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

Hillary, Sarah; Brown, Brian; Brown, Nicola J.; Balasubramanian, Sabapathy P

doi:10.1007/s00268-019-05169-7

Cited by 14 publications

(23 citation statements)

References 24 publications

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“…As in thyroid surgery, preoperative identification and treatment of vitamin D deficiency may help reduce the incidence and severity of post laryngectomy hypocalcaemia. Furthermore, the use of fluorescent imaging [36] and electric impedance spectroscopy [37] has been studied to aid intraoperative parathyroid localisation. These novel preventative measures may guide preservation and direct autotransplantation.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Edafe

Sandler

Beasley

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Post-laryngectomy hypoparathyroidism is associated with significant short- and long-term morbidities. This systematic review aimed to determine incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism. Methods Medline, EMBASE and the Cochrane library were searched for relevant articles on hypocalcaemia and/or hypoparathyroidism after laryngectomy or pharyngectomy. Two authors independently screened titles and abstracts from the search. Data from individual studies were collated and presented (without meta-analysis). Quality assessment of included studies was undertaken. The review protocol was registered in the PROSPERO database (CRD42019133879). Results Twenty-three observational studies were included. The rates of transient and long-term hypoparathyroidism following laryngectomy with concomitant hemi- or total thyroidectomy ranged from 5.6 to 57.1% (n = 13 studies) and 0 to 12.8% (n = 5 studies), respectively. Higher transient (62.1–100%) and long-term (12.5–91.6%) rates were reported in patients who had concomitant oesophagectomy and total thyroidectomy (n = 4 studies). Other risk factors included bilateral selective lateral neck dissection, salvage laryngectomy and total pharyngectomy. There is a lack of data on prevention and management. Conclusion Hypoparathyroidism occurs in a significant number of patients after laryngectomy. Patients who underwent laryngectomy with concomitant hemithyroidectomy may still develop hypoparathyroidism. Research on prevention and treatment is lacking and needs to be encouraged.

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Section: Discussionmentioning

confidence: 99%

“…The reported rates (i.q.r.) of transient and long-term hypocalcaemia following bilateral thyroid surgery were 27% (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) and 1% (0-3) [1]. The estimated prevalence of PoSH in Europe and United States of America was 22 per 100,000 and 23 per 100,000, respectively [2].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Edafe

Sandler

Beasley

et al. 2020

Eur Arch Otorhinolaryngol

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“…Each impedance measurement (Z) was taken for 14 frequencies ( f ) starting at 76 Hz and doubling each step up to a maximum of 625 kHz. This frequency range has been utilised in other mucosal surface based applications of impedance spectroscopy (Jokhi et al 2009, Hillary et al 2020, Anumba et al 2021. Impedance is a complex quantity and is separated into real and imaginary parts as Z( f ) = R( f ) + jX( f ), with R( f ) being the resistance and X( f ) being the reactance.…”

Section: Raw Data Descriptionmentioning

confidence: 99%

Tensor electrical impedance myography identifies clinically relevant features in amyotrophic lateral sclerosis

et al. 2021

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Objective. Electrical impedance myography (EIM) shows promise as an effective biomarker in amyotrophic lateral sclerosis (ALS). EIM applies multiple input frequencies to characterise muscle properties, often via multiple electrode configurations. Herein, we assess if non-negative tensor factorisation (NTF) can provide a framework for identifying clinically relevant features within a high dimensional EIM dataset. Approach. EIM data were recorded from the tongue of healthy and ALS diseased individuals. Resistivity and reactivity measurements were made for 14 frequencies, in three electrode configurations. This gives 84 (2 × 14 × 3) distinct data points per participant. NTF was applied to the dataset for dimensionality reduction, termed tensor EIM. Significance tests, symptom correlation and classification approaches were explored to compare NTF to using all raw data and feature selection. Main Results. Tensor EIM provides highly significant differentiation between healthy and ALS patients (p < 0.001, AUROC = 0.78). Similarly tensor EIM differentiates between mild and severe disease states (p < 0.001, AUROC = 0.75) and significantly correlates with symptoms (ρ = 0.7, p < 0.001). A trend of centre frequency shifting to the right was identified in diseased spectra, which is in line with the electrical changes expected following muscle atrophy. Significance. Tensor EIM provides clinically relevant metrics for identifying ALS-related muscle disease. This procedure has the advantage of using the whole spectral dataset, with reduced risk of overfitting. The process identifies spectral shapes specific to disease allowing for a deeper clinical interpretation.

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“…Different mathematical models have been defined to evaluate the BIS characteristics associated with these dispersions. The use of equivalent electrical circuit models creates an opportunity to conduct qualitative analyses in addition to quantitative examinations of biological structures, by fitting to the current measured BIS data [ 5 , 19 ]. The Cole–Cole model, developed by the Cole brothers in 1941, is a relaxation model which is often used to describe dielectric relaxation corresponding to

dispersions [ 20 ]:

where…”

Section: Introductionmentioning

confidence: 99%

Physical Validation of a Residual Impedance Rejection Method during Ultra-Low Frequency Bio-Impedance Spectral Measurements

Vizvári

Gyorfi

Odry

et al. 2020

Sensors

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Accurate and reliable measurement of the electrical impedance spectrum is an essential requirement in order to draw relevant conclusions in many fields and a variety of applications; in particular, for biological processes. Even in the state-of-the-art methods developed for this purpose, the accuracy and efficacy of impedance measurements are reduced in biological systems, due to the regular occurrence of parameters causing measurement errors such as residual impedance, parasitic capacitance, generator anomalies, and so on. Recent observations have reported the necessity of decreasing such inaccuracies whenever measurements are performed in the ultra-low frequency range, as the above-mentioned errors are almost entirely absent in such cases. The current research work proposes a method which can reject the anomalies listed above when measuring in the ultra-low frequency range, facilitating data collection at the same time. To demonstrate our hypothesis, originating from the consideration of the determinant role of the measuring frequency, a physical model is proposed to examine the effectiveness of our method by measuring across the commonly used vs. ultra-low frequency ranges. Validation measurements reflect that the range of frequencies and the accuracy is much greater than in state-of-the-art methods. Using the proposed new impedance examination technique, biological system characterization can be carried out more accurately.

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

Cited by 14 publications

References 24 publications

Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Tensor electrical impedance myography identifies clinically relevant features in amyotrophic lateral sclerosis

Physical Validation of a Residual Impedance Rejection Method during Ultra-Low Frequency Bio-Impedance Spectral Measurements

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