Conventional four-electrode impedance measurements (FEIM) cannot localize a zone of interest in a volume conductor. On the other hand, the recently developed electrical impedance tomography (EIT) system offers an image with reasonable resolution, but is complex and needs many electrodes. By placing two FEIM systems perpendicular to each other over a common zone at the center and combining the two results, it is possible to obtain enhanced sensitivity over this central zone. This is the basis of the proposed new method of focused impedance measurement (FIM). Sensitivity maps in both 2D and 3D show the desired improvement. A comparison of stomach-emptying studies also indicates the improvement achieved. This new method may be useful for impedance measurements of large organs like stomach, heart, and lungs. Being much simpler in comparison to EIT, multifrequency systems can be simply built for FIM. Besides, FIM may have utility in other fields like geology where impedance measurements are performed.

This work is based on the Applied Potential Tomography (APT) system developed in Sheffield and the results specifically relate to this system. Using a cylindrical phantom containing saline, the effects of extended layers in the third dimension on the two-dimensional tomographic images have been studied. Experimentally obtained magnitudes of pixel values corresponding to different conditions in the third dimension are presented. Analysis of these data brings out two phenomena: (i) layers of changed resistivity out of the electrode plane can appear as both increased and decreased resistivity in the image; and (ii) the position of the maximum resistivity change in the image occurs at increasing distances from the edge of the phantom, as the layers of resistivity change are introduced further from the electrode plane and they have a one to one relationship. An intuitive interpretation related to perturbation of equicurrent surfaces in the third dimension has been suggested to explain these phenomena.

One of the problems with tetrapolar impedance measurements is the lack of spatial sensitivity within the measured volume. In this paper we compare the sensitivity of tetrapolar measurements and the focused impedance measurements (FIM) proposed by Rabbani et al (1999 Ann. New York Acad. Sci. 873 408-20), which give an improved sensitivity profile. Using a previously validated model of sensitivity based on Geselowitz's lead theory, the sensitivity of FIM using eight, six and four electrodes was investigated. All electrode configurations showed a maximum in the average sensitivity of a plane at a depth of one-third of the drive-receive electrode spacing. No difference was found in the sensitivity value of this maximum between electrode configurations having the same drive-receive electrode spacing. The six- and eight-electrode configurations showed negative sensitivity regions down to half of the drive-receive electrode spacing, whilst the four-electrode measurement showed negative sensitivity regions down to one-third of the drive-receive electrode spacing. The single peak in sensitivity beneath the centre of the electrode configuration became dominant at 0.56, 1.4 and 0.14 of the receive electrode spacing for the eight-, six- and four-electrode configurations respectively. Thus, the four-electrode FIM configuration gives a single peak closest to the surface.

A recently developed Focused Impedance Measurement (FIM) system (by the authors' group) uses six electrodes to localize a zone of interest. Because of 3D sensitivity it could give physiological information on large organs like stomach, lungs, etc. using surface electrodes in the frontal plane. This paper presents a modified FIM technique using four electrodes placed at the corners of a square matrix. Firstly current is driven through an adjacent electrode pair while the potential is measured across the opposite pair from which an impedance value is obtained. Then a similar measurement is made at 90 degrees to the above by changing connections to the electrode pairs appropriately. The sum of these two impedance values has a dominant contribution from the central region within the square matrix, giving the desired focusing. Experimental sensitivity maps obtained from a 2D phantom have verified the focusing effect. Compared to the previous six-electrode FIM system the focusing effect is slightly less, but this new technique has less negative artifacts in the periphery. This new FIM method can be applied both in the frontal plane and in the transverse plane of the human thorax, giving a further advantage besides requiring fewer electrodes.

On electrical stimulation of a peripheral motor nerve, a delayed and reduced F-response is obtained, which is known to occur due to random backfiring of a few percent of the motor nerve fibres at the spinal end after antidromic conduction. F-latencies obtained from multiple stimulations vary in latency, size and shape because of this randomness. We hypothesised that, being a random process, recruitment of fibres for F-response would depend on the distribution of conduction velocity (DCV) for motor nerve fibres directly, and therefore, a frequency distribution of F-latencies (DFL) from such multiple F-responses would be an approximate mirror image of DCV, latency being inversely proportional to velocity. First, obtaining DFL from many human subjects, we have shown that this is a reproducible parameter for a nerve trunk of a subject, and hence reveals a new physiological phenomenon. DFL has a single peaked distribution, which is also expected for the DCV of a normal healthy motor nerve. To validate its hypothesised relationship to DCV further, DFLs were obtained from both median nerves of patients with unilateral carpal tunnel syndrome (CTS). The patterns of DFL from both sides remained almost the same except for a delay shift equal to that in between the two M-responses, which lends support to this hypothesis. DFL, and DCV as its suggested mirror image, appear to change systematically with certain known disorders such as cervical spondylosis, even at a subclinical stage, which needs further study. This also indicates that DFL may become a new and improved investigative diagnostic tool in neurophysiology.

Analysing published experimental findings this paper revealed that for myelinated nerves the conduction velocity (CV) increases on stretching out of the nerve, which has not been pointed out by anyone before. This apparently contradicts existing concepts since stretching out of a nerve fibre reduces its diameter which is expected to reduce the CV. Besides, the change is reversible and immediate, which cannot be explained with existing knowledge either. In order to explain this anomaly, the present work invoked a new resistance to ion flow between the nerve axon and the extracellular fluid created by interdigitated fingerlike processes of myelin sheaths coming from two sides of a node of Ranvier, analyzing published electron microscopic images. When stretched out, the gaps between the processes increase, decreasing the resistance to ion flow and thereby hastening depolarization, increasing CV in turn. The gaps close immediately on the release of the stretching force because of the pull of the elastic endoneurium, thus retrieving the original CV. To represent this new mechanism, a new resistive element has been added to the existing electrical model of a myelinated nerve, which is being claimed to be the dominant component that determines the conduction delay. Stretching also affects other nerve parameters and this paper developed a mathematical formulation involving all these parameters to show satisfactorily that CV indeed increases with stretching, in which the contribution of the proposed resistance dominates. The paper also proposed an appropriate modification of the representative schematic model commonly used to depict propagation of action potential in a myelinated nerve fibre. The suggested new mechanism and the resistance model is a breakthrough in the explanation of neural conduction and opens up the door for new study as well as for reviewing all previous experiments on myelinated nerves afresh. Bangladesh Journal of Medical Physics Vol.11 No.1 2018 P 38-56

When a breast lump is detected through palpation, mammography or ultrasonography, the final test for characterization of the tumour, whether it is malignant or benign, is biopsy. This is invasive and carries hazards associated with any surgical procedures. The present work was undertaken to study the feasibility for such characterization using non-invasive electrical impedance measurements and machine learning techniques. Because of changes in cell morphology of malignant and benign tumours, changes are expected in impedance at a fixed frequency, and versus frequency of measurement. Tetrapolar impedance measurement (TPIM) using four electrodes at the corners of a square region of sides 4 cm was used for zone localization. Data of impedance in two orthogonal directions, measured at 5 and 200 kHz from 19 subjects, and their respective slopes with frequency were subjected to machine learning procedures through the use of feature plots. These patients had single or multiple tumours of various types in one or both breasts, and four of them had malignant tumours, as diagnosed by core biopsy. Although size and depth of the tumours are expected to affect the measurements, this preliminary work ignored these effects. Selecting 12 features from the above measurements, feature plots were drawn for the 19 patients, which displayed considerable overlap between malignant and benign cases. However, based on observed qualitative trend of the measured values, when all the feature values were divided by respective ages, the two types of tumours separated out reasonably well. Using K-NN classification method the results obtained are, positive prediction value: 60%, negative prediction value: 93%, sensitivity: 75%, specificity: 87% and efficacy: 84%, which are very good for such a test on a small sample size. Study on a larger sample is expected to give confidence in this technique, and further improvement of the technique may have the ability to replace biopsy.

Tetrapolar Impedance Method (TPIM) and Focused Impedance Method (FIM) are two simple modalities of electrical bio-impedance measurement that could be employed to give useful physiological and diagnostic information of the human body. FIM is based on TPIM but uses a combination of two sets of TPIM, producing a focusing effect, which is useful to localize specific target organs. Most non-invasive electrical bio-impedance measurements based on TPIM and FIM use electrodes on one side of the body, outside the skin surface, which gives a shallow depth sensitivity. The sensitivity decreases with depth so that deep organs like lungs, heart, liver, stomach and bladder are not fully assessed through such measurements. Based on a long experience of studying electrical impedance methods, several qualitative ideas are presented in this article for probing deep organs using a few modified TPIM and FIM configurations. The suggestions are based on visualisations of both equipotentials and a popular sensitivity equation for transfer impedance, but not based on any quantitative analysis. Simulation and phantom studies based on these ideas may produce some practically useful electrode configurations for real life bio-impedance measurements. Bangladesh Journal of Medical Physics Vol.11 No.1 2018 P 1-15