Electrical impedance tomography reconstruction for three-dimensional imaging of the prostate

Measurement of current distribution using infrared thermography

Current distribution measurement methods are widely used in medical examinations, predicting faults in semiconductor devices and assessing structural integrity. Several methods for measuring current distribution are available, such as electrode arrays, coils, and magnetic sensors. However, these measurement methods are unable to obtain images of current distribution with high spatial resolution. Therefore, there is a need to develop a non-contact method to measure current distribution that is capable of capturing images with high spatial resolution. In this study, a non-contact current distribution measurement method based on infrared thermography is proposed. The method uses thermal variations to quantify the current amplitude and reconstructs the current direction based on the passivity of the electric field. For quantification of low frequency current amplitude, the experimental results show that the method can provide accurate current measurement results, for example, at the power frequency (50 Hz), in the range of 1.05-3.45 A, its relative error can be improved to ±3.66% when the calibration fitting method is used. For the high-frequency current, an effective estimate of the current amplitude is obtained using the first-order derivative of temperature variation. When applied to the eddy current detection (256 KHz), it achieves a high-resolution image of the current distribution, and the effectiveness of the method is verified through simulation experiments. The experimental results show that the proposed method not only measures the current amplitude accurately but also improves the spatial resolution in acquiring two-dimensional current distribution images.

A new current injection and voltage measurement strategy of 3D electrical impedance tomography based on scanning electrode

Electrical impedance tomography (EIT) technology is an important imaging approach to show the conductivity distribution of the area noninvasively. Recently, 3D EIT has been extensively studied for its more comprehensive display of electrical properties. Nonetheless, most 3D EIT electrode models are based on multilayer ring electrodes and only suitable for specific scenarios. In order to overcome its limitations and alleviate the ill-condition of 3D EIT, we propose a new current injection and voltage measurement strategy based on scanning row electrodes (SRE) called the back electrode excitation (BEEM) strategy and select the optimal number of excitation electrodes according to different imaging effects. A 3D electrical impedance imaging system based on SRE is designed. Then, the traditional excitation measurement strategy is introduced, and the two strategies are compared through simulation and actual experiments. The results show that the BEEM strategy with SRE can not only obtain rich potential information in the finite field but also significantly improve the imaging detection depth, accuracy, and noise immunity compared with the flat electrode array.

Detection of subclinical hemorrhage using electrical impedance: a porcine study

OBJECTIVE

Analyze the performance of electrical impedance tomography (EIT) in an innovative porcine model of subclinical hemorrhage and investigate associations between EIT and hemodynamic trends.

APPROACH

Twenty-five swine were bled at slow rates to create an extended period of subclinical hemorrhage during which the animal's heart rate (HR) and blood pressure (BP) remained stable from before hemodynamic deterioration, where stable was defined as < 15% decrease in BP and < 20% increase in HR - i.e. hemorrhages were hidden from standard vital signs of HR and BP. Continuous vital signs, photo-plethysmography, and continuous non-invasive EIT data were recorded and analyzed with the objective of developing an improved means of detecting subclinical hemorrhage - ideally as early as possible.

MAIN RESULTS

Best area-under-the-curve (AUC) values from comparing bleed to no-bleed epochs were 0.96 at a 80 ml bleed (~15.4 minutes) using an EIT-data-based metric and 0.79 at a 120 ml bleed (~23.1 minutes) from invasively measured BP - i.e. the EIT-data-based metric achieved higher AUCs at earlier points compared to standard clinical metrics without requiring image reconstructions.

SIGNIFICANCE

In this clinically relevant porcine model of subclinical hemorrhage, EIT appears to be superior to standard clinical metrics in early detection of hemorrhage.

Retrieval of the conductivity spectrum of tissuesin vitrowith novel multimodal tomography

OBJECTIVE

Imaging of tissue engineered three-dimensional (3D) specimens is challenging due to their thickness. We propose a novel multimodal imaging technique to obtain multi-physical 3D images and the electrical conductivity spectrum of tissue engineered specimensin vitro.

APPROACH

We combine simultaneous recording of rotational multifrequency electrical impedance tomography (R-mfEIT) with optical projection tomography (OPT). Structural details of the specimen provided by OPT are used here as geometrical priors for R-mfEIT.

MAIN RESULTS

This data fusion enables accurate retrieval of the conductivity spectrum of the specimen. We demonstrate experimentally the feasibility of the proposed technique using a potato phantom, adipose and liver tissues, and stem cells in biomaterial spheroids. The results indicate that the proposed technique can distinguish between viable and dead tissues and detect the presence of stem cells.

SIGNIFICANCE

This technique is expected to become a valuable tool for monitoring tissue engineered specimens' growth and viabilityin vitro.

An efficient Point-Matching Method-of-Moments for 2D and 3D Electrical Impedance Tomography Using Radial Basis functions

AbstractObjective: The inverse problem of computing conductivity distributions in 2D and 3D objects interrogated by low frequency electrical signals, which is called Electrical Impedance Tomography (EIT), is treated using a Method-of-Moment technique.

METHODS

A Point-Matching-Method-of-Moment technique is used to formulate a global integral equation solver. Radial Basis Functions are adopted to express the conductivity distribution. Single-step quadratic-norm (L2) and iterative total variation (L1) regularization techniques are exploited to solve the inverse problem.

RESULTS

Simulation and experimental tests on a circular reconstruction domain show satisfactory performance in deriving conductivity distribution, achieving a Correlation Coefficient (CC) up to 0:863 for 70 dB voltage SNR and 0:842 for 40 dB voltage SNR. The proposed methodology with L2-norm regularization provided better results than traditional iterative Gauss-Newtons approach, whereas with L1-norm regularization it showed promising performance. Moreover, 3D reconstructions on a cylindrical cavity demonstrated superior results near the electrodes planes compared to those of the conventional linearized approach. Finally, application to EIT medical data for dynamic lung imaging successfully revealed the breath-cycle conductivity changes.

CONCLUSION

The results show that the proposed method can be effective for both 2D and 3D EIT and applicable to many applications.

SIGNIFICANCE

Strong conductivity variations are successfully tackled with a very good Correlation Coefficient. In contrast to conventional EIT solutions based on weak-form and linearization on small conductivity changes, the proposed method requires only one step to converge with L2-norm regularization. The proposed method with L1-norm regularization also achieves good reconstruction quality with a low number of iterations.

Phantom Studies of Fused-Data TREIT Using Only Biopsy-Probe Electrodes

Transrectal electrical impedance tomography (TREIT) is a novel imaging modality being developed for prostate biopsy guidance and cancer characterization. We describe a novel fused-data TREIT (fd-TREIT) system and approach developed to improve imaging robustness and evaluate it on challenging clinically-representative phantoms. The new approach incorporates 8 electrodes (in 2 rows) on a biopsy probe (BP) and 12 electrodes on the face of a transrectal ultrasound (TRUS) probe and includes a biopsy gun, instrument tracking, 3D-printed needle guide, and EIT hardware and software. The approach was evaluated via simulation, a series of prostate-shaped gel phantoms, and an ex vivo bovine tissue sample using only absolute reconstructions. The simulations surprisingly found that using only biopsy-probe electrode measurements, i.e. omitting TRUS-probe electrode measurements, significantly improves robustness to noise thus leading to simpler modeling and significant decreases in computational times (~13x speed-up/reconstructions in ~27 minutes). The gel phantom experiments resulted in reconstructions with area under the curve (AUC) values extracted from receiver operator characteristic curves of >0.85 for 4 out of the 5 tests, and when incorporating inclusion boundaries resulted in absolute reconstructions yielding 1.9% and 12.2% average percent errors for 3 consistent tests and all 5 tests, respectively. Ex vivo bovine tests revealed qualitatively that the fd-TREIT approach can largely discriminate a complex adipose and muscle interface in a realistic setting using data from 9 biopsy probe states (biopsy core locations). The algorithms developed here on challenging phantoms suggest strong promise for this technology to aid in imaging during routine 12-core biopsies.

Thoracic EIT in 3D: experiences and recommendations

OBJECTIVE

In EIT applications to the thorax, a single electrode plane has typically been used to reconstruct a transverse 2D 'slice'. However, such images can be misleading as EIT is sensitive to contrasts above and below the electrode plane, and ventilation and aeration inhomogeneities can be distributed in complex ways. Using two (or more) electrode planes, 3D EIT images may be reconstructed, but 3D reconstructions are currently little used in thoracic EIT. In this paper, we investigate an incremental pathway towards 3D EIT reconstructions, using two electrode planes to calculate improved transverse slices as an intermediate step. We recommend a specific placement of electrode planes, and further demonstrate the feasibility of multi-slice reconstruction in two species.

APPROACH

Simulations of the forward and reconstructed sensitivities were analysed for two electrode planes using a 'square' pattern of electrode placement as a function of two variables: the stimulation and measurement 'skip', and the electrode plane separation. Next, single- versus two-plane measurements were compared in a horse and in human volunteers. We further show the feasibility of 3D reconstructions by reconstructing multiple transverse and, unusually, frontal slices during ventilation.

MAIN RESULTS

Using two electrode planes leads to a reduced position error and improvement in off-plane contrast rejection. 2D reconstructions from two-plane measurements showed better separation of lungs, as compared to the single plane measurements which tend to push contrasts in the center of the image. 3D reconstructions of the same data show anatomically plausible images, inside as well as outside the volume between the two electrode planes.

SIGNIFICANCE

Based on the results, we recommend EIT electrode planes separated by less than half of the minimum thoracic dimension with a 'skip 4' pattern and 'square' placement to produce images with good slice selectivity.

Toward Electrical Impedance Tomography Coupled Ultrasound Imaging for Assessing Muscle Health

This paper establishes for the first time that a coupled ultrasound (US) and electrical impedance tomography (EIT) system can serve as a non-invasive, spatially localized approach to extract clinically relevant muscle properties. The US/EIT system represents a potential enhancement to electrical impedance myography (EIM), which has shown promise as a non-invasive technology that may have important clinical use in indicating neuromuscular disease status and as a diagnostic tool. A 2.5D EIT algorithm evaluated on simulation, measured phantoms, and measured patient data was studied to evaluate US/EIT's ability to distinguish different aspects of muscle tissue. Simulated and phantom experiments revealed the depths of distinguishability of 3.2 and 4.2 mm in simulation for 10% and 20% changes in muscle properties, respectively, and 3.6 mm in measured phantom experiments assuming a 12% muscle conductivity change. Reconstructions from the patient data established that there were consistent differences 1) between longitudinal (along) and transverse (across) muscle conductivity reconstructions at frequencies of 40 and 80 kHz and 2) side-by-side comparison between healthy and diseased tissue in terms of conductivity, permittivity, and phase at 40 and 80 kHz. Comparisons were made between the EIT reconstructed values and electrical impedance spectroscopy (EIS) measurements (an available surrogate in place of standard EIM measurements) made with the US/EIT system, wherein 1) EIS and EIT show similar sensitivity to longitudinal and transverse differences and 2) EIT showed a more consistent ability to differentiate healthy and diseased tissue. These results suggest that US/EIT appears very promising for non-invasive and spatially localized diagnosis of muscle health.

Focusing Sensor Design for Open Electrical Impedance Tomography Based on Shape Conformal Transformation

Electrical Impedance Tomography (EIT) is a non-invasive detection method to image the conductivity changes inside an observation region by using the electrical measurements at the boundary of this region. In some applications of EIT, the observation domain is infinite and is only accessible from one side, which leads to the so-called open EIT (OEIT) problem. Compared with conventional EIT problems, the observation region in OEIT can only be measured from limited projection directions, which makes high resolution imaging much more challenging. To improve the imaging quality of OEIT, a focusing sensor design strategy is proposed based on shape conformal theory. The conformal bijection is used to map a standard EIT sensor defined at a unit circle to a focusing OEIT sensor defined at an upper half plane. A series of numerical and experimental testes are conducted. Compared with the traditional sensor structure, the proposed focusing sensor has higher spatial resolution at the near-electrode region and is good at distinguishing multi-inclusions which are close to each other.

Fused-data transrectal EIT for prostate cancer imaging

OBJECTIVE

Prostate cancer is a significant problem affecting 1 in 7 men. Unfortunately, the diagnostic gold-standard of ultrasound-guided biopsy misses 10%-30% of all cancers. The objective of this study was to develop an electrical impedance tomography (EIT) approach that has the potential to image the entire prostate using multiple impedance measurements recorded between electrodes integrated onto an end-fired transrectal ultrasound (TRUS) device and a biopsy probe (BP).

APPROACH

Simulations and sensitivity analyses were used to investigate the best combination of electrodes, and measured tank experiments were used to evaluate a fused-data transrectal EIT (fd-TREIT) and BP approach.

MAIN RESULTS

Simulations and sensitivity analysis revealed that (1) TREIT measurements are not sufficiently sensitive to image the whole prostate, (2) the combination of TREIT  +  BP measurements increases the sensitive region of TREIT-only measurements by 12×, and (3) the fusion of multiple TREIT  +  BP measurements collected during a routine or customized 12-core biopsy procedure can cover up to 76.1% or 94.1% of a nominal 50 cm³ prostate, respectively. Three measured tank experiments of the fd-TREIT  +  BP approach successfully and accurately recovered the positions of 2-3 metal or plastic inclusions.

SIGNIFICANCE

The measured tank experiments represent important steps in the development of an algorithm that can combine EIT from multiple locations and from multiple probes-data that could be collected during a routine TRUS-guided 12-core biopsy. Overall, this result is a step towards a clinically deployable impedance imaging approach to scanning the entire prostate, which could significantly help to improve prostate cancer diagnosis.

Absolute Reconstructions Using Rotational Electrical Impedance Tomography for Breast Cancer Imaging

A rotational Electrical Impedance Tomography (rEIT) methodology is described and shown to produce spatially accurate absolute reconstructions with improved image contrast and an improved ability to distinguish closely spaced inclusions compared to traditional EIT on data recorded from cylindrical and breast-shaped tanks. Rotations of the tank without altering the interior conductivity distribution are used to produce the rEIT data. Quantitatively, rEIT was able to distinguish two inclusions that were 1.5 cm closer together than traditional EIT could achieve for inclusions placed 2 to 3 cm from the center for the cylindrical tank, and rEIT was able to distinguish two tumor-like inclusions where traditional EIT could not reliably do so. Mathematical analysis showed that rEIT improves the number of stable singular vectors by up to 4.2 and 4.7 times than that of traditional EIT for the cylindrical and breast-shaped tanks, respectively, which is an indication of improved resolution. Direct investigations into measurements revealed minimum rotation angles that should yield data uncorrupted by noise. Two inverse approaches (one that inverts then fuses the data (I/DF) and one that fuses the data then inverts (DF/I)) and two mesh modeling approaches were considered. It was found that DF/I produces far better results compared to I/DF and a rotated-mesh approach produces further improvements. The ability to obtain improved absolute reconstructions using rEIT on a practical clinical scenario (breast-shaped tank experiment) is an important step towards using rEIT to improve previous EIT results in medical applications.

Comparative study of separation between ex vivo prostatic malignant and benign tissue using electrical impedance spectroscopy and electrical impedance tomography

OBJECTIVE

Currently no efficient and reliable technique exists to routinely assess surgical margins during a radical prostatectomy. Electrical impedance spectroscopy (EIS) has been reported as a potential technique to provide surgeons with real-time intraoperative margin assessment. In addition to providing a quantified measure of margin status, a co-registered electrical impedance tomography (EIT) image presented on a surgeon's workstation could add value to the margin assessment process.

APPROACH

To investigate this, we conducted a comparative study between EIS and EIT to evaluate the potential these technologies might have for margin assessment. EIS and EIT data was acquired from ex vivo human prostates using a multi-electrode endoscopic impedance acquisition probe.

MAIN RESULTS

EIS and EIT show good predictive performance with a 0.76 and 0.80 area-under-curve (AUC), respectively, when considering discrete frequencies only. A machine learning (ML) algorithm is implemented to combine features, which improves the AUCs of EIS and EIT to 0.84 and 0.85, respectively. Single-step EIT takes significantly less time to reconstruct than multi-step EIT, yet provides similarly accurate classification results, making the single-step approach a potential candidate for real-time margin assessment. While the ML-based approach clearly exhibits benefits as compared to the single feature assessment, the decision to use EIS versus EIT is unclear since each approach performs better for different subsets of tissue classifications.

SIGNIFICANCE

The results presented in this paper corroborate our previous studies and present the strongest evidence yet that an intraoperative-capable impedance probe can be used to distinguish benign from malignant prostate tissues. An in vivo study with a large cohort will be necessary to definitively determine the preferred approach and to show the clinical effectiveness of using this technology for margin assessment.

A Novel Regularization Technique for Microendoscopic Electrical Impedance Tomography

A novel regularization technique is developed for end-fired microendoscopic electrical impedance tomography using the dual-mesh method. The new regularization technique coupled with appropriate forward modeling and inverse mesh design is shown to produce dramatically improved reconstructions over previous methods. 3D absolute and difference reconstructions from measured saline tank and ex vivo adipose and muscle tissue experiments are used to validate the approach. The ex vivo experiments are used as a surrogate for prostate tissue, which is the primary clinical application for the probe. Inclusion center of mass errors were less than 0.47 mm for tank experiments with inclusion depths and radial offsets ranging less than 3 mm and 1.5 mm, respectively. Absolute 3D reconstructions on the tissue show quantitatively good accuracy and the ability to spatially distinguish small tissue features (adipose strands of approximately 2.5 mm in width). The reconstruction algorithm developed provides strong evidence for the promise of surgical margin detection using microendoscopic EIT.

Empirical validation of statistical parametric mapping for group imaging of fast neural activity using electrical impedance tomography

Electrical impedance tomography (EIT) allows for the reconstruction of internal conductivity from surface measurements. A change in conductivity occurs as ion channels open during neural activity, making EIT a potential tool for functional brain imaging. EIT images can have  >10 000 voxels, which means statistical analysis of such images presents a substantial multiple testing problem. One way to optimally correct for these issues and still maintain the flexibility of complicated experimental designs is to use random field theory. This parametric method estimates the distribution of peaks one would expect by chance in a smooth random field of a given size. Random field theory has been used in several other neuroimaging techniques but never validated for EIT images of fast neural activity, such validation can be achieved using non-parametric techniques. Both parametric and non-parametric techniques were used to analyze a set of 22 images collected from 8 rats. Significant group activations were detected using both techniques (corrected p  <  0.05). Both parametric and non-parametric analyses yielded similar results, although the latter was less conservative. These results demonstrate the first statistical analysis of such an image set and indicate that such an analysis is an approach for EIT images of neural activity.

Characterisation and imaging of cortical impedance changes during interictal and ictal activity in the anaesthetised rat

Epilepsy affects approximately 50 million people worldwide, and 20–30% of these cases are refractory to antiepileptic drugs. Many patients with intractable epilepsy can benefit from surgical resection of the tissue generating the seizures; however, difficulty in precisely localising seizure foci has limited the number of patients undergoing surgery as well as potentially lowered its effectiveness. Here we demonstrate a novel imaging method for monitoring rapid changes in cerebral tissue impedance occurring during interictal and ictal activity, and show that it can reveal the propagation of pathological activity in the cortex. Cortical impedance was recorded simultaneously to ECoG using a 30-contact electrode mat placed on the exposed cortex of anaesthetised rats, in which interictal spikes (IISs) and seizures were induced by cortical injection of 4-aminopyridine (4-AP), picrotoxin or penicillin. We characterised the tissue impedance responses during IISs and seizures, and imaged these responses in the cortex using Electrical Impedance Tomography (EIT). We found a fast, transient drop in impedance occurring as early as 12 ms prior to the IISs, followed by a steep rise in impedance within ~ 120 ms of the IIS. EIT images of these impedance changes showed that they were co-localised and centred at a depth of 1 mm in the cortex, and that they closely followed the activity propagation observed in the surface ECoG signals. The fast, pre-IIS impedance drop most likely reflects synchronised depolarisation in a localised network of neurons, and the post-IIS impedance increase reflects the subsequent shrinkage of extracellular space caused by the intense activity. EIT could also be used to picture a steady rise in tissue impedance during seizure activity, which has been previously described. Thus, our results demonstrate that EIT can detect and localise different physiological changes during interictal and ictal activity and, in conjunction with ECoG, may in future improve the localisation of seizure foci in the clinical setting.

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Cortical impedance was measured simultaneously to EEG during epileptic activity.

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Interictal spikes were preceded by fast decreases in cortical impedance.

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Steep increases in impedance followed both interictal spikes and onset of ictal activity.

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Imaging with Electrical Impedance Tomography revealed the location of epilepsy-related impedance changes.

A fast parallel solver for the forward problem in electrical impedance tomography

Electrical impedance tomography (EIT) is a noninvasive imaging modality, where imperceptible currents are applied to the skin and the resulting surface voltages are measured. It has the potential to distinguish between ischaemic and haemorrhagic stroke with a portable and inexpensive device. The image reconstruction relies on an accurate forward model of the experimental setup. Because of the relatively small signal in stroke EIT, the finite-element modeling requires meshes of more than 10 million elements. To study the requirements in the forward modeling in EIT and also to reduce the time for experimental image acquisition, it is necessary to reduce the run time of the forward computation. We show the implementation of a parallel forward solver for EIT using the Dune-Fem C++ library and demonstrate its performance on many CPU's of a computer cluster. For a typical EIT application a direct solver was significantly slower and not an alternative to iterative solvers with multigrid preconditioning. With this new solver, we can compute the forward solutions and the Jacobian matrix of a typical EIT application with 30 electrodes on a 15-million element mesh in less than 15 min. This makes it a valuable tool for simulation studies and EIT applications with high precision requirements. It is freely available for download.

Imaging fast electrical activity in the brain with electrical impedance tomography

Imaging of neuronal depolarization in the brain is a major goal in neuroscience, but no technique currently exists that could image neural activity over milliseconds throughout the whole brain. Electrical impedance tomography (EIT) is an emerging medical imaging technique which can produce tomographic images of impedance changes with non-invasive surface electrodes. We report EIT imaging of impedance changes in rat somatosensory cerebral cortex with a resolution of 2ms and <200μm during evoked potentials using epicortical arrays with 30 electrodes. Images were validated with local field potential recordings and current source-sink density analysis. Our results demonstrate that EIT can image neural activity in a volume 7×5×2mm in somatosensory cerebral cortex with reduced invasiveness, greater resolution and imaging volume than other methods. Modeling indicates similar resolutions are feasible throughout the entire brain so this technique, uniquely, has the potential to image functional connectivity of cortical and subcortical structures.

3D Microendoscopic Electrical Impedance Tomography for Margin Assessment During Robot-Assisted Laparoscopic Prostatectomy

Radially configured microendoscopic electrical impedance probes intended for intraoperative surgical margin assessment during robot-assisted laparoscopic prostatectomy (RALP) were examined through simulation, bench-top experimentation, and ex vivo tissue studies. Three probe designs with 8, 9, and 17 electrodes, respectively, were analyzed through finite element method based simulations. One mm diameter spherical inclusions ( σinclusion = 1 S/m) are positioned at various locations within a hemispherical background ( σbackground = 0.1 S/m) of radius 5 mm. An 8-electrode configuration is not able to localize the inclusion at these positions while 9 and 17-electrode configurations are able to accurately reconstruct the inclusion at maximum depth of 1 mm and 3 mm, respectively. All three probe designs were constructed and evaluated using saline phantoms and ex vivo porcine and human prostate tissues. The 17-electrode probe performed best in saline phantom studies, accurately reconstructing high contrast, 1-mm-diameter metal cylindrical inclusions in a saline bath ( σsaline = 0.1 S/m) with a position and area error of 0.46 mm and 0.84 mm2, respectively. Additionally, the 17-electrode probe was able to adequately distinguish cancerous from benign tissues in three ex vivo human prostates. Simulations, bench-top saline experiments, and ex vivo tissue sampling suggest that for intraoperative surgical margin assessment during RALP, the 17-electrode probe (as compared to an 8 and 9 electrode probe) will be necessary to provide sufficient accuracy and sensitivity.

A method for reconstructing tomographic images of evoked neural activity with electrical impedance tomography using intracranial planar arrays

A method is presented for reconstructing images of fast neural evoked activity in rat cerebral cortex recorded with electrical impedance tomography (EIT) and a 6 × 5 mm(2) epicortical planar 30 electrode array. A finite element model of the rat brain and inverse solution with Tikhonov regularization were optimized in order to improve spatial resolution and accuracy. The optimized FEM mesh had 7 M tetrahedral elements, with finer resolution (0.05 mm) near the electrodes. A novel noise-based image processing technique based on t-test significance improved depth localization accuracy from 0.5 to 0.1 mm. With the improvements, a simulated perturbation 0.5 mm in diameter could be localized in a region 4 × 5 mm(2) under the centre of the array to a depth of 1.4 mm, thus covering all six layers of the cerebral cortex with an accuracy of <0.1 mm. Simulated deep brain hippocampal or thalamic activity could be localized with an accuracy of 0.5 mm with a 256 electrode array covering the brain. Parallel studies have achieved a temporal resolution of 2 ms for imaging fast neural activity by EIT during evoked activity; this encourages the view that fast neural EIT can now resolve the propagation of depolarization-related fast impedance changes in cerebral cortex and deeper in the brain with a resolution equal or greater to the dimension of a cortical column.

A feasibility study of magnetic resonance electrical impedance tomography for prostate cancer detection

Magnetic resonance electrical impedance tomography (MREIT) is an imaging technique that reconstructs the conductivity distribution inside the subject using magnetic flux density or current density measurements acquired by a magnetic resonance imaging system. Since the primary prostate cancer diagnostic method, prostate biopsy, has limited accuracy in cancer diagnosis and malignant tissues have shown significantly different electrical properties from normal or benign tissues, MREIT has potential application in prostate cancer detection. The feasibility of utilizing MREIT in detecting prostate cancer was evaluated via a series of well-designed computer simulations in the present study. MREIT techniques with three different electrode configurations (external, trans-rectal, and trans-urethral electrode arrays) and two different reconstruction algorithms (J-substitution algorithm and harmonic Bz algorithm) were successfully developed. The performance of different MREIT techniques were evaluated and compared based on the imaging accuracy of the reconstructed conductivity distribution in the prostate. Without the presence of noise, the external MREIT achieves a better imaging accuracy than the two endo-MREIT (trans-rectal and trans-urethral) techniques, while the trans-urethral MREIT achieves the best imaging accuracy in noisy environments. We also found that the J-substitution reconstruction algorithm consistently offered better imaging accuracy than the harmonic Bz algorithm. When Gaussian distributed random noise with a standard deviation of 0.25 nT was added, the relative errors (RE) between the reconstructed and target conductivity distributions inside the prostate were observed to be 14.18% and 17.35% by the trans-urethral MREIT with the J-substitution and harmonic Bz algorithms respectively. The lower REs of 9.64% and 11.17% were achieved respectively when the standard deviation of noise was reduced to 0.05 nT. The simulation results demonstrate the feasibility of applying MREIT for prostate cancer detection.

Transrectal electrical impedance tomography of the prostate: spatially coregistered pathological findings for prostate cancer detection

PURPOSE

Prostate cancer ranks as one of the most common malignancies and currently represents the second leading cancer-specific cause of death in men. The current use of single modality transrectal ultrasound (TRUS) for biopsy guidance has a limited sensitivity and specificity for accurately identifying cancerous lesions within the prostate. This study introduces a novel prostate cancer imaging method that combines TRUS with electrical impedance tomography (EIT) and reports on initial clinical findings based on in vivo measurements.

METHODS

The ultrasound system provides anatomic information, which guides EIT image reconstruction. EIT reconstructions are correlated with semiquantitative pathological findings. Thin plate spline warping transformations are employed to overlay electrical impedance images and pathological maps describing the spatial distribution of prostate cancer, with the latter used as reference for data analysis. Clinical data were recorded from a total of 50 men prior to them undergoing radical prostatectomy for prostate cancer treatment. Student's t-tests were employed to statistically examine the electrical property difference between cancerous tissue and benign tissue as defined through histological assessment of the excised gland.

RESULTS

Example EIT reconstructions are presented along with a statistical analysis comparing EIT and pathology. An average transformation error of 1.67% is found when 381 spatially coregistered pathological images are compared with their target EIT reconstructed counterparts. At EIT signal frequencies of 0.4, 3.2, and 25.6 kHz, paired-testing demonstrated that the conductivity of cancerous regions is significantly greater than that of benign regions ( p < 0.0304).

CONCLUSIONS

These preliminary clinical findings suggest the potential benefits electrical impedance measurements might have for prostate cancer detection.

Anatomically accurate hard priors for transrectal electrical impedance tomography (TREIT) of the prostate

Current prostate biopsy procedures entail sampling tissues at template-based locations that are not patient specific. Ultrasound (US)-coupled transrectal electrical impedance tomography (TREIT), featuring an endorectal US probe retrofitted with electrodes, has been developed for prostate imaging. This multi-modal imaging system aims to identify suspicious tumor regions based on their electrical properties and ultimately provide additional patient-specific locations where to take biopsy samples. Unfortunately, the open-domain geometry associated with TREIT results in a severely ill-posed problem due to the small number of measurements and unbounded imaging domain. Furthermore, reconstructing contrasts within the prostate volume is challenging because the conductivity differences between the prostate and surrounding tissues are much larger than the conductivity differences between benign and malignant tissues within the prostate. To help overcome these problems, anatomically accurate hard priors can be employed to limit estimation of the electrical property distribution to within the prostate volume; however, this requires the availability of structural information. Here, a method that extracts the prostate surface from US images and incorporates this surface into the image reconstruction algorithm has been developed to enable estimation of electrical parameters within the prostate volume. In this paper, the performance of this algorithm is evaluated against a more traditional EIT algorithm that does not use anatomically accurate structural information, in the context of numerical simulations and phantom experiments. The developed anatomically accurate hard-prior algorithm demonstrably identifies contrasts within the prostate volume while an algorithm that does not rely on anatomically accurate structural information is unable to localize these contrasts. While inclusions are identified in the correct locations, they are found to be smaller in size than the actual object due to the rapid decay in sensitivity at increasing distances from the probe surface. Despite this, identifying the size of the inclusion accurately may not be essential for biopsy guidance in a clinical setting; instead, knowledge of the general vicinity of a cancerous lesion may be sufficient for suggesting and guiding clinicians to extract additional biopsy cores.

Incorporating a biopsy needle as an electrode in transrectal electrical impedance imaging

Previous studies have shown that prostate cancer may be detected by a combined transrectal ultrasound and electrical impedance tomography imaging system. However, the sensitivity of the imaging system is limited due to very little current established in the far field distant from the probe surface. Consequently, biopsy needles are introduced to the imaging system to provide current paths in the distal regions. This study demonstrates that image sensitivity can be improved by incorporating the needle electrodes. A phantom experiment is presented to show that contrast to the background is enhanced by 17.4% when imaging with needle electrodes. Simulated reconstructions and some preliminary clinical data also suggest the sensitivity improvement. In summary, TREIT with needle electrodes in the tissue may have great potential in future clinical prostate cancer detection.

Passive bioelectrical properties for assessing high- and low-grade prostate adenocarcinoma

BACKGROUND

The electrical properties of prostate tissues are dependent on cellular morphology and have been demonstrated to distinguish between benign and malignant formations. Because Gleason grading is also based on tissue architecture we explored the hypothesis that the electrical properties might also provide discriminating power between high- and low-Gleason grade cancers.

METHODS

Electrical properties (σ, ε, Δσ, σ(∞) , f(c) , and α) were gauged from 546 prostate tissue samples and correlated with histopathological assessment. Primary and secondary Gleason grades and a Gleason score were assigned to the tissues identified as cancer. We evaluated how well differently graded cancers were separable from benign tissues and from each other on the basis of these properties using ROC curves.

RESULTS

Of the 546 prostate tissue samples, 71 were identified as cancer and 465 as benign. ε, Δσ, σ(∞) , and f(c) provided the most discriminatory power with area under the curves (AUCs) ranging from 0.77-0.82 for detecting any cancer, 0.72-0.8 for low-grade cancer, and increasing to 0.87-0.9 for detecting high-grade cancer. Further, ε, Δσ, and σ(∞) , provided AUCs ranging from 0.74 to 0.75 for discriminating between low- and high-grade cancers.

CONCLUSIONS

Using the electrical properties to identify prostate cancer is improved when high-grade cancers are sought. These electrical properties can also discriminate between different grades of tumors. These findings suggest that technologies being developed to sense and image these properties in vivo may discriminate between aggressive and indolent lesions.

Sensitivity study of an ultrasound coupled transrectal electrical impedance tomography system for prostate imaging

In 2009, prostate cancer ranked as the most common cancer and the second most fatal cancer in men in the United States. Unfortunately, the current clinical diagnostic methods (e.g. prostate-specific antigen (PSA), digital rectal examination, endorectal MRI, transrectal ultrasound, biopsy) used for detecting and staging prostate cancer are limited. It has been shown that cancerous prostate tissue has significantly different electrical properties when compared to benign tissues. Based on these electrical property findings, a transrectal electrical impedance tomography (TREIT) system is proposed as a novel prostate imaging modality. The TREIT system comprises an array of electrodes interfaced with a clinical transrectal ultrasound (TRUS) probe. We evaluate this imaging system through a series of phantom imaging experiments to assess the system's ability to image high and low contrast objects at various positions. We found that the TREIT system can easily discern high contrast inclusions of 1 cm in diameter at distances centered at two times the radius of the TREIT probe away from the probe surface. Furthermore, this technology's ability to detect low contrast inclusions suggests that it has the potential to successfully detect prostate cancer.