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Zhu CZ, Ting HN, Ng KH, Mun KS, Ong TA. Dielectric properties of urine in relation to bladder cancer. Phys Eng Sci Med 2024; 47:61-71. [PMID: 37843766 DOI: 10.1007/s13246-023-01341-5] [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: 06/07/2023] [Accepted: 09/17/2023] [Indexed: 10/17/2023]
Abstract
Many studies have investigated the dielectric properties of human and animal tissues, particularly to differentiate between normal cells and tumors. However, these studies are invasive as tissue samples have to be excised to measure the properties. This study aims to investigate the dielectric properties of urine in relation to bladder cancer, which is safe and non-invasive to patients. 30 healthy subjects and 30 bladder cancer patients were recruited. Their urine samples were subjected to urinalysis and cytology assessment. A vector network analyzer was used to measure the dielectric constant (Ɛ') and loss factor (Ɛ″) at microwave frequencies of between 0.2 and 50 GHz at 25 °C, 30 °C and 37 °C. Significant differences in Ɛ' and Ɛ″ were observed between healthy subjects and patients, especially at frequencies of between 25 and 40 GHz at 25 °C. Bladder cancer patients had significant lower Ɛ' and higher Ɛ″ compared with healthy subjects. The Ɛ' was negatively correlated with urinary exfoliated urothelial cell number, and Ɛ″ was positively correlated. The study achieved a receiver operating characteristic area under curve (ROC-AUC) score of 0.69099 and an optimum accuracy of 75% with a sensitivity of 80% and a specificity of 70%. The number of exfoliated urothelial cell had significant effect on the dielectric properties, especially in bladder cancer patients. Urinary dielectric properties could potentially be used as a tool to detect bladder cancer.
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Affiliation(s)
- Chao-Zhe Zhu
- School of Medical Engineering, Jining Medical University, Jining, Shandong, China
| | - Hua-Nong Ting
- School of Medical Engineering, Jining Medical University, Jining, Shandong, China.
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Kwan-Hoong Ng
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Science, UCSI University, Springhill, Negri Sembilan, Malaysia
| | - Kein-Seong Mun
- Department of Pathology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Teng-Aik Ong
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Wang HHS, Thaker H, Bigger-Allen A, Nagy JA, Rutkove SB. Novel phenotype characterization utilizing electrical impedance myography signatures in murine spinal cord injury neurogenic bladder models. Sci Rep 2023; 13:19520. [PMID: 37945675 PMCID: PMC10636012 DOI: 10.1038/s41598-023-46740-6] [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: 05/16/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
Neurogenic bladder (NB) affects people of all ages. Electric impedance myography (EIM) assesses localized muscle abnormalities. Here, we sought to investigate whether unique detrusor EIM signatures are present in NB due to spinal cord injury (SCI). Twenty-eight, 8-10 weeks old, C57BL/6J female mice were studied. Twenty underwent spinal cord transection; 8 served as controls. Cohorts were euthanized at 4 and 6 weeks after spinal cord transection. Each bladder was measured in-situ with EIM with applied frequencies of 1 kHz to 10 MHz, and then processed for molecular and histologic study. SCI mice had greater bladder-to-body weight ratio (p < 0.0001), greater collagen deposition (p = 0.009), and greater smooth-muscle-myosin-heavy-chain isoform A/B ratio (p < 0.0001). Compared with the control group, the SCI group was associated with lower phase, reactance, and resistance values (p < 0.01). Significant correlations (p < 0.001) between bladder-to-body weight ratios and EIM measurements were observed across the entire frequency spectrum. A severely hypertrophied phenotype was characterized by even greater bladder-to-body weight ratios and more depressed EIM values. Our study demonstrated distinct EIM alterations in the detrusor muscle of mice with NB due to SCI. With further refinement, EIM may offer a potential point-of-care tool for the assessment of NB and its response to treatment.
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Affiliation(s)
- Hsin-Hsiao Scott Wang
- Department of Urology, Boston Children's Hospital, 300 Longwood Ave, HU390, Boston, MA, USA.
- Harvard Medical School, Boston, MA, 02215, USA.
| | - Hatim Thaker
- Department of Urology, Boston Children's Hospital, 300 Longwood Ave, HU390, Boston, MA, USA
- Harvard Medical School, Boston, MA, 02215, USA
| | - Alex Bigger-Allen
- Department of Urology, Boston Children's Hospital, 300 Longwood Ave, HU390, Boston, MA, USA
| | - Janice A Nagy
- Harvard Medical School, Boston, MA, 02215, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Seward B Rutkove
- Harvard Medical School, Boston, MA, 02215, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Meani F, Barbalace G, Meroni D, Pagani O, Perriard U, Pagnamenta A, Aliverti A, Meroni E. Electrical Impedance Spectroscopy for Ex-Vivo Breast Cancer Tissues Analysis. Ann Biomed Eng 2023:10.1007/s10439-023-03159-4. [PMID: 37061594 DOI: 10.1007/s10439-023-03159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/02/2023] [Indexed: 04/17/2023]
Abstract
This paper describes a cancer detection procedure based on customised electrical impedance spectroscopy (EIS) in breast cancer surgical samples and an analysis of its outcomes. A tissue analyser was developed to inject a low-amplitude alternating current with penetrating electrodes into breast specimens along a broad spectrum of frequencies. Experimental measurements were carried out on more than one hundred excised breast cancer specimens, with the goal of discriminating between the tumour and surrounding non-neoplastic tissue. The probe was inserted in different locations immediately after surgical excision in order to measure tissue impedance (modulus and phase). Electrical impedance varied significantly between neoplastic and surrounding non-neoplastic tissues, with a low standard deviation among the different measurements, confirming good reproducibility. Tumours could be discriminated from non-neoplastic tissues according to their impedance modulus value for high frequencies and phase value for low frequencies. Impedance also varied significantly in both non-neoplastic and tumour tissues depending on the patient's age and tumour characteristics, such as size and histological sub-type. EIS is able to discriminate between healthy tissue and cancer. Future developments of this technology could be exploited for intraoperative real-time evaluation of the transition zone between cancer and normal tissues.
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Affiliation(s)
- Francesco Meani
- Centro di Senologia della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
- Centro di Competenza Senologica, Gruppo Ospedaliero Moncucco, Lugano, Switzerland.
| | - Giuseppe Barbalace
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Innovative Integrated Instrumentation for Nanoscience (I3N), Politecnico di Milano, Via Giuseppe Colombo 81, 20133, Milan, Italy.
| | - Davide Meroni
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Innovative Integrated Instrumentation for Nanoscience (I3N), Politecnico di Milano, Via Giuseppe Colombo 81, 20133, Milan, Italy
| | - Olivia Pagani
- Centro di Senologia della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Ulrike Perriard
- Centro di Senologia della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Istituto di Patologia Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Alberto Pagnamenta
- Intensive Care Unit, Regional Hospital Mendrisio, Mendrisio, Switzerland
- Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Innovative Integrated Instrumentation for Nanoscience (I3N), Politecnico di Milano, Via Giuseppe Colombo 81, 20133, Milan, Italy
| | - Emanuele Meroni
- Unit of Gastroenterology, Regional Hospital Mendrisio, Mendrisio, Switzerland
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Di Gregorio E, Israel S, Staelens M, Tankel G, Shankar K, Tuszyński JA. The distinguishing electrical properties of cancer cells. Phys Life Rev 2022; 43:139-188. [PMID: 36265200 DOI: 10.1016/j.plrev.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
In recent decades, medical research has been primarily focused on the inherited aspect of cancers, despite the reality that only 5-10% of tumours discovered are derived from genetic causes. Cancer is a broad term, and therefore it is inaccurate to address it as a purely genetic disease. Understanding cancer cells' behaviour is the first step in countering them. Behind the scenes, there is a complicated network of environmental factors, DNA errors, metabolic shifts, and electrostatic alterations that build over time and lead to the illness's development. This latter aspect has been analyzed in previous studies, but how the different electrical changes integrate and affect each other is rarely examined. Every cell in the human body possesses electrical properties that are essential for proper behaviour both within and outside of the cell itself. It is not yet clear whether these changes correlate with cell mutation in cancer cells, or only with their subsequent development. Either way, these aspects merit further investigation, especially with regards to their causes and consequences. Trying to block changes at various levels of occurrence or assisting in their prevention could be the key to stopping cells from becoming cancerous. Therefore, a comprehensive understanding of the current knowledge regarding the electrical landscape of cells is much needed. We review four essential electrical characteristics of cells, providing a deep understanding of the electrostatic changes in cancer cells compared to their normal counterparts. In particular, we provide an overview of intracellular and extracellular pH modifications, differences in ionic concentrations in the cytoplasm, transmembrane potential variations, and changes within mitochondria. New therapies targeting or exploiting the electrical properties of cells are developed and tested every year, such as pH-dependent carriers and tumour-treating fields. A brief section regarding the state-of-the-art of these therapies can be found at the end of this review. Finally, we highlight how these alterations integrate and potentially yield indications of cells' malignancy or metastatic index.
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Affiliation(s)
- Elisabetta Di Gregorio
- Dipartimento di Ingegneria Meccanica e Aerospaziale (DIMEAS), Politecnico di Torino, Corso Duca degli Abruzzi, 24, Torino, 10129, TO, Italy; Autem Therapeutics, 35 South Main Street, Hanover, 03755, NH, USA
| | - Simone Israel
- Dipartimento di Ingegneria Meccanica e Aerospaziale (DIMEAS), Politecnico di Torino, Corso Duca degli Abruzzi, 24, Torino, 10129, TO, Italy; Autem Therapeutics, 35 South Main Street, Hanover, 03755, NH, USA
| | - Michael Staelens
- Department of Physics, University of Alberta, 11335 Saskatchewan Drive NW, Edmonton, T6G 2E1, AB, Canada
| | - Gabriella Tankel
- Department of Mathematics & Statistics, McMaster University, 1280 Main Street West, Hamilton, L8S 4K1, ON, Canada
| | - Karthik Shankar
- Department of Electrical & Computer Engineering, University of Alberta, 9211 116 Street NW, Edmonton, T6G 1H9, AB, Canada
| | - Jack A Tuszyński
- Dipartimento di Ingegneria Meccanica e Aerospaziale (DIMEAS), Politecnico di Torino, Corso Duca degli Abruzzi, 24, Torino, 10129, TO, Italy; Department of Physics, University of Alberta, 11335 Saskatchewan Drive NW, Edmonton, T6G 2E1, AB, Canada; Department of Oncology, University of Alberta, 11560 University Avenue, Edmonton, T6G 1Z2, AB, Canada.
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Jeong HJ, Kim K, Kim HW, Park Y. Classification between Normal and Cancerous Human Urothelial Cells by Using Micro-Dimensional Electrochemical Impedance Spectroscopy Combined with Machine Learning. SENSORS (BASEL, SWITZERLAND) 2022; 22:7969. [PMID: 36298320 PMCID: PMC9610759 DOI: 10.3390/s22207969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Although the high incidence and recurrence rates of urothelial cancer of the bladder (UCB) are heavy burdens, a noninvasive tool for effectively detecting UCB as an alternative to voided urine cytology, which has low sensitivity, is yet to be reported. Herein, we propose an intelligent discrimination method between normal (SV-HUC-1) and cancerous (TCCSUP) urothelial cells by using a combination of micro-dimensional electrochemical impedance spectroscopy (µEIS) with machine learning (ML) for a noninvasive and high-accuracy UCB diagnostic tool. We developed a unique valved flow cytometry, equipped with a pneumatic valve to increase sensitivity without cell clogging. Since contact between a cell and electrodes is tight with a high volume fraction, the electric field can be effectively confined to the cell. This enables the proposed sensor to highly discriminate different cell types at frequencies of 10, 50, 100, 500 kHz, and 1 MHz. A total of 236 impedance spectra were applied to six ML models, and systematic comparisons of the ML models were carried out. The hyperparameters were estimated by conducting a grid search or Bayesian optimization. Among the ML models, random forest strongly discriminated between SV-HUC-1 and TCCSUP, with an accuracy of 91.7%, sensitivity of 92.9%, precision of 92.9%, specificity of 90%, and F1-score of 93.8%.
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Affiliation(s)
- Ho-Jung Jeong
- Lighting Materials and Components Research Center, Korea Photonics Technology Institute (KOPTI), Gwangju 61007, Korea
| | - Kihyun Kim
- Department of Mechanical Design Engineering, Chonnam National University, 50 Daehak-ro, Yeosu 59626, Korea
| | - Hyeon Woo Kim
- Department of Urology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
- Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
| | - Yangkyu Park
- Department of Mechanical Design Engineering, Chonnam National University, 50 Daehak-ro, Yeosu 59626, Korea
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Anushree U, Shetty S, Kumar R, Bharati S. Adjunctive Diagnostic Methods for Skin Cancer Detection: A Review of Electrical Impedance-Based Techniques. Bioelectromagnetics 2022; 43:193-210. [PMID: 35181899 DOI: 10.1002/bem.22396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/06/2021] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
Skin cancer is among the fastest-growing cancers with an excellent prognosis, if detected early. However, the current method of diagnosis by visual inspection has several disadvantages such as overlapping tumor characteristics, subjectivity, low sensitivity, and specificity. Hence, several adjunctive diagnostic techniques such as thermal imaging, optical imaging, ultrasonography, tape stripping methods, and electrical impedance imaging are employed along with visual inspection to improve the diagnosis. Electrical impedance-based skin cancer detection depends upon the variations in electrical impedance characteristics of the transformed cells. The information provided by this technique is fundamentally different from other adjunctive techniques and thus has good prospects. Depending on the stage, type, and location of skin cancer, various impedance-based devices have been developed. These devices when used as an adjunct to visual methods have increased the sensitivity and specificity of skin cancer detection up to 100% and 87%, respectively, thus demonstrating their potential to minimize unnecessary biopsies. In this review, the authors track the advancements and progress made in this technique for the detection of skin cancer, focusing mainly on the advantages and limitations in the clinical setting. © 2022 Bioelectromagnetics Society.
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Affiliation(s)
- U Anushree
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sachin Shetty
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanjay Bharati
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Blößer S, May A, Welsch L, Ast M, Braun S, Velten T, Biehl M, Tschammer J, Roeb E, Knabe M. Virtual Biopsy by Electrical Impedance Spectroscopy in Barrett's Carcinoma. J Gastrointest Cancer 2021; 53:948-957. [PMID: 34559362 PMCID: PMC9630236 DOI: 10.1007/s12029-021-00703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/25/2022]
Abstract
Purpose Early detection of adenocarcinomas in the esophagus is crucial for achieving curative endoscopic therapy. Targeted biopsies of suspicious lesions, as well as four-quadrant biopsies, represent the current diagnostic standard. However, this procedure is time-consuming, cost-intensive, and examiner-dependent. The aim of this study was to test whether impedance spectroscopy is capable of distinguishing between healthy, premalignant, and malignant lesions. An ex vivo measurement method was developed to examine esophageal lesions using impedance spectroscopy immediately after endoscopic resection. Methods After endoscopic resection of suspicious lesions in the esophagus, impedance measurements were performed on resected cork-covered tissue using a measuring head that was developed, with eight gold electrodes, over 10 different measurement settings and with frequencies from 100 Hz to 1 MHz. Results A total of 105 measurements were performed in 60 patients. A dataset of 400 per investigation and a total of more than 42,000 impedance measurements were therefore collected. Electrical impedance spectroscopy (EIS) was able to detect dysplastic esophageal mucosa with a sensitivity of 81% in Barrett’s esophagus. Conclusion In summary, EIS was able to distinguish different tissue characteristics in the different esophageal tissues. EIS thus holds potential for further development of targeted biopsies during surveillance endoscopy. Trial Registration NCT04046601
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Affiliation(s)
- Sandra Blößer
- Department of Medicine II, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany
- Department of Medicine I, Asklepios Paulinen Klinik Wiesbaden, Geisenheimer Strasse 10, 65197, Wiesbaden, Germany
| | - Andrea May
- Department of Medicine II, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany
- Department of Medicine I, Asklepios Paulinen Klinik Wiesbaden, Geisenheimer Strasse 10, 65197, Wiesbaden, Germany
| | - Lukas Welsch
- Department of Gastroenterology, Medizinische Klinik I, University Hospital, Goethe University, Frankfurt, Germany, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Michael Ast
- Stockert GmbH, Bötzinger Strasse 72, 79111, Freiburg, Germany
| | - Susanne Braun
- Institute of Pathology, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany
| | - Thomas Velten
- Fraunhofer Institute for Biomedical Engineering (IBMT), Ensheimer Strasse 48, 66386, St. Ingbert, Germany
| | - Margit Biehl
- Fraunhofer Institute for Biomedical Engineering (IBMT), Ensheimer Strasse 48, 66386, St. Ingbert, Germany
| | - Jonas Tschammer
- Institute for Medical Informatics, Justus Liebig University of Giessen, Rudolf-Buchheim-Str. 6, 35392, Giessen, Germany
| | - Elke Roeb
- Department of Gastroenterology, Justus Liebig University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany
| | - Mate Knabe
- Department of Gastroenterology, Medizinische Klinik I, University Hospital, Goethe University, Frankfurt, Germany, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
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Pathiraja AA, Weerakkody RA, von Roon AC, Ziprin P, Bayford R. The clinical application of electrical impedance technology in the detection of malignant neoplasms: a systematic review. J Transl Med 2020; 18:227. [PMID: 32513179 PMCID: PMC7282098 DOI: 10.1186/s12967-020-02395-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/29/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Electrical impedance technology has been well established for the last 20 years. Recently research has begun to emerge into its potential uses in the detection and diagnosis of pre-malignant and malignant conditions. The aim of this study was to systematically review the clinical application of electrical impedance technology in the detection of malignant neoplasms. METHODS A search of Embase Classic, Embase and Medline databases was conducted from 1980 to 22/02/2018 to identify studies reporting on the use of bioimpedance technology in the detection of pre-malignant and malignant conditions. The ability to distinguish between tissue types was defined as the primary endpoint, and other points of interest were also reported. RESULTS 731 articles were identified, of which 51 reported sufficient data for analysis. These studies covered 16 different cancer subtypes in a total of 7035 patients. As the studies took various formats, a qualitative analysis of each cancer subtype's data was undertaken. All the studies were able to show differences in electrical impedance and/or related metrics between malignant and normal tissue. CONCLUSIONS Electrical impedance technology provides a novel method for the detection of malignant tissue, with large studies of cervical, prostate, skin and breast cancers showing encouraging results. Whilst these studies provide promising insights into the potential of this technology as an adjunct in screening, diagnosis and intra-operative margin assessment, customised development as well as multi-centre clinical trials need to be conducted before it can be reliably employed in the clinical detection of malignant tissue.
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Affiliation(s)
- Angela A. Pathiraja
- Department of Surgery and Cancer, Imperial College London, London, UK
- St Mary’s Hospital, 10th Floor QEQM Building, Paddington, London, W2 1NY UK
| | - Ruwan A. Weerakkody
- Department of Surgery and Cancer, Imperial College London, London, UK
- St Mary’s Hospital, 10th Floor QEQM Building, Paddington, London, W2 1NY UK
| | - Alexander C. von Roon
- Department of Surgery and Cancer, Imperial College London, London, UK
- St Mary’s Hospital, 10th Floor QEQM Building, Paddington, London, W2 1NY UK
| | - Paul Ziprin
- Department of Surgery and Cancer, Imperial College London, London, UK
- St Mary’s Hospital, 10th Floor QEQM Building, Paddington, London, W2 1NY UK
| | - Richard Bayford
- Department of Natural Sciences, Middlesex University, London, UK
- School of Science and Technology, Middlesex University, The Burroughs, Hendon, London, NW4 4BT UK
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Hillary SL, Brown BH, Brown NJ, Balasubramanian SP. Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery. World J Surg 2019; 44:479-485. [PMID: 31511942 DOI: 10.1007/s00268-019-05169-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Electrical impedance (EI) measures tissue resistance to alternating current across several frequencies and may help identify tissue type. A recent rabbit model demonstrated that electrical impedance spectroscopy (EIS) may facilitate identification of parathyroid glands and potentially improve outcomes following surgery. This study looks at the EI patterns of soft tissues in the human neck to determine whether parathyroid tissue can be accurately identified. METHODS This was a phase 1, single-arm interventional study involving 56 patients undergoing thyroid and/or parathyroid surgery. Up to 12 EI readings were taken from in vivo and ex vivo thyroid and parathyroid glands, adipose tissue and muscle of each patient. Each reading consists of a series of measurements over 14 frequencies from each tissue. EI patterns were analysed. Two patients were excluded due to data loss due to device malfunction. RESULTS The median age of participants was 53.5 (range 20-85) years. Thirty-five participants had surgery for thyroid pathology, 17 for parathyroid pathology and four for both. Six hundred and six EIS spectra were reviewed for suitability. One hundred and eighty-four spectra were rejected leaving 422 spectra for analysis. The impedance patterns of the soft tissues differed by histological type. The EI ratio of low (152 Hz) to high (312 kHz) frequencies demonstrated a significant difference between the soft tissues (p = 0.006). Using appropriate thresholds, parathyroid tissue can be distinguished from thyroid tissue with a sensitivity of 76% and specificity of 60%. CONCLUSIONS This study demonstrates the feasibility of using EIS to aid parathyroid identification and preservation. Further changes to the device and modelling of the EI patterns across the range of frequencies may improve accuracy and facilitate intraoperative use. TRIAL REGISTRATION ClinicalTrials.gov (NCT02901873).
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Affiliation(s)
| | | | | | - Saba P Balasubramanian
- Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, UK
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Maglioli CC, Caldwell DG, Mattos LS. A bioimpedance sensing system for in-vivo cancer tissue identification: Design and preliminary evaluation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:4235-4238. [PMID: 29060832 DOI: 10.1109/embc.2017.8037791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
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.
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Pathiraja A, Ziprin P, Shiraz A, Mirnezami R, Tizzard A, Brown B, Demosthenous A, Bayford R. Detecting colorectal cancer using electrical impedance spectroscopy: an ex vivo feasibility study. Physiol Meas 2017; 38:1278-1288. [PMID: 28333038 DOI: 10.1088/1361-6579/aa68ce] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Colorectal cancer is the fourth most common cancer worldwide, with a lifetime risk of around 20%. Current techniques do not allow clinicians to objectively assess tissue abnormality during endoscopy and perioperatively. A method capable of objectively assessing samples in real time and which can be included in minimally invasive diagnostic and management strategies would be highly transformative. Electrical impedance spectroscopy (EIS) may provide such a solution. This paper presents a feasibility study on using EIS in assessing colorectal tissue. APPROACH We performed tetrapolar EIS using ZedScan on excised human colorectal tumour tissue and the matched normal colonic mucosa in 22 freshly resected specimens following elective surgery for colorectal cancer. Histopathological examination was used to confirm the final diagnosis. Statistical significance was assessed using the Wilcoxon signed rank test. MAIN RESULTS Tetrapolar EIS could discriminate cancer with statistically significant results when applying frequencies between 305 Hz and 625 kHz (p < 0.05). 300 Ω was set as the transfer impedance threshold to detect cancer. Thus, the area under the corresponding receiver operating characteristic curve for this threshold was 0.7105. SIGNIFICANCE This feasibility study demonstrates that impedance spectra changes in colorectal cancer tissue are detectable and may be statistically significant, suggesting that EIS has the potential to be the core technology in a novel non-invasive point of care test for detecting colorectal cancer. These results warrant further development by increasing the size of the study with a device specifically designed for colorectal cancer.
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Cosoli G, Scalise L, Tricarico G, Tomasini EP, Cerri G. An innovative therapy for peri-implantitis based on radio frequency electric current: numerical simulation results and clinical evidence. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:5652-5655. [PMID: 28269537 DOI: 10.1109/embc.2016.7592009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Peri-implantitis is a severe inflammatory pathology that affects soit and hard tissues surrounding dental implants. Nowadays, only prevention is effective to contrast peri-implantitis, but, in recent years, there is the clinical evidence of the efficiency of a therapy based on the application of radio frequency electric current, reporting that 81% of the cases (66 implants, 46 patients) were successfully treated. The aim of this paper is to present the therapy mechanism, exploring the distribution of the electric currents in normal and pathologic tissues. A 3D numerical FEM model of tooth root with a dental implant screwed in the alveolar bone has been realized and the therapy has been simulated in COMSOL Multiphysics® environment. Results show that the electric current is focused in the inflamed zone around the implant, due to the fact that its conductivity is higher than the healthy tissue one. Moreover, by means of a movable return electrode, the electric current and field lines can be guided in the most inflamed area, limiting the interference on healthy tissues and improving the therapy in the area of interest. In conclusion, it can be stated that this innovative therapy would make a personalized therapy for peri-implantitis possible, also through impedance measurements, allowing the clinician to evaluate the tissue inflammation state.
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Healthy and tumoral tissue resistivity in wild-type and sparc-/- animal models. Med Biol Eng Comput 2016; 54:1949-1957. [PMID: 27099155 DOI: 10.1007/s11517-016-1489-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 03/18/2016] [Indexed: 10/21/2022]
Abstract
Despite the technological improvement of radiologic, endoscopic and nuclear imaging, the accuracy of diagnostic procedures for tumors can be limited whenever a mass-forming lesion is identified. This is true also because bioptical sampling cannot be properly guided into the lesions so as to puncture neoplastic tissue and to avoid necrotic areas. Under these circumstances, invasive and expensive procedures are still required to obtain diagnosis which is mandatory to plan the most appropriate therapeutic strategy. In order to test if electrical impedance spectroscopy may be helpful in providing further evidence for cancer detection, resistivity measurements were taken on 22 mice, 11 wild-type and 11 sparc-/- (knock out for the protein SPARC: secreted protein acidic and rich in cysteine), bearing mammary carcinomas, by placing a needle-probe into tumor, peritumoral and contralateral healthy fat areas. Tumor resistivity was significantly lower than both peritumoral fat and contralateral fat tissues. Resistivity in sparc-/- mice was lower than wild-type animals. A significant frequency dependence of resistivity was present in tissues analyzed. We conclude that accurate measurements of resistivity may allow to discriminate between tissues with different pathological and/or structural characteristics. Therefore, resistivity measurements could be considered for in vivo detection and differential diagnosis of tumor masses.
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Altered Impedance of Ear Acupuncture Point MT2 in Breast Cancer Patients: A Preliminary Observation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:909246. [PMID: 26504483 PMCID: PMC4609471 DOI: 10.1155/2015/909246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 06/11/2015] [Indexed: 01/30/2023]
Abstract
Skin impedance at acupuncture points (APs) has been used as a diagnostic aid for more than 50 years. In this study, we have a diagnostic tool (JXT-2008) to measure the skin impedance of ear APs of 30 breast cancer patients and the corresponding skin impedance of ear APs of 30 healthy humans, and then we compared these changes in ear AP impedance in breast cancer patients and healthy individuals.
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Balidemaj E, van den Berg CAT, Trinks J, van Lier ALHMW, Nederveen AJ, Stalpers LJA, Crezee H, Remis RF. CSI-EPT: A Contrast Source Inversion Approach for Improved MRI-Based Electric Properties Tomography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:1788-1796. [PMID: 25706578 DOI: 10.1109/tmi.2015.2404944] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Electric properties tomography (EPT) is an imaging modality to reconstruct the electric conductivity and permittivity inside the human body based on B1(+) maps acquired by a magnetic resonance imaging (MRI) system. Current implementations of EPT are based on the local Maxwell equations and assume piecewise constant media. The accuracy of the reconstructed maps may therefore be sensitive to noise and reconstruction errors occur near tissue boundaries. In this paper, we introduce a multiplicative regularized CSI-EPT method (contrast source inversion-electric properties tomography) where the electric tissue properties are retrieved in an iterative fashion based on a contrast source inversion approach. The method takes the integral representations for the electromagnetic field as a starting point and the tissue parameters are obtained by iteratively minimizing an objective function which measures the discrepancy between measured and modeled data and the discrepancy in satisfying a consistency equation known as the object equation. Furthermore, the objective function consists of a multiplicative Total Variation factor for noise suppression during the reconstruction process. Finally, the presented implementation is able to simultaneously include more than one B1(+) data set acquired by complementary RF excitation settings. We have performed in vivo simulations using a female pelvis model to compute the B1(+) fields. Three different RF excitation settings were used to acquire complementary B1(+) fields for an improved overall reconstruction. Numerical results illustrate the improved reconstruction near tissue boundaries and the ability of CSI-EPT to reconstruct small tissue structures.
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Extracting the parameters of the double-dispersion Cole bioimpedance model from magnitude response measurements. Med Biol Eng Comput 2014; 52:749-58. [PMID: 25023892 DOI: 10.1007/s11517-014-1175-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
In the field of bioimpedance measurements, the Cole impedance model is widely used for characterizing biological tissues and biochemical materials. In this work, a nonlinear least squares fitting is applied to extract the double-dispersion Cole impedance parameters from simulated magnitude response datasets without requiring the direct impedance data or phase information. The technique is applied to extract the impedance parameters from MATLAB simulated noisy magnitude datasets showing less than 1.2 % relative error when 60 dB SNR Gaussian white noise is present. This extraction is verified experimentally using apples as the Cole impedances showing less than 3 % relative error between simulated responses (using the extracted impedance parameters) and the experimental results over the entire dataset.
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