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Jong LJS, Veluponnar D, Geldof F, Sanders J, Guimaraes MDS, Vrancken Peeters MJTFD, van Duijnhoven F, Sterenborg HJCM, Dashtbozorg B, Ruers TJM. Toward real-time margin assessment in breast-conserving surgery with hyperspectral imaging. Sci Rep 2025; 15:9556. [PMID: 40108280 PMCID: PMC11923364 DOI: 10.1038/s41598-025-94526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 03/14/2025] [Indexed: 03/22/2025] Open
Abstract
Margin assessment in breast-conserving surgery (BSC) remains a critical challenge, with 20-25% of cases resulting in inadequate tumor resection, increasing the risk of local recurrence and the need for additional treatment. In this study, we evaluate the diagnostic performance of hyperspectral imaging (HSI) as a non-invasive technique for assessing resection margins in ex vivo lumpectomy specimens. A dataset of over 200 lumpectomy specimens was collected using two hyperspectral cameras, and a classification algorithm was developed to distinguish between healthy and tumor tissue within margins of 0 and 2 mm. The proposed approach achieved its highest diagnostic performance at a 0 mm margin, with a sensitivity of 92%, specificity of 78%, accuracy of 83%, Matthews correlation coefficient of 68%, and an area under the curve of 89%. The entire resection surface could be imaged and evaluated within 10 minutes, providing a rapid and non-invasive alternative to conventional margin assessment techniques. These findings represent a significant advancement toward real-time intraoperative margin assessment, highlighting the potential of HSI to enhance surgical precision and reduce re-excision rates in BCS.
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Affiliation(s)
- Lynn-Jade S Jong
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Faculty of Science and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB, The Netherlands
| | - Dinusha Veluponnar
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Faculty of Science and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB, The Netherlands
| | - Freija Geldof
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Joyce Sanders
- Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Marcos Da Silva Guimaraes
- Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | | | - Frederieke van Duijnhoven
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Henricus J C M Sterenborg
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Behdad Dashtbozorg
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
| | - Theo J M Ruers
- Image-Guided Surgery, Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Faculty of Science and Technology, University of Twente, Drienerlolaan 5, Enschede, 7522 NB, The Netherlands
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Leung JH, Karmakar R, Mukundan A, Lin WS, Anwar F, Wang HC. Technological Frontiers in Brain Cancer: A Systematic Review and Meta-Analysis of Hyperspectral Imaging in Computer-Aided Diagnosis Systems. Diagnostics (Basel) 2024; 14:1888. [PMID: 39272675 PMCID: PMC11394276 DOI: 10.3390/diagnostics14171888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
Brain cancer is a substantial factor in the mortality associated with cancer, presenting difficulties in the timely identification of the disease. The precision of diagnoses is significantly dependent on the proficiency of radiologists and neurologists. Although there is potential for early detection with computer-aided diagnosis (CAD) algorithms, the majority of current research is hindered by its modest sample sizes. This meta-analysis aims to comprehensively assess the diagnostic test accuracy (DTA) of computer-aided design (CAD) models specifically designed for the detection of brain cancer utilizing hyperspectral (HSI) technology. We employ Quadas-2 criteria to choose seven papers and classify the proposed methodologies according to the artificial intelligence method, cancer type, and publication year. In order to evaluate heterogeneity and diagnostic performance, we utilize Deeks' funnel plot, the forest plot, and accuracy charts. The results of our research suggest that there is no notable variation among the investigations. The CAD techniques that have been examined exhibit a notable level of precision in the automated detection of brain cancer. However, the absence of external validation hinders their potential implementation in real-time clinical settings. This highlights the necessity for additional studies in order to authenticate the CAD models for wider clinical applicability.
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Affiliation(s)
- Joseph-Hang Leung
- Department of Radiology, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia Yi 60002, Taiwan;
| | - Riya Karmakar
- Department of Mechanical Engineering, National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi 62102, Taiwan; (R.K.); (A.M.)
| | - Arvind Mukundan
- Department of Mechanical Engineering, National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi 62102, Taiwan; (R.K.); (A.M.)
| | - Wen-Shou Lin
- Neurology Division, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Lingya District, Kaohsiung City 80284, Taiwan
| | - Fathima Anwar
- Faculty of Allied Health Sciences, The University of Lahore, 1-Km Defense Road, Lahore 54590, Punjab, Pakistan;
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi 62102, Taiwan; (R.K.); (A.M.)
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Road, Dalin, Chia Yi 62247, Taiwan
- Department of Technology Development, Hitspectra Intelligent Technology Co., Ltd., 8F.11-1, No. 25, Chenggong 2nd Rd., Qianzhen Dist., Kaohsiung City 80661, Taiwan
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Cui R, Yu H, Xu T, Xing X, Cao X, Yan K, Chen J. Deep Learning in Medical Hyperspectral Images: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22249790. [PMID: 36560157 PMCID: PMC9784550 DOI: 10.3390/s22249790] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/13/2023]
Abstract
With the continuous progress of development, deep learning has made good progress in the analysis and recognition of images, which has also triggered some researchers to explore the area of combining deep learning with hyperspectral medical images and achieve some progress. This paper introduces the principles and techniques of hyperspectral imaging systems, summarizes the common medical hyperspectral imaging systems, and summarizes the progress of some emerging spectral imaging systems through analyzing the literature. In particular, this article introduces the more frequently used medical hyperspectral images and the pre-processing techniques of the spectra, and in other sections, it discusses the main developments of medical hyperspectral combined with deep learning for disease diagnosis. On the basis of the previous review, tne limited factors in the study on the application of deep learning to hyperspectral medical images are outlined, promising research directions are summarized, and the future research prospects are provided for subsequent scholars.
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Affiliation(s)
- Rong Cui
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
| | - He Yu
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
- Jilin Provincial Key Laboratory of Human Health Status Identification and Function Enhancement, Changchun University, Changchun 130022, China
| | - Tingfa Xu
- Image Engineering & Video Technology Lab, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
- Beijing Institute of Technology Chongqing Innovation Center, Chongqing 401120, China
| | - Xiaoxue Xing
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
- Jilin Provincial Key Laboratory of Human Health Status Identification and Function Enhancement, Changchun University, Changchun 130022, China
| | - Xiaorui Cao
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
| | - Kang Yan
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
| | - Jiexi Chen
- College of Electronic and Information Engineering, Changchun University, Changchun 130022, China
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Wu Y, Xu Z, Yang W, Ning Z, Dong H. Review on the Application of Hyperspectral Imaging Technology of the Exposed Cortex in Cerebral Surgery. Front Bioeng Biotechnol 2022; 10:906728. [PMID: 35711634 PMCID: PMC9196632 DOI: 10.3389/fbioe.2022.906728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
The study of brain science is vital to human health. The application of hyperspectral imaging in biomedical fields has grown dramatically in recent years due to their unique optical imaging method and multidimensional information acquisition. Hyperspectral imaging technology can acquire two-dimensional spatial information and one-dimensional spectral information of biological samples simultaneously, covering the ultraviolet, visible and infrared spectral ranges with high spectral resolution, which can provide diagnostic information about the physiological, morphological and biochemical components of tissues and organs. This technology also presents finer spectral features for brain imaging studies, and further provides more auxiliary information for cerebral disease research. This paper reviews the recent advance of hyperspectral imaging in cerebral diagnosis. Firstly, the experimental setup, image acquisition and pre-processing, and analysis methods of hyperspectral technology were introduced. Secondly, the latest research progress and applications of hyperspectral imaging in brain tissue metabolism, hemodynamics, and brain cancer diagnosis in recent years were summarized briefly. Finally, the limitations of the application of hyperspectral imaging in cerebral disease diagnosis field were analyzed, and the future development direction was proposed.
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Affiliation(s)
- Yue Wu
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Zhongyuan Xu
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Wenjian Yang
- Research Center for Intelligent Sensing Systems, Zhejiang Lab, Hangzhou, China
| | - Zhiqiang Ning
- Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences (CAS), Hefei, China.,Science Island Branch, Graduate School of USTC, Hefei, China
| | - Hao Dong
- Research Center for Sensing Materials and Devices, Zhejiang Lab, Hangzhou, China
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Akram Abdulrazzaq A, Sulaiman Hamid S, Al-Douri AT, Hamad Mohamad AA, Selvi D, Mohamed Ibrahim A. Hyperspectral Image Analysis of Colon Tissue and Deep Learning for Characterization of Health care. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:8670534. [PMID: 35685861 PMCID: PMC9173909 DOI: 10.1155/2022/8670534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022]
Abstract
Colon cancer is a disease characterized by the unusual and uncontrolled development of cells that are found in the large intestine. If the tumour extends to the lower part of the colon (rectum), the cancer may be colorectal. Medical imaging is the denomination of methods used to create visual representations of the human body for clinical analysis, such as diagnosing, monitoring, and treating medical conditions. In this research, a computational proposal is presented to aid the diagnosis of colon cancer, which consists of using hyperspectral images obtained from slides with biopsy samples of colon tissue in paraffin, characterizing pixels so that, afterwards, imaging techniques can be applied. Using computer graphics augmenting conventional histological deep learning architecture, it can classify pixels in hyperspectral images as cancerous, inflammatory, or healthy. It is possible to find connections between histochemical characteristics and the absorbance of tissue under various conditions using infrared photons at various frequencies in hyperspectral imaging (HSI). Deep learning techniques were used to construct and implement a predictor to detect anomalies, as well as to develop a computer interface to assist pathologists in the diagnosis of colon cancer. An infrared absorbance spectrum of each of the pixels used in the developed classifier resulted in an accuracy level of 94% for these three classes.
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Affiliation(s)
- Ammar Akram Abdulrazzaq
- Department of Medical Laboratory Techniques, Al-maarif University College, Ramadi, Al-Anbar, Iraq
| | | | - Asaad T. Al-Douri
- Department of Dental Industry, College of Medical Technology, Al-Kitab University, Kirkuk, Iraq
| | - A. A. Hamad Mohamad
- Department of Medical Laboratory Techniques, Dijlah University College, Baghdad 10021, Iraq
- The University of Mashreq, Research Center, Baghdad, Iraq
| | - D. Selvi
- Department of Physics, Jayaraj Annapackiam College for Women Periyakulam, Theni, Tamil Nadu, India
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Maktabi M, Tkachenko M, Kohler H, Schierle K, Gockel I, Jansen-Winkeln B, Chalopin C. Using physiological parameters measured by hyperspectral imaging to detect colorectal cancer. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3865-3868. [PMID: 34892077 DOI: 10.1109/embc46164.2021.9630160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The accurate detection of malignant tissue during colorectal surgery impacts operation outcome. The non-invasive spectral imaging combined with machine learning (ML) methods showed to be promising for tumor identification. However, large spectral range implies large computing time. To reduce the number of features, ML methods (e.g. logistic regression and convolutional neuronal network CNN) were evaluated based on four physiological tissue parameters to automatically classify cancer and healthy mucosa in resected colon tissue. A ROC AUC of 0.81 was achieved with the CNN. This study shows that the use of only specific wavelengths bands can detect cancer.Clinical Relevance- These outcomes support the possibility to automatically classify colon tumor based on physiological parameters calculated using only specific wavelength bands. Hence, future image-guided colorectal surgeries can be performed with real-time multispectral imaging.
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Collins T, Maktabi M, Barberio M, Bencteux V, Jansen-Winkeln B, Chalopin C, Marescaux J, Hostettler A, Diana M, Gockel I. Automatic Recognition of Colon and Esophagogastric Cancer with Machine Learning and Hyperspectral Imaging. Diagnostics (Basel) 2021; 11:1810. [PMID: 34679508 PMCID: PMC8535008 DOI: 10.3390/diagnostics11101810] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 01/23/2023] Open
Abstract
There are approximately 1.8 million diagnoses of colorectal cancer, 1 million diagnoses of stomach cancer, and 0.6 million diagnoses of esophageal cancer each year globally. An automatic computer-assisted diagnostic (CAD) tool to rapidly detect colorectal and esophagogastric cancer tissue in optical images would be hugely valuable to a surgeon during an intervention. Based on a colon dataset with 12 patients and an esophagogastric dataset of 10 patients, several state-of-the-art machine learning methods have been trained to detect cancer tissue using hyperspectral imaging (HSI), including Support Vector Machines (SVM) with radial basis function kernels, Multi-Layer Perceptrons (MLP) and 3D Convolutional Neural Networks (3DCNN). A leave-one-patient-out cross-validation (LOPOCV) with and without combining these sets was performed. The ROC-AUC score of the 3DCNN was slightly higher than the MLP and SVM with a difference of 0.04 AUC. The best performance was achieved with the 3DCNN for colon cancer and esophagogastric cancer detection with a high ROC-AUC of 0.93. The 3DCNN also achieved the best DICE scores of 0.49 and 0.41 on the colon and esophagogastric datasets, respectively. These scores were significantly improved using a patient-specific decision threshold to 0.58 and 0.51, respectively. This indicates that, in practical use, an HSI-based CAD system using an interactive decision threshold is likely to be valuable. Experiments were also performed to measure the benefits of combining the colorectal and esophagogastric datasets (22 patients), and this yielded significantly better results with the MLP and SVM models.
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Affiliation(s)
- Toby Collins
- Institute for Research against Digestive Cancer (IRCAD), 67091 Strasbourg, France; (M.B.); (J.M.); (A.H.); (M.D.)
| | - Marianne Maktabi
- Innovation Center Computer-Assisted Surgery (ICCAS), University of Leipzig, 04103 Leipzig, Germany; (M.M.); (C.C.)
| | - Manuel Barberio
- Institute for Research against Digestive Cancer (IRCAD), 67091 Strasbourg, France; (M.B.); (J.M.); (A.H.); (M.D.)
- General Surgery Department, Card. G. Panico, 73039 Tricase, Italy
| | - Valentin Bencteux
- ICUBE Laboratory, Photonics Instrumentation for Health, University of Strasbourg, 67400 Strasbourg, France;
| | - Boris Jansen-Winkeln
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, 04103 Leipzig, Germany; (B.J.-W.); (I.G.)
| | - Claire Chalopin
- Innovation Center Computer-Assisted Surgery (ICCAS), University of Leipzig, 04103 Leipzig, Germany; (M.M.); (C.C.)
| | - Jacques Marescaux
- Institute for Research against Digestive Cancer (IRCAD), 67091 Strasbourg, France; (M.B.); (J.M.); (A.H.); (M.D.)
| | - Alexandre Hostettler
- Institute for Research against Digestive Cancer (IRCAD), 67091 Strasbourg, France; (M.B.); (J.M.); (A.H.); (M.D.)
| | - Michele Diana
- Institute for Research against Digestive Cancer (IRCAD), 67091 Strasbourg, France; (M.B.); (J.M.); (A.H.); (M.D.)
- ICUBE Laboratory, Photonics Instrumentation for Health, University of Strasbourg, 67400 Strasbourg, France;
- Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, 67091 Strasbourg, France
- INSERM, Institute of Viral and Liver Disease, 67091 Strasbourg, France
- Mitochondrion, Oxidative Stress and Muscle Protection (MSP)-EA 3072, Institute of Physiology, Faculty of Medicine, University of Strasbourg, 67085 Strasbourg, France
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, 04103 Leipzig, Germany; (B.J.-W.); (I.G.)
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Manni F, van der Sommen F, Fabelo H, Zinger S, Shan C, Edström E, Elmi-Terander A, Ortega S, Marrero Callicó G, de With PHN. Hyperspectral Imaging for Glioblastoma Surgery: Improving Tumor Identification Using a Deep Spectral-Spatial Approach. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6955. [PMID: 33291409 PMCID: PMC7730670 DOI: 10.3390/s20236955] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 12/16/2022]
Abstract
The primary treatment for malignant brain tumors is surgical resection. While gross total resection improves the prognosis, a supratotal resection may result in neurological deficits. On the other hand, accurate intraoperative identification of the tumor boundaries may be very difficult, resulting in subtotal resections. Histological examination of biopsies can be used repeatedly to help achieve gross total resection but this is not practically feasible due to the turn-around time of the tissue analysis. Therefore, intraoperative techniques to recognize tissue types are investigated to expedite the clinical workflow for tumor resection and improve outcome by aiding in the identification and removal of the malignant lesion. Hyperspectral imaging (HSI) is an optical imaging technique with the power of extracting additional information from the imaged tissue. Because HSI images cannot be visually assessed by human observers, we instead exploit artificial intelligence techniques and leverage a Convolutional Neural Network (CNN) to investigate the potential of HSI in twelve in vivo specimens. The proposed framework consists of a 3D-2D hybrid CNN-based approach to create a joint extraction of spectral and spatial information from hyperspectral images. A comparison study was conducted exploiting a 2D CNN, a 1D DNN and two conventional classification methods (SVM, and the SVM classifier combined with the 3D-2D hybrid CNN) to validate the proposed network. An overall accuracy of 80% was found when tumor, healthy tissue and blood vessels were classified, clearly outperforming the state-of-the-art approaches. These results can serve as a basis for brain tumor classification using HSI, and may open future avenues for image-guided neurosurgical applications.
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Affiliation(s)
- Francesca Manni
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (F.v.d.S.); (S.Z.); (P.H.N.d.W.)
| | - Fons van der Sommen
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (F.v.d.S.); (S.Z.); (P.H.N.d.W.)
| | - Himar Fabelo
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), 35017 Las Palmas de Gran Canaria, Spain; (H.F.); (S.O.); (G.M.C.)
| | - Svitlana Zinger
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (F.v.d.S.); (S.Z.); (P.H.N.d.W.)
| | - Caifeng Shan
- College of Electrical Engineering and Automation, Shandong University of Science and Technology, Qingdao 266590, China;
| | - Erik Edström
- Department of Neurosurgery, Karolinska University Hospital and Department of Clinical Neuroscience, Karolinska Institutet, SE-171 46 Stockholm, Sweden; (E.E.); (A.E.-T.)
| | - Adrian Elmi-Terander
- Department of Neurosurgery, Karolinska University Hospital and Department of Clinical Neuroscience, Karolinska Institutet, SE-171 46 Stockholm, Sweden; (E.E.); (A.E.-T.)
| | - Samuel Ortega
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), 35017 Las Palmas de Gran Canaria, Spain; (H.F.); (S.O.); (G.M.C.)
| | - Gustavo Marrero Callicó
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), 35017 Las Palmas de Gran Canaria, Spain; (H.F.); (S.O.); (G.M.C.)
| | - Peter H. N. de With
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (F.v.d.S.); (S.Z.); (P.H.N.d.W.)
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