Smart needle to diagnose metastatic lymph node using electrical impedance spectroscopy

Hong, Yong Tae; Yun, Joungil; Lee, Jong Hyun; Hong, Ki‐Hwan

doi:10.1016/j.anl.2020.08.011

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Currently used imaging methods would benefit from innovations that would make the methods more accurate and/or easier to use. Bioimpedance measurement has been integrated into several medical instruments for target tissue detection and preliminary results from animal studies and ex vivo studies aiming to develop needle guidance have been reported by multiple groups (Kalvøy et al 2009, Trebbels et al 2012, Halonen et al 2015, Park et al 2018, Halonen et al 2019 or cancer detection (Lee et al 1999, Mishra et al 2013, Baghbani et al 2018, Cheng et al 2020, Hong et al 2021. The potential benefit of the bioimpedance needle method would be that it provides real-time information in a harmless way and can be combined with currently used ultrasound imaging.…”

Section: Introductionmentioning

confidence: 99%

Human in vivo liver and tumor bioimpedance measured with biopsy needle

Halonen¹,

Ovissi²,

Boyd³

et al. 2022

Physiol. Meas.

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Objective: Liver biopsy is an essential procedure in cancer diagnostics but targeting the biopsy to the actual tumor tissue is challenging. Aim of this study was to evaluate the clinical feasibility of a novel bioimpedance biopsy needle system in liver biopsy and simultaneously to gather in vivo bioimpedance data from human liver and tumor tissues. Approach: We measured human liver and tumor impedance data in vivo from 26 patients who underwent diagnostic ultrasound-guided liver biopsy. Our novel 18G core biopsy needle tip forms a bipolar electrode that was used to measure bioimpedance during the biopsy in real-time with frequencies from 1 kHz to 349 kHz. The needle tip location was determined by ultrasound. Also, the sampled tissue type was determined histologically. Main results: The bioimpedance values showed substantial variation between individual cases, and liver and tumor data overlapped each other. However, Mann-Whitney U test showed that the median bioimpedance values of liver and tumor tissue are significantly (p<0.05) different concerning the impedance magnitude at frequencies below 25 kHz and the phase angle at frequencies below 3 kHz and above 30 kHz. Significance: This study uniquely employed a real-time bioimpedance biopsy needle in clinical liver biopsies and reported the measured human in vivo liver and tumor impedance data. Impedance is always device-dependent and therefore not directly comparable to measurements with other devices. Although the variation in tumor types prevented coherent tumor identification, our study provides preliminary evidence that tumor tissue differs from liver tissue in vivo and this association is frequency-dependent.

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Section: Introductionmentioning

confidence: 99%

Human in vivo liver and tumor bioimpedance measured with biopsy needle

Halonen¹,

Ovissi²,

Boyd³

et al. 2022

Physiol. Meas.

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“…Bioimpedance technology can detect cancerous lymph nodes (Hong et al 2020), diagnose a broad range of disorders (Ibrahim et al 2005, Haas et (Lorenzo et al 2020). The working principle consists of applying a nonstimulating, nonionizing electrical current through tissue using two dedicated current electrodes and recording the voltage generated with a second pair of dedicated electrodes.…”

Section: Introductionmentioning

confidence: 99%

A framework for modeling bioimpedance measurements of nonhomogeneous tissues: a theoretical and simulation study

2021

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Objective. Bioimpedance technology is experiencing an increased use to assess health in a wide range of new consumer, research and clinical applications. However, the interaction between tissues producing bioimpedance data is often unclear. Methods. This work provides a novel theoretical framework to model bioimpedance measurements of nonhomogeneous tissues. We consider five case studies to validate the usefulness of our approach against finite element model simulations. Results. Theoretical and FEM-simulated apparent resistance and reactance data were in good agreement, with a maximum relative errors <4% and <8%, respectively. Conclusion. The biophysics-driven framework developed provides compact analytical expressions to model nonhomogeneous bioimpedance measurements including multiple tissues with arbitrary shape and electrical properties. This work provides a new perspective to interpret nonhomogeneous bioimpedance measurements using series, parallel, and series-parallel circuit-like topology equivalents. Significance. Our framework is a new tool to better understand and describe complex nonhomogeneous biological measurements as, for example, cardiac, brain and respiratory applications using (non)invasive electrodes.

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Intraoperative pathologically-calibrated diagnosis of lymph nodes involved by breast cancer cells based on electrical impedance spectroscopy; a prospective diagnostic human model study

Mahdavi

Yousefpour

Abbasvandi

et al. 2021

International Journal of Surgery

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Background Nodal status evaluation is a crucial step in determining prognostic factors and managing treatment strategies for breast cancer patients. Preoperative (CNB), intraoperative (SLNB), and even postoperative techniques (Formalin-Fixed Paraffin-Embedded sectioning, FFPE) have definite limitations of precision or sometimes are time-consuming for the result declaration. The primary purpose of this prospective study is to provide a precise complementary system for distinguishing lymph nodes (LNs) involved by cancerous cells in breast cancer patients intraoperatively. Methods The proposed system, Electrical Lymph Scoring(ELS), is designed based on the dielectric properties of the under-test LNs. The system has a needle-shaped 2-electrode probe entered into SLNs or ALNs dissected from patients through standard surgical guidelines. Impedance magnitude in f = 1 kH (Z1kHz) and Impedance Phase Slope in frequency ranges of 100 kHz–500 kHz (IPS) were then extracted from the impedance spectroscopy data in a cohort study of 77 breast cancer patients(totally 282 dissected LNs) who had been undergone surgery before (n = 55) or after (n = 22) chemical therapies (non-neoadjuvant or neoadjuvant chemotherapy). A new admittance parameterSymbol also proposed for LN detection in neoadjuvant chemotherapy patients. Results Considering the permanent pathology result as the gold standard checked by two independent expert pathologists, a significant correlation was observed between the presence of cancerous cells in LNs and individual ranges of the ELS electrical responses. Compared with normal LNs containing fatty ambient and immune cells, LNs involved by cancerous clusters would reduce the Z1kHz and increase the IPS. These changes correlate with fat metabolism by cancer cells due to their Fatty Acid Oxidation (FAO) in LN, which results in different dielectric properties between high and low-fat content of normal and cancerous LNs, respectively. Conclusions By finding the best correlation between our defined impedimetric parameters and pathological states of tested LNs, a real-time intraoperative detection approach was developed for highly-sensitive (92%, P<0.001) diagnosis of involved sentinel or axillary LNs. The impact of real-time intraoperative scoring of SLNs would make a pre-estimation about the necessity of excising further LNs to help the surgeon for less invasive surgery, especially in the absence of frozen-section equipment. Graphical abstract Highlights

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Smart needle to diagnose metastatic lymph node using electrical impedance spectroscopy

Cited by 4 publications

References 22 publications

Human in vivo liver and tumor bioimpedance measured with biopsy needle

Human in vivo liver and tumor bioimpedance measured with biopsy needle

A framework for modeling bioimpedance measurements of nonhomogeneous tissues: a theoretical and simulation study

Intraoperative pathologically-calibrated diagnosis of lymph nodes involved by breast cancer cells based on electrical impedance spectroscopy; a prospective diagnostic human model study

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