Toward microendoscopic electrical impedance tomography for intraoperative surgical margin assessment.
Toward microendoscopic electrical impedance tomography for intraoperative surgical margin assessment.
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DOI：
10.1109/tbme.2014.2329461
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发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Kim YJ
中科院分区：
文献类型：
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作者：
Halter RJ;Kim YJ
在前列腺手术期间，没有常规使用临床方案来评估手术切缘状态。相反，通过根治性前列腺切除术后的前列腺病理学评估来评估切缘，此时提供额外的手术干预为时已晚。已经开发了一种术中装置，其可能能够基于良性和恶性前列腺组织之间的电特性对比来评估手术切缘状态。具体而言，显微内窥镜电阻抗断层扫描（EIT）探头已被构造成以近毫米分辨率感测和成像异质生物组织内的电导率对比度，目的是为外科医生提供边缘病理的实时评估。该器械由8个直径为0.6 mm的电极环组成，这些电极嵌入直径为5 mm的穿刺针尖中，可通过12 mm的腹腔镜端口进入。进行实验以评估由探针感测的组织体积。还用明胶中的内含物以及具有明确定义的脂肪和肌肉区域的猪组织样品测试了探针。探头的灵敏度区域由9.1 mm 2的圆形区域组成，最大灵敏度深度约为1.5 mm。探头能够在亚毫米尺度（~500 μm）上区分高对比度肌肉和脂肪组织。这些初步结果表明，EIT可能适用于设计为适合12 mm腹腔镜入路端口的穿刺针。
No clinical protocols are routinely used to intraoperatively assess surgical margin status during prostate surgery. Instead, margins are evaluated through pathological assessment of the prostate following radical prostatectomy, when it is too late to provide additional surgical intervention. An intraoperative device potentially capable of assessing surgical margin status based on the electrical property contrast between benign and malignant prostate tissue has been developed. Specifically, a microendoscopic electrical impedance tomography (EIT) probe has been constructed to sense and image, at near millimeter resolution, the conductivity contrast within heterogeneous biological tissues with the goal of providing surgeons with real-time assessment of margin pathologies. This device consists of a ring of eight 0.6-mm diameter electrodes embedded in a 5-mm diameter probe tip to enable access through a 12-mm laparoscopic port. Experiments were performed to evaluate the volume of tissue sensed by the probe. The probe was also tested with inclusions in gelatin, as well as on a sample of porcine tissue with clearly defined regions of adipose and muscle. The probe's area of sensitivity consists of a circular area of 9.1 mm2 and the maximum depth of sensitivity is approximately 1.5 mm. The probe is able to distinguish between high contrast muscle and adipose tissue on a sub-mm scale (~500 μm). These preliminary results suggest that EIT is possible in a probe designed to fit within a 12-mm laparoscopic access port.