Electrical Impedance Spectroscopy to Aid Parathyroid Identification and Preservation in Central Compartment Neck Surgery

Antakia, Ramez; Brown, Brian; Highfield, Peter E.; Stephenson, Tim; Brown, Nicola J.; Balasubramanian, Sabapathy P

doi:10.1177/1553350615607639

Cited by 8 publications

(11 citation statements)

References 17 publications

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“…As demonstrated in rabbits [17], in this human study there is a significant difference in ratios of EI at low (152 Hz) to high (312 kHz) frequencies between thyroid, normal parathyroid and muscle ( Fig. 4; Friedman's twoway analysis of variance by ranks test; p = 0.006).…”

Section: Resultssupporting

confidence: 67%

Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery

Hillary

Brown

et al. 2019

World j. surg.

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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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Section: Resultssupporting

confidence: 67%

Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery

Hillary

Brown

et al. 2019

World j. surg.

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“…Electrical impedance is the measurement of resistance that a circuit poses to an alternating current when voltage is applied ( 26 ). The electrical properties of biological tissues in various frequency ranges are determined by the cellular components and structures, which generate characteristic impedance spectra ( 27 ).…”

Section: Introductionmentioning

confidence: 99%

“…As for thyroid neoplasm, there were several studies focused on the diagnosis of thyroid nodules ( 37 – 40 ). Antakia and colleagues used the BIS technique to identify parathyroid glands in neck central compartment surgeries of a rabbit model ( 26 ). In a study of 54 patients, Hillary et al.…”

Section: Introductionmentioning

confidence: 99%

Bioelectrical impedance spectroscopy can assist to identify the parathyroid gland during thyroid surgery

Wang

Liu²,

Wu³

et al. 2022

Front. Endocrinol.

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ObjectiveThis study aimed to explore the effectiveness of bioelectrical impedance spectroscopy in the identification of parathyroid glands during thyroid surgeries.MethodAll patients who received thyroid surgeries at our department from January 2018 to February 2020 were recruited for this study. The bioelectrical impedance spectroscopy analyzer was applied to analyze on following tissues: thyroid tissues, lymph nodes, adipose tissues, and the tissues suspected to be parathyroid glands. Postoperative pathological reports were obtained as the golden standard to compare with the characteristic parameters obtained from bioelectrical impedance spectroscopy. The receiver operating characteristic curve analysis was used to assess the diagnostic value and the selection of the optimal threshold of these parameters from bioelectrical impedance spectroscopy.ResultsA total of 512 patients were enrolled in the study and 1898 specimens were measured by the bioelectrical impedance spectroscopy analyzer. There were significant differences in the parameter of fc among parathyroid glands, thyroid tissues, lymph nodes, and adipose tissues (252.2 ± 45.8 vs 144.7 ± 26.1, 491.7 ± 87.4, 602.3 ± 57.3; P<0.001, P<0.001, P<0.001). The area under the receiver operating characteristic curves was 0.993 (95%CI: 0.989-0.996) for fc. When the diagnostic criterion of fc was set at 188.85 kHz~342.55 kHz, the sensitivity and specificity to identify parathyroid glands from lymph nodes and adipose tissues were both 100%. At this fc, the sensitivity and specificity to identify parathyroid glands from thyroid tissues were 91.1% and 99.0%, respectively.ConclusionIn conclusion, bioelectrical impedance spectroscopy could assist to differentiate parathyroid glands from peripheral tissues during thyroid surgeries.

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“…The performance of the sensor was investigated in terms of linearity, sensitivity, repeatability, and reproducibility. R. Antakia [17] studied the impedance spectroscopy of soft tissue structures such as rabbit neck thyroid, and confirmed that all excised thyroid glands were removed. Y. Cheng [18] measured the excised thyroid.…”

Section: Introductionmentioning

confidence: 80%

Evaluation of electrical characteristics of biological tissue with electrical impedance spectroscopy

Yao

Wang

et al. 2020

Electrophoresis

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The electrical characteristics of biological tissue is evaluated by establishing an electrical equivalent circuit with electrical impedance spectroscopy. The least squares method is used to realize electrical equivalent circuit fitting by using the developed portable electrical impedance spectroscopy system. The EIS system is used to obtain the impedance spectrum data of the measured biological tissue. In the experiment, the impedance spectrum data of eggs under different heating time were measured, and the established equivalent circuit model of eggs was fitted by nonlinear least squares fitting algorithm. Moreover, the electrical characteristics of the biological tissue are also revealed by numerical simulation with HANAI model. The experimental and simulation results show that the extracted equivalent electrical parameters can clearly characterize the variation of the internal change of components of biological tissues.

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Electrical Impedance Spectroscopy to Aid Parathyroid Identification and Preservation in Central Compartment Neck Surgery

Cited by 8 publications

References 17 publications

Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery

Use of Electrical Impedance Spectroscopy for Intraoperative Tissue Differentiation During Thyroid and Parathyroid Surgery

Bioelectrical impedance spectroscopy can assist to identify the parathyroid gland during thyroid surgery

Evaluation of electrical characteristics of biological tissue with electrical impedance spectroscopy

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