Cryosurgery employs freezing for targeted destruction of undesirable tissues such as cancer. Ice front imaging has made controlled treatment of deep body tumors possible. One promising method, recently explored for this task, is EIT, which recovers images of electrical impedance from measurements made at boundary electrodes. However, since frozen tissue near the ice front survives, ice front imaging is insufficient. Monitoring treatment effect would enable iterative cryosurgery, where extents of ablation and need for further treatment are assessed upon thawing. Since lipid bilayers are strong barriers to low frequency electrical current and cell destruction implies impaired membranes, EIT should be able to detect the desired effect of cryosurgery: cell death. Previous work has tested EIT for ice front imaging with tank studies while others have simulated EIT in detecting cryoablation, but in vivo tests have not been reported in either case. To address this, we report 3D images of differential conductivity throughout the freeze-thaw cycle in a rat liver model in vivo with histological validation, first testing our system for ice front imaging in a gel and for viability imaging post-thaw in a raw potato slice.
Imaging has made cryosurgery, the destruction of unwanted tissue through freezing, valuable. Electrical impedance tomography (EIT) has been explored as a method to determine the volume of tissue that is frozen during the procedure. However, studies have shown that tissue near the edge of the frozen zone often survives since in this region it may only be the extra-cellular space that is frozen. This threatens the usefulness of cryosurgery for cancer therapy since inaccurate ablation either allows the cancer to survive or increases the chances of complications. Since low-frequency conductivity of tissue increases due to cell membrane impairment, and ablated tissue implies impaired membranes, EIT has the capability to recover images of tissue viability. Cryosurgery is a technique that can benefit from this: EIT scans before freezing and after thawing can show changes in conductivity and hence viability due to treatment. Assuming unfrozen tissue will survive treatment, we explore the use of differential EIT in combination with intra-operative ice front imaging modes that are currently in clinical practice to recover enhanced-resolution images of cryosurgical treatment efficacy in a set of simulated experiments. We also investigate the sensitivity to violation of this assumption and predict tolerable levels of measurement noise.
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