Towards intraoperative surgical margin assessment: Validation of an electrical impedance-based probe with ex vivo bovine tissue.
Towards intraoperative surgical margin assessment: Validation of an electrical impedance-based probe with ex vivo bovine tissue.
复制标题
术中手术切缘评估：用离体牛组织验证基于电阻抗的探针。
DOI：
10.1109/embc40787.2023.10340037
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Halter,RyanJ
中科院分区：
文献类型：
--
作者：
Doussan,AllaireF;Lloyd,Sophie;Murphy,EthanK;Halter,RyanJ
根治性前列腺切除术（RP）是治疗前列腺癌的常用手术疗法。该手术具有较高的手术切缘阳性率（PSM），范围为4- 48%。PSM患者的癌症复发率较高，并且经常接受有害的辅助治疗。术中手术切缘评估（SMA）与电阻抗为基础的探头可以潜在地识别PSM的实时。这将使外科医生能够在手术室中做出基于数据的决策，以改善患者的预后。本文的重点是表征阻抗传感SMA探头与专用电极，以提高速度和带宽，同时保持精度。从离体牛组织生成3D电阻抗断层扫描（EIT）重建，以表征探头成像并确定最佳施加压力范围（15 Pa至38 Pa）。脂肪和肌肉组织的分类精度进行了评估，通过比较实验数据集的模拟数据的基础上的地面真二进制地图的组织。实验AUC ≥0.83的频率维持在50 kHz。所开发的阻抗传感探头成功地分类之间的肌肉和脂肪组织在离体牛模型。未来的工作包括改进SMA探头的性能与定制的硬件和收集数据，从体外和体内prostate tissues.Clinical Relevance-这项技术预计将减少率PSM RP和减少使用手术后辅助治疗。还预期术中阻抗测量将增加神经保留手术的功效并减少诸如失禁和勃起功能障碍的并发症。
Radical prostatectomy (RP) is a common surgical therapy to treat prostate cancer. The procedure has a high positive surgical margin (PSM) rate ranging from 4-48%. Patients with PSMs have a higher rate of cancer recurrence and often undergo noxious adjuvant therapy. Intraoperative surgical margin assessment (SMA) with an electrical impedance-based probe can potentially identify PSMs in real-time. This would enable surgeons to make data-based decisions in the operating room to improve patient outcomes. This paper focuses on characterizing an impedance sensing SMA probe with specialized electrodes to improve speed and bandwidth while maintaining accuracy. 3D electrical impedance tomography (EIT) reconstructions were generated from ex vivo bovine tissue to characterize probe imaging and to determine an optimal applied pressure range (15 Pa to 38 Pa). Classification accuracy of adipose and muscle tissue was evaluated by comparing the experimental data set to simulated data based on a ground truth binary map of the tissue. Experimental AUCs ≥0.83 were maintained up to 50 kHz. The developed impedance sensing probe successfully classified between muscle and adipose tissue in an ex vivo bovine model. Future work includes improving performance of the SMA probe with custom hardware and collecting data from ex vivo and in vivo prostatic tissues.Clinical Relevance—This technology is expected to reduce the rate of PSMs in RP and decrease the use of post-surgical adjuvant therapies. It is also anticipated that intraoperative impedance measurements will increase efficacy of nerve sparing procedures and reduce complications such as incontinence and erectile dysfunction.