Intraradiological pathology‐calibrated electrical impedance spectroscopy in the evaluation of excision‐required breast lesions

Abstract

Evaluating a real-time complementary bioelectrical diagnostic device based on electrical impedance spectroscopy (EIS) for improving breast imagingreporting and data system (BI-RADS) scoring accuracy, especially in high-risk or borderline breast diseases. The primary purpose is to characterize breast tumors based on their dielectric properties. Early detection of high-risk lesions and increasing the accuracy of tumor sampling and pathological diagnosis are secondary objectives of the study. Methods: The tumor detection probe (TDP) was first applied to the mouse model for electrical safety evaluations by electrical current measurement. Then it was utilized for characterization of 138 human palpable breast lesions that were to undergo core needle biopsy (CNB), vacuum-assisted biopsy (VAB), or fine needle aspiration (FNA) on the surgeon's requests. Impedance phase slope (IPS) in frequency ranges of 100-500 kHz and impedance magnitude in f = 1 kHz were extracted as the classification parameters. Consistency of radiological and pathological declarations for the excisional recommendation was then compared with the IPS values. Results: Considering pathological results as the gold standard, meaningful correlations between IPS and pathophysiological status of lesions recommended for excision (such as atypical ductal hyperplasia, papillary lesions, complex sclerosing adenosis, and fibroadenoma) were observed (p < 0.0001). These pathophysiological properties may include cell size, membrane permeability, packing density, adenosis, cytoplasm structure, etc. Benign breast lesions showed IPS values greater than 0, while high-risk proliferative, precancerous, or cancerous lesions had negative IPS values.Statistical analysis showed 95% sensitivity with area under the curve (AUC) equal to 0.92. Conclusion: Borderline breast diseases and high-risk lesions that should be excised according to standard guidelines can be diagnosed with TDP before any sampling process. It is an important outcome for high-risk lesions that are radiologically underestimated to BI-RADS3, specifically in younger patients with dense breast masses that present challenges in mammographic and sonographic evaluations. Also, the lowest IPS value detects the most pathologic portions of the tumor for increasing sampling accuracy in large tumors.

Intraoperative Assessment of High-Risk Thyroid Nodules Based on Electrical Impedance Measurements: A Feasibility Study

“…The TN-IMS response was calculated by analyzing the dielectric properties of thyroid samples obtained via two impedimetric classification parameters of Z 1kHz and IPS. These two parameters have been used in previous studies on cancerous breast tumor margins and involved lymph nodes with promising results [ 28 , 29 ]. According to the surgeon’s diagnosis, these two parameters were recorded for each palpable thyroid nodule or any area that seemed suspicious.…”

“…The TN-IMS tested at least three points of each nodule with a measurement time of 3 s to cover all the nodule areas because of the heterogeneous nature of high-risk thyroid nodules [ 28 ]. The ECG lead was connected to the submental region at the beginning of surgery during preparation of the patient.…”

Assessment of Specificity and Sensitivity of Tru-Cut Biopsy as Compared With Postoperative Histopathological Results in Young Females With Breast Mass

“…Overall, the use of CNB is recommended for the FNAC interpretation. [15] After core biopsy, all 37 cases of BIRADS 5 lesions that were declared malignant on radiography were found to be malignant. As a result, the BIRADS 5 lesions had a 100% positive predictive value for malignancy.…”

Intraoperative use of electrical impedance spectroscopy for adenoid cystic carcinoma of the lacrimal gland: A case report

“…Impedimetric detection is performed using a handheld intraoperative ITDS, which extracts two classification parameters: Z1kHz (impedance magnitude at f = 1 kHz) and IPS (Impedance phase slope in the frequency range of 100 kHz–500 kHz) (Figure 3). These two parameters were previously introduced and evaluated in several projects to diagnose breast tumor margins, intraradiological breast tumor detection, and the diagnosis of involved lymph nodes in breast cancer patients 13,14 …”

“…Many previously released reports reveal that EIS can alter clinical management and improve accuracy. [12][13][14] In this regard, Svoboda et al assessed the impact of EIS results on clinicians' diagnostic accuracy and biopsy decisions. The results showed that the EIS score could lead to a change in the decision to biopsy in 25% of cases, improving diagnostic accuracy and resulting in fewer biopsies of benign lesions and more biopsies of melanomas.…”