconstructions with area under the curve (AUC) values extracted from receiver operator characteristic curves of >0.85 for 4 out of the 5 tests, and when incorporating inclusion boundaries resulted in absolute reconstructions yielding 1.9% and 12.2% average percent errors for 3 consistent tests and all 5 tests, respectively. Ex vivo bovine tests revealed qualitatively that the fd-TREIT approach can largely discriminate a complex adipose and muscle interface in a realistic setting using data from 9 biopsy probe states (biopsy core locations). The algorithms developed here on challenging phantoms suggest strong promise for this technology to aid in imaging during routine 12-core biopsies.

A Review on Electrical Impedance Tomography Spectroscopy

Electrical Impedance Tomography Spectroscopy (EITS) enables the reconstruction of material distributions inside an object based on the frequency-dependent characteristics of different substances. In this paper, we present a review of EITS focusing on physical principles of the technology, sensor geometries, existing measurement systems, reconstruction algorithms, and image representation methods. In addition, a novel imaging method is proposed which could fill some of the gaps found in the literature. As an example of an application, EITS of ice and water mixtures is used.

A 1 MHz Miniaturized Electrical Impedance Tomography System for Prostate Imaging

An ASIC for a high frequency electrical impedance tomography (EIT) imaging system for prostate cancer screening is presented. The ASIC enables a small form-factor architecture, which ensures high signal-to-noise ratio (SNR) at MHz frequencies. The 4-channel ASIC was designed and fabricated in a standard CMOS 0.18- μm technology and integrates a novel current driver for current stimulus, instrumentation amplifier to interface with the tissue, VGA to provide variable gain and ADC with SPI interface for digitization. A prototype miniaturized EIT system was built and it was evaluated using a model transrectal imaging probe immersed into a tank filled with saline and a metal inclusion that demonstrated the open-domain problem of imaging prostate cancer lesion. The system maintained an SNR between 66 and 76 dB over the frequency range of 500 Hz to 1 MHz. Also, it produced reconstructed EIT images that depicted the presence of the small metal inclusion that modeled a prostate cancer imaging application.

A Parametric EIT System Spice Simulation with Phantom Equivalent Circuits

In this paper a number of LT Spice simulations have been carried out on an Electrical Impedance Tomography (EIT) system, which includes the whole analog and digital circuitry as well as the subject to be examined (phantom model). The aim of this study is to show how the analog and digital parts, the electrodes and the subject’s physical properties may impact the measurements and the quality of the reconstructed image. This could provide a useful tool for designing an EIT system. Special attention has been given to the current source’s output impedance and swing, to the noise produced by the circuits and to the Analog to Digital Converters (ADCs) resolution and sampling rate. Furthermore, some 3D phantom subjects have been modeled and simulated as equivalent circuits, merged with the EIT simulated hardware, in order to observe how changes on their properties interact with the whole circuitry and affect the final result. Observations show that mirrored current sources with z o u t > 350 k Ω and sufficiently high ADC acquisition sampling rate ( f s a m p l e ≥ 16 f i n ) can result to accurate impedance measurements and therefore quality image reconstruction within a frequency span of at least 10 to 100 kHz. Moreover, possible hardware failures (electrode disconnections and imbalanced contact impedances) can be detected with a simple examination of the first extracted image and measurement set, so that by direct modification of the reconstruction process, a corrected result can be obtained.

On the Implementation of Simultaneous Multi-Frequency Excitations and Measurements for Electrical Impedance Tomography

The investigation of quickly-evolving flow patterns in high-pressure and high-temperature flow rigs requires the use of a high-speed and non-intrusive imaging technique. Electrical Impedance Tomography (EIT) allows reconstructing the admittivity distribution characterizing a flow from the knowledge of currents and voltages on its periphery. The need for images at high frame rates leads to the strategy of simultaneous multi-frequency voltage excitations and simultaneous current measurements, which are discriminated using fast Fourier transforms. The present study introduces the theory for a 16-electrode simultaneous EIT system, which is then built based on a field programmable gate array data acquisition system. An analysis of the propagation of uncertainties through the measurement process is investigated, and experimental results with fifteen simultaneous signals are presented. It is shown that the signals are successfully retrieved experimentally at a rate of 1953 frames per second. The associated signal-to-noise ratio varies from 59.6–69.1 dB, depending on the generated frequency. These preliminary results confirm the relevance and the feasibility of simultaneous multi-frequency excitations and measurements in EIT as a means to significantly increase the imaging rate.

A Power Adaptive, 1.22-pW/Hz, 10-MHz Read-Out Front-End for Bio-Impedance Measurement

This paper presents a read-out front-end application-specific integrated circuit (ASIC) for the measurement of tissue impedances. The 10 mm² 2-channel front-end ASIC is fabricated in a 0.18 μm CMOS technology. The measurement results show that the proposed ASIC operates over a frequency range of 100 Hz up to 10 MHz. The ASIC has 1.22 pW/Hz power performance, with an SNR over 72 dB for frequencies ≤ 1 MHz, and over 65 dB SNR for frequencies ≥ 1 MHz. The total measured power consumption of the read-out front-end is shown to range from 2.1 to 21.7 mW depending on the input frequency. To achieve a wide dynamic range, the instrumentation amplifier has an adaptive gain control feature, and it employs programmable bias currents and reconfigurable structure to save power while processing low-frequency signals. A dual digital-to-analog converter (DAC) hybrid SAR analog-to-digital converter (ADC) is presented that reduces the power consumption of the ADC driver by sevenfold for frequencies between 4 kHz and 1 MHz.

Noise-robust bioimpedance approach for cardiac output measurement

OBJECTIVE

Congestive heart failure is a problem affecting millions of Americans. A continuous, non-invasive, telemonitoring device that can accurately monitor cardiac metrics could greatly help this population, reducing unnecessary hospitalizations and cost.

APPROACH

Machine learning (ML) algorithms trained on electrical-impedance tomography (EIT) data are presented for portable cardiac monitoring. The approach was validated on a simulated thorax and a measured tank experiment. A highly detailed 4D chest model (finite element method mesh and conductivity profiles) was developed utilizing the 4D XCAT phantom to provide realistic data. The ML algorithms were trained using databases that assumed the presence of poorly contacting electrodes without any assumptions of knowing which electrodes would be bad in the experiment. The trained ML algorithms were compared to EIT evaluated with and without removing bad electrodes.

MAIN RESULTS

A regression support vector machine and a deep neural network (DNN) were found to be the most accurate and robust to poorly contacting electrodes while not needing to know which electrodes were in poor contact in the simulated and measured experiments, respectively.

SIGNIFICANCE

Although the ML algorithms are not always better than EIT (with bad electrodes removed), the comparable results without needing a priori knowledge of which electrodes are bad is seen as a very promising feature. An evaluation of computational costs showed that the DNN required comparable computational power to the other methods while requiring less memory, which could make the DNNs an attractive algorithm for a low-power, portable system. This work represents an important validation of the method using measured data, and model development, which is needed to apply this method on real clinical data. Additionally, the developed 4D simulated thorax model could be an important tool within the EIT community.

Toward Electrical Impedance Tomography Coupled Ultrasound Imaging for Assessing Muscle Health

This paper establishes for the first time that a coupled ultrasound (US) and electrical impedance tomography (EIT) system can serve as a non-invasive, spatially localized approach to extract clinically relevant muscle properties. The US/EIT system represents a potential enhancement to electrical impedance myography (EIM), which has shown promise as a non-invasive technology that may have important clinical use in indicating neuromuscular disease status and as a diagnostic tool. A 2.5D EIT algorithm evaluated on simulation, measured phantoms, and measured patient data was studied to evaluate US/EIT's ability to distinguish different aspects of muscle tissue. Simulated and phantom experiments revealed the depths of distinguishability of 3.2 and 4.2 mm in simulation for 10% and 20% changes in muscle properties, respectively, and 3.6 mm in measured phantom experiments assuming a 12% muscle conductivity change. Reconstructions from the patient data established that there were consistent differences 1) between longitudinal (along) and transverse (across) muscle conductivity reconstructions at frequencies of 40 and 80 kHz and 2) side-by-side comparison between healthy and diseased tissue in terms of conductivity, permittivity, and phase at 40 and 80 kHz. Comparisons were made between the EIT reconstructed values and electrical impedance spectroscopy (EIS) measurements (an available surrogate in place of standard EIM measurements) made with the US/EIT system, wherein 1) EIS and EIT show similar sensitivity to longitudinal and transverse differences and 2) EIT showed a more consistent ability to differentiate healthy and diseased tissue. These results suggest that US/EIT appears very promising for non-invasive and spatially localized diagnosis of muscle health.

Multi-frequency electrical impedance tomography and neuroimaging data in stroke patients

Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which has the potential to expedite the differentiation of ischaemic or haemorrhagic stroke, decreasing the time to treatment. Whilst demonstrated in simulation, there are currently no suitable imaging or classification methods which can be successfully applied to human stroke data. Development of these complex methods is hindered by a lack of quality Multi-Frequency EIT (MFEIT) data. To address this, MFEIT data were collected from 23 stroke patients, and 10 healthy volunteers, as part of a clinical trial in collaboration with the Hyper Acute Stroke Unit (HASU) at University College London Hospital (UCLH). Data were collected at 17 frequencies between 5 Hz and 2 kHz, with 31 current injections, yielding 930 measurements at each frequency. This dataset is the most comprehensive of its kind and enables combined analysis of MFEIT, Electroencephalography (EEG) and Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) data in stroke patients, which can form the basis of future research into stroke classification.

A Multichannel Real-Time Bioimpedance Measurement Device for Pulse Wave Analysis

Pulse wave analysis is an important method used to gather information about the cardiovascular system. Instead of detecting the pulse wave via pressure sensors, bioimpedance measurements can be performed to acquire minuscule changes in the conductivity of the tissue, caused by the pulse wave. This work presents a microcontroller-based bioimpedance measurement system, which has the capability to acquire impedance measurements from up to four independent channels simultaneously. By combining a problem-specific analog measurement circuit with a 24 bits analog-to-digital converter, the system is capable of acquiring 1000 impedances per second with a signal-to-noise ratio in a range from 92 to 96 dB. For data storage and analysis, the digitized data are sent via universal serial bus to a host PC. A graphical user interface filters and plots the data of all channels in real-time. The performance of the system regarding measuring constant impedances, as well as impedance changes over time is demonstrated. Two different applications for pulse wave analysis via multichannel bioimpedance measurements are presented. Additionally, first measurement results from a human subject are shown to demonstrate the system's applicability of analyzing the pulse wave morphology as well as the aortic pulse wave velocity.

Fused-data transrectal EIT for prostate cancer imaging

OBJECTIVE

Prostate cancer is a significant problem affecting 1 in 7 men. Unfortunately, the diagnostic gold-standard of ultrasound-guided biopsy misses 10%-30% of all cancers. The objective of this study was to develop an electrical impedance tomography (EIT) approach that has the potential to image the entire prostate using multiple impedance measurements recorded between electrodes integrated onto an end-fired transrectal ultrasound (TRUS) device and a biopsy probe (BP).

APPROACH

Simulations and sensitivity analyses were used to investigate the best combination of electrodes, and measured tank experiments were used to evaluate a fused-data transrectal EIT (fd-TREIT) and BP approach.

MAIN RESULTS

Simulations and sensitivity analysis revealed that (1) TREIT measurements are not sufficiently sensitive to image the whole prostate, (2) the combination of TREIT  +  BP measurements increases the sensitive region of TREIT-only measurements by 12×, and (3) the fusion of multiple TREIT  +  BP measurements collected during a routine or customized 12-core biopsy procedure can cover up to 76.1% or 94.1% of a nominal 50 cm³ prostate, respectively. Three measured tank experiments of the fd-TREIT  +  BP approach successfully and accurately recovered the positions of 2-3 metal or plastic inclusions.

SIGNIFICANCE

The measured tank experiments represent important steps in the development of an algorithm that can combine EIT from multiple locations and from multiple probes-data that could be collected during a routine TRUS-guided 12-core biopsy. Overall, this result is a step towards a clinically deployable impedance imaging approach to scanning the entire prostate, which could significantly help to improve prostate cancer diagnosis.

A 10 MHz Read-Out Chain for Electrical Impedance Tomography

This paper presents the design and implementation of a read-out chain for electrical impedance tomography (EIT) imaging. The EIT imaging approach can be incorporated to take spectral images of the tissue under study, offering an affordable, portable device for home health monitoring. A fast read-out channel covering a wide range of frequencies is a must for such applications. The proposed read-out channel comprising a programmable gain instrumentation amplifier, an analog-to-digital converter (ADC), and an ADC driver is designed and fabricated in a 0.18  m CMOS technology. The proposed read-out chain operates over the wide frequency range of 100 Hz to 10 MHz, with an average signal-to-noise ratio of more than 60 dB. The entire read-out channel consumes between 6.9 and 21.8 mW, depending on its frequency of operation.

Howland current source for high impedance load applications

For Electrical Impedance Spectroscopy (EIS) applications, the Enhanced Howland Current Source (EHCS) is a popular choice as an excitation circuit due to its simplicity, reliability, and safety. However, its output impedance degradation at high frequency leads to errors that are unacceptable for high load impedance applications, such as the ones which use dry or microelectrodes. Based on a proposed mathematical model, this work designed an EHCS circuit which includes an output current buffer and frequency compensation. PSpice simulations were performed as proof of concept, and then the measured data were collected for comparison. For the proposed circuit, called here Load-in-the-Loop Compensated Enhanced Howland Source (LLC-EHCS), the results showed that the output current errors are lower than 1% up to 3.7 MHz over the load range of 560-2200 Ω and 1.2 MHz with 5.6 kΩ. On the other hand, for the case of the standard EHCS circuit, these frequencies are 170 and 80 kHz, respectively. Also, the output linear swing was found to be 3 times higher than the EHCS. It can be concluded that the proposed LLC-EHCS may be widely used as an excitation circuit for high load and wide bandwidth EIS applications.

Design of current source for multi-frequency simultaneous electrical impedance tomography

Multi-frequency electrical impedance tomography has been evolving from the frequency-sweep approach to the multi-frequency simultaneous measurement technique which can reduce measuring time and will be increasingly attractive for time-varying biological applications. The accuracy and stability of the current source are the key factors determining the quality of the image reconstruction. This article presents a field programmable gate array-based current source for a multi-frequency simultaneous electrical impedance tomography system. A novel current source circuit was realized by combining the classic current mirror based on the feedback amplifier AD844 with a differential topology. The optimal phase offsets of harmonic sinusoids were obtained through the crest factor analysis. The output characteristics of this current source were evaluated by simulation and actual measurement. The results include the following: (1) the output impedance was compared with one of the Howland pump circuit in simulation, showing comparable performance at low frequencies. However, the proposed current source makes lower demands for resistor tolerance but performs even better at high frequencies. (2) The output impedance in actual measurement below 200 kHz is above 1.3 MΩ and can reach 250 KΩ up to 1 MHz. (3) An experiment based on a biological RC model has been implemented. The mean error for the demodulated impedance amplitude and phase are 0.192% and 0.139°, respectively. Therefore, the proposed current source is wideband, biocompatible, and high precision, which demonstrates great potential to work as a sub-system in the multi-frequency electrical impedance tomography system.

Signal-to-Noise Ratio Analysis of a Phase-Sensitive Voltmeter for Electrical Impedance Tomography

In this paper, thorough analysis along with mathematical derivations of the matched filter for a voltmeter used in electrical impedance tomography systems are presented. The effect of the random noise in the system prior to the matched filter, generated by other components, are considered. Employing the presented equations allow system/circuit designers to find the maximum tolerable noise prior to the matched filter that leads to the target signal-to-noise ratio (SNR) of the voltmeter, without having to over-design internal components. A practical model was developed that should fall within 2 dB and 5 dB of the median SNR measurements of signal amplitude and phase, respectively. In order to validate our claims, simulation and experimental measurements have been performed with an analog-to-digital converter (ADC) followed by a digital matched filter, while the noise of the whole system was modeled as the input referred at the ADC input. The input signal was contaminated by a known value of additive white Gaussian noise (AWGN) noise, and the noise level was swept from 3% to 75% of the least significant bit (LSB) of the ADC. Differences between experimental and both simulated and analytical SNR values were less than 0.59 and 0.35 dB for RMS values ≥ 20% of an LSB and less than 1.45 and 2.58 dB for RMS values < 20% of an LSB for the amplitude and phase, respectively. Overall, this study provides a practical model for circuit designers in EIT, and a more accurate error analysis that was previously missing in EIT literature.

Absolute Reconstructions Using Rotational Electrical Impedance Tomography for Breast Cancer Imaging

A rotational Electrical Impedance Tomography (rEIT) methodology is described and shown to produce spatially accurate absolute reconstructions with improved image contrast and an improved ability to distinguish closely spaced inclusions compared to traditional EIT on data recorded from cylindrical and breast-shaped tanks. Rotations of the tank without altering the interior conductivity distribution are used to produce the rEIT data. Quantitatively, rEIT was able to distinguish two inclusions that were 1.5 cm closer together than traditional EIT could achieve for inclusions placed 2 to 3 cm from the center for the cylindrical tank, and rEIT was able to distinguish two tumor-like inclusions where traditional EIT could not reliably do so. Mathematical analysis showed that rEIT improves the number of stable singular vectors by up to 4.2 and 4.7 times than that of traditional EIT for the cylindrical and breast-shaped tanks, respectively, which is an indication of improved resolution. Direct investigations into measurements revealed minimum rotation angles that should yield data uncorrupted by noise. Two inverse approaches (one that inverts then fuses the data (I/DF) and one that fuses the data then inverts (DF/I)) and two mesh modeling approaches were considered. It was found that DF/I produces far better results compared to I/DF and a rotated-mesh approach produces further improvements. The ability to obtain improved absolute reconstructions using rEIT on a practical clinical scenario (breast-shaped tank experiment) is an important step towards using rEIT to improve previous EIT results in medical applications.

Comparative study of separation between ex vivo prostatic malignant and benign tissue using electrical impedance spectroscopy and electrical impedance tomography

OBJECTIVE

Currently no efficient and reliable technique exists to routinely assess surgical margins during a radical prostatectomy. Electrical impedance spectroscopy (EIS) has been reported as a potential technique to provide surgeons with real-time intraoperative margin assessment. In addition to providing a quantified measure of margin status, a co-registered electrical impedance tomography (EIT) image presented on a surgeon's workstation could add value to the margin assessment process.

APPROACH

To investigate this, we conducted a comparative study between EIS and EIT to evaluate the potential these technologies might have for margin assessment. EIS and EIT data was acquired from ex vivo human prostates using a multi-electrode endoscopic impedance acquisition probe.

MAIN RESULTS

EIS and EIT show good predictive performance with a 0.76 and 0.80 area-under-curve (AUC), respectively, when considering discrete frequencies only. A machine learning (ML) algorithm is implemented to combine features, which improves the AUCs of EIS and EIT to 0.84 and 0.85, respectively. Single-step EIT takes significantly less time to reconstruct than multi-step EIT, yet provides similarly accurate classification results, making the single-step approach a potential candidate for real-time margin assessment. While the ML-based approach clearly exhibits benefits as compared to the single feature assessment, the decision to use EIS versus EIT is unclear since each approach performs better for different subsets of tissue classifications.

SIGNIFICANCE

The results presented in this paper corroborate our previous studies and present the strongest evidence yet that an intraoperative-capable impedance probe can be used to distinguish benign from malignant prostate tissues. An in vivo study with a large cohort will be necessary to definitively determine the preferred approach and to show the clinical effectiveness of using this technology for margin assessment.

A Versatile and Reproducible Multi-Frequency Electrical Impedance Tomography System

A highly versatile Electrical Impedance Tomography (EIT) system, nicknamed the ScouseTom, has been developed. The system allows control over current amplitude, frequency, number of electrodes, injection protocol and data processing. Current is injected using a Keithley 6221 current source, and voltages are recorded with a 24-bit EEG system with minimum bandwidth of 3.2 kHz. Custom PCBs interface with a PC to control the measurement process, electrode addressing and triggering of external stimuli. The performance of the system was characterised using resistor phantoms to represent human scalp recordings, with an SNR of 77.5 dB, stable across a four hour recording and 20 Hz to 20 kHz. In studies of both haeomorrhage using scalp electrodes, and evoked activity using epicortical electrode mats in rats, it was possible to reconstruct images matching established literature at known areas of onset. Data collected using scalp electrode in humans matched known tissue impedance spectra and was stable over frequency. The experimental procedure is software controlled and is readily adaptable to new paradigms. Where possible, commercial or open-source components were used, to minimise the complexity in reproduction. The hardware designs and software for the system have been released under an open source licence, encouraging contributions and allowing for rapid replication.

Prostate Cancer Detection Using Composite Impedance Metric

Prostate cancer (PCa) recurrences are often predicted by assessing the status of surgical margins (SM)- positive surgical margins (PSM) increase the chances of biochemical recurrence by 2-4 times which may lead to PCa recurrence. To this end, an electrical impedance acquisition system with a microendoscopic probe was employed in an ex-vivo study of human prostates. This system measures the tissue bioimpedance over a range of frequencies (1 kHz to 1MHz), and computes a number of Composite Impedance Metrics (CIM). A classifier trained using CIM data can be used to classify tissue as benign or cancerous. The system was used to collect the impedance spectra from 14 excised prostates, which were obtained from men undergoing radical prostatectomy, for a total of 23 cancerous and 53 benign measurements. The data revealed statistically significant (p < 0.05) differences in the impedance properties of the benign and tumorous tissues, and among the measurements taken on the apical, base, and lateral surface of the prostate. Further, in the leave-one-patient-out cross validation, a maximum predictive accuracy of 90.79% was achieved by combining high frequency CIM phase data to train a support vector machine classifier with a radial basis function kernel. The observations are consistent with the physiology and morphology of benign and malignant prostate tissue. CIMs were found to be an effective tool in distinguishing benign from cancerous tissues.

A Novel Regularization Technique for Microendoscopic Electrical Impedance Tomography

A novel regularization technique is developed for end-fired microendoscopic electrical impedance tomography using the dual-mesh method. The new regularization technique coupled with appropriate forward modeling and inverse mesh design is shown to produce dramatically improved reconstructions over previous methods. 3D absolute and difference reconstructions from measured saline tank and ex vivo adipose and muscle tissue experiments are used to validate the approach. The ex vivo experiments are used as a surrogate for prostate tissue, which is the primary clinical application for the probe. Inclusion center of mass errors were less than 0.47 mm for tank experiments with inclusion depths and radial offsets ranging less than 3 mm and 1.5 mm, respectively. Absolute 3D reconstructions on the tissue show quantitatively good accuracy and the ability to spatially distinguish small tissue features (adipose strands of approximately 2.5 mm in width). The reconstruction algorithm developed provides strong evidence for the promise of surgical margin detection using microendoscopic EIT.

Electronic hardware design of electrical capacitance tomography systems

Electrical tomography techniques for process imaging are very prominent for industrial applications, such as the oil and gas industry and chemical refineries, owing to their ability to provide the flow regime of a flowing fluid within a relatively high throughput. Among the various techniques, electrical capacitance tomography (ECT) is gaining popularity due to its non-invasive nature and its capability to differentiate between different phases based on their permittivity distribution. In recent years, several hardware designs have been provided for ECT systems that have improved its resolution of measurements to be around attofarads (aF, 10(-18) F), or the number of channels, that is required to be large for some applications that require a significant amount of data. In terms of image acquisition time, some recent systems could achieve a throughput of a few hundred frames per second, while data processing time could be achieved in only a few milliseconds per frame. This paper outlines the concept and main features of the most recent front-end and back-end electronic circuits dedicated for ECT systems. In this paper, multiple-excitation capacitance polling, a front-end electronic technique, shows promising results for ECT systems to acquire fast data acquisition speeds. A highly parallel field-programmable gate array (FPGA) based architecture for a fast reconstruction algorithm is also described. This article is part of the themed issue 'Supersensing through industrial process tomography'.

3D Microendoscopic Electrical Impedance Tomography for Margin Assessment During Robot-Assisted Laparoscopic Prostatectomy

Radially configured microendoscopic electrical impedance probes intended for intraoperative surgical margin assessment during robot-assisted laparoscopic prostatectomy (RALP) were examined through simulation, bench-top experimentation, and ex vivo tissue studies. Three probe designs with 8, 9, and 17 electrodes, respectively, were analyzed through finite element method based simulations. One mm diameter spherical inclusions ( σinclusion = 1 S/m) are positioned at various locations within a hemispherical background ( σbackground = 0.1 S/m) of radius 5 mm. An 8-electrode configuration is not able to localize the inclusion at these positions while 9 and 17-electrode configurations are able to accurately reconstruct the inclusion at maximum depth of 1 mm and 3 mm, respectively. All three probe designs were constructed and evaluated using saline phantoms and ex vivo porcine and human prostate tissues. The 17-electrode probe performed best in saline phantom studies, accurately reconstructing high contrast, 1-mm-diameter metal cylindrical inclusions in a saline bath ( σsaline = 0.1 S/m) with a position and area error of 0.46 mm and 0.84 mm2, respectively. Additionally, the 17-electrode probe was able to adequately distinguish cancerous from benign tissues in three ex vivo human prostates. Simulations, bench-top saline experiments, and ex vivo tissue sampling suggest that for intraoperative surgical margin assessment during RALP, the 17-electrode probe (as compared to an 8 and 9 electrode probe) will be necessary to provide sufficient accuracy and sensitivity.