Todd E Kerner

Electrical impedance spectroscopy of the breast: clinical imaging results in 26 subjects

Electrical impedance spectroscopy (EIS) is a potential, noninvasive technique to image women for breast cancer. Studies have shown characteristic frequency dispersions in the electrical conductivity and permittivity of malignant versus normal tissue. Using a multifrequency EIS system, we imaged the breasts of 26 women. All patients had mammograms ranked using the American College of Radiology (ACR) BIRADS system. Of the 51 individual breasts imaged, 38 were ACR 1 negative, six had ACR 4-5 suspicious lesions, and seven had ACR 2 benign findings such as fibroadenomas or calcifications. A radially translatable circular array of 16 Ag/AgCl electrodes was placed around the breast while the patient lay prone. We applied trigonometric voltage patterns at ten frequencies between 10 and 950 kHz. Anatomically coronal images were reconstructed from this data using nonlinear partial differential equation methods. Typically, ACR 1-rated breasts were interrogated in a single central plane whereas ACR 2-5-rated breasts were imaged in multiple planes covering the region of suspicion. In general, a characteristic homogeneous image emerged for mammographically normal cases while focal inhomogeneities were observed in images from women with malignancies. Using a specific visual criterion, EIS images identified 83% of the ACR 4-5 lesions while 67% were detected using a numerical criterion. Overall, multifrequency electrical impedance imaging appears promising for detecting breast malignancies, but improvements must be made before the method reaches its full potential.

Multifrequency electrical impedance imaging: preliminary in vivo experience in breast

We have deployed a recently completed spectroscopic electrical impedance tomography (EITS) imaging system in a small series of women (13 participants accrued to date) in order to investigate the feasibility of delivering EITS breast examinations on a routine basis. Hardware is driven with sinusoidally varying spatial patterns of applied voltage delivered to 16 electrodes over the 10 kHz to 1 MHz spectral range using a radially translating interface which couples the electrodes to the breast through direct contact. Imaging examinations have consisted of the acquisition of multi-channel measurements at ten frequencies on both breasts. Participants lie prone on an examination table with the breast to be imaged pendant in the electrode array that is located below the table. Examinations were comfortable and easy to deliver (about 10 minutes per breast including electrode-positioning time). Although localized near-surface electrode artefacts are evident in the acquired images, several findings have emerged. Permittivity images have generally been more informative than their conductivity counterparts, except in the case of fluid-filled cysts. Specifically, the mammographically normal breast appears to have characteristic absolute EITS permittivity and conductivity images that emerge across subjects. Structural features in the EITS images have correlated with limited clinical information available on participants with benign and malignant abnormality, cysts and scarring from previous lumpectomy and follow-up radiation therapy. Several cases from this preliminary experience are described.

Comparisons of three alternative breast modalities in a common phantom imaging experiment.

Four model-based imaging systems are currently being developed for breast cancer detection at Dartmouth College. A potential advantage of multimodality imaging is the prospect of combining information collected from each system to provide a more complete diagnostic tool that covers the full range of the patient and pathology spectra. In this paper it is shown through common phantom experiments on three of these imaging systems that it was possible to correlate different types of image information to potentially improve the reliability of tumor detection. Imaging experiments were conducted with common phantoms which mimic both dielectric and optical properties of the human breast. Cross modality comparison was investigated through a statistical study based on the repeated data sets of reconstructed parameters for each modality. The system standard error between all methods was generally less than 10% and the correlation coefficient across modalities ranged from 0.68 to 0.91. Future work includes the minimization of bias (artifacts) on the periphery of electrical impedance spectroscopy images to improve cross modality correlation and implementation of the multimodality diagnosis for breast cancer detection.

Dartmouth's next generation EIS system: preliminary hardware considerations

Our previous system covered the frequency range of 0 to 1 MHz. In this new design we propose to cover the range from 0 to 10 MHz. The higher frequencies have forced us to reconsider several design decisions in view of both the physics of the problem and the performance of available electronic components. In this presentation we examine in detail the constraints faced by the designer, starting from wiring consideration to measurement techniques. We will also present the solutions we selected to overcome the limitations we discovered. The problems include phase detection, amplitude measurements, system organization and layout and finally system calibration.

Electrical impedance imaging at multiple frequencies in phantoms

We have recently built and tested a 32 channel, multi-frequency (1 kHz to 1 MHz) voltage mode system to investigate electrical impedance spectroscopy (EIS) imaging. We completed a series of phantom experiments to define the baseline imaging performance of our system. Our phantom consisted of a plastic circular tank (20 cm diameter) filled with 0.9% aqueous NaCl solution. Conductors and nonconductors of decreasing width (W5: 3.4 cm, W4: 2.54 cm, W3: 0.95 cm, W2: 0.64 cm and WI: 0.32 cm) were positioned at various distances from the tank edge (1 cm, 2 cm, 4 cm and 8 cm). The results suggest that the detection of objects less than 1 cm in width is limited to the first 1 to 2 cm from the tank edge for absolute images, but this depth can extend to 8 cm in difference images. Larger 3.4 cm wide objects can be detected in absolute images at depths up to 8 cm from the tank edge. Generally, conductor images were clearer than their nonconductor counterparts. Not only did electrode artefacts lessen as the frequency increased, but the systems maximum resolution was attained at the highest operating frequencies. Although the system recovered the value of the electrical conductivity at the correct order of magnitude, it tended to smooth out large property discontinuities. The calculated electrical permittivity in these phantom studies was inconclusive due to the presence of electrode artefacts.

Imaging the breast with EIS: an initial study of exam consistency

Use of electrical impedance spectroscopy (EIS) to image the breasts of women with both normal and abnormal conditions requires the ability to deliver a consistent and repeatable exam. To investigate the degree to which our current imaging system can meet this requirement we conducted an initial study of exam consistency. The trial involved the imaging of 25 breasts stratified into four separate substudies with increasing levels of electrode placement uncertainty. The degree of complexity ranged from single-placement single-session imaging to multiple-placement single-session imaging to multiple-placement multiple-session imaging. Both visual analysis and quantitative comparisons using mean squared difference (MSD) measures between pairs of permittivity and conductivity images were performed. A new breast interface with the improved vertical and radial electrode array positioning capability required to complete this study is described. Not surprisingly, the results show a dominant trend of increased image variability with increased electrode placement uncertainty. Importantly, quantitative levels of image consistency are reported through MSD analysis. On average across all frequencies analysed, MSDs for single placements are well below 1%, near 2-3% for repositioned breasts during the same session and approximately 15% for re-examined breasts in multiple sessions conducted over time. Overall, these results suggest that EIS breast exams are consistent provided the electrode placement is well controlled, typically with better than 1 cm accuracy.

An improved data acquisition method for electrical impedance tomography

Isaacson, Cheney and Seager have demonstrated that simultaneously applying trigonometric patterns of current to a circular electrode array optimizes the sensitivity of EIT to inner structure. We have found that it is less desirable to measure voltage at an electrode that also applies a current due to variable contact impedance. In order to preserve the optimum sensitivity while minimizing the effect of electrode artefacts, we have devised an approach where we sequentially apply a current between each individual electrode and a separate, fixed ground while measuring voltages at all other electrodes for each consecutive current impulse. By adding weighted sums of both the applied currents and corresponding measured voltages from individual passes, we can synthesize trigonometric patterns of any spatial frequency. Since only one of the electrodes in any given acquired data set is used as a source, this approach significantly dilutes the effect of contact impedance on the resulting voltage measurements. We present simulated data showing the equivalency between the synthesized and actual trigonometric excitation patterns. In addition, we report experimental data, both in vitro and in vivo, that show improved results using this data acquisition technique.

Simulation of error propagation in finite element image reconstruction for electrical impedance tomography

Using extensive simulations, we have investigated the behaviour of finite element image reconstruction for electrical impedance tomography in the presence of inaccuracies likely to exist in real measurements. This study characterizes reconstruction when subjected to noise propagation using different excitation patterns and modes of operation. Specifically, a generalized framework for finite element image reconstruction is presented which allows electrical impedance images to be recovered from data collected in either voltage, current or impedance modes of operation that correspond naturally to the allowable boundary condition types which determine unique model solutions to the underlying partial differential equation as the basis for property estimation. Driving conditions consisting of electrode pairs, trigonometric or synthesized trigonometric patterns have been considered. The simulations presented here are based on an arbitrary impedance distribution for which applied and observed voltages and currents were computed. The applied and observed patterns were then processed identically to real data with the addition of 0, 0.1% and 1% random Gaussian noise. The mean squared error (MSE) between the reconstructed and exact impedance images constituted the measure of algorithmic performance. Our findings suggest that finite element reconstruction tolerates noise on the measurement data better than on the applied portion of the signal; pair excitations consistently produced the lowest MSE; noise appears to compound itself in the synthesized trigonometric patterns mode; and the applied voltage mode consistently yields more accurate images in the presence of noise than the equivalent cases corresponding to current mode. While only evaluated with trigonometric patterns, the impedance mode generally produced the lowest MSE in a limited set of simulation comparisons.

Electrical impedance imaging with electrode models: initial in vivo experience in the breast

Electrical impedance imaging of the breast is potentially promising but faces a number of challenges related to improving the sensitivity and reliability of the technique. Electrode models have been accepted as important components of image reconstruction but little practical experience with their use during image reconstruction from in vivo data has been reported. In this paper, we describe our approach to electrode modeling and present representative image reconstructions of in vivo breast exams with and without the use of an electrode model. Incorporation of an electrode model is found to improve image quality, especially in terms of reducing near-surface artifacts and improving the sensitivity of the conductivity image component image; however, the effects are generally secondary to the dominant image trends that appear with or without the use of an electrode model.

Modular architecture for nanosatellites

Miniaturization and reduction of design and production costs of electronics is at the forefront of todays technological efforts. Ground based applications have been the forerunner of this trend. It is proposed that a space analog be created. A modular architectural approach to the construction of an extremely small satellite may provide a standard for future space-based research, educational, and communication platforms. Dartsat is to meet such specifications while providing the footing for ongoing research ons pace operations at Dartmouth College. The first iteration of Dartsat is to serve as a model for future missions. Dartsat has dimensions of ten centimeters cubed; the maximum allowable mass is one kilogram. Of this volume, roughly 75 cm3 is occupied by mechanical superstructure. The remainder of the volume, approximately 925 cm3, is divided into modular bays. The control, power, and radio communication (CPR) of the satellite occupies one of these bays. The other bays are to be outfitted with standardized interfaces allowing the snap-in of interchangable, independently engineered payloads. The unique design of Dartsat is to provide a benchmark for future space flight orbital operations.