Histology-validated electromagnetic characterization of ex-vivo ovine lung tissue for microwave-based medical applications.

Microwave thermal ablation is an established therapeutic technique for treating malignant tissue in various organs. Its success greatly depends on the knowledge of dielectric properties of the targeted tissue and on how they change during the treatment. Innovation in lung navigation has recently increased the clinical interest in the transbronchial microwave ablation treatment of lung cancer. However, lung tissue is not largely characterized, thus its dielectric properties investigation prior and post ablation is key. In this work, dielectric properties of ex-vivo ovine lung parenchyma untreated and ablated at 2.45 GHz were recorded in the 0.5-8 GHz frequency range. The measured dielectric properties were fitted to 2-pole Cole-Cole relaxation model and the obtained model parameters were compared. Based on observed changes in the model parameters, the physical changes of the tissue post-ablation were discussed and validated through histology analysis. Additionally, to investigate the link of achieved results with the rate of heating, another two sets of samples, originating from both ovine and porcine tissues, were heated with a microwave oven for different times and at different powers. Dielectric properties were measured in the same frequency range. It was found that lung tissue experiences a different behavior according to heating rates: its dielectric properties increase post-ablation while a decrease is found for low rates of heating. It is hypothesized, and validated by histology, that during ablation, although the tissue is losing water, the air cavities deform, lowering air content and increasing the resulting tissue properties.

Histology-Validated Dielectric Characterisation of Lung Carcinoma Tissue for Microwave Thermal Ablation Applications.

Microwave thermal ablation is a promising emerging treatment for early-stage lung cancer. Applicator design optimisation and treatment planning rely on accurate knowledge of dielectric tissue properties. Limited dielectric data are available in the literature for human lung tissue and pulmonary tumours. In this work, neoplastic and non-neoplastic lung dielectric properties are characterised and correlated with gross and histological morphology. Fifty-six surgical specimens were obtained from twelve patients undergoing lung resection for lung cancer in University Hospital of Galway, Ireland. Dielectric spectroscopy in the microwave frequency range (500 MHz-8.5 GHz) was performed on the ex vivo lung specimens with the open-ended coaxial probe technique (in the Department of Pathology). Dielectric data were analysed and correlated with the tissue histology. The dielectric properties of twelve lung tumours (67% non-small cell carcinoma (NSCC)) and uninvolved lung parenchyma were obtained. The values obtained from the neoplastic lung specimens (relative permittivity: 52.0 ± 5.4, effective conductivity: 1.9 ± 0.2 S/m, at 2.45 GHz) were on average twice the value of the non-neoplastic lung specimens (relative permittivity: 28.3 ± 6.7, effective conductivity: 1.0 ± 0.3 S/m, at 2.45 GHz). Dense fibrosis was comparable with tumour tissue (relative permittivity 49.3 ± 4.6, effective conductivity: 1.8 ± 0.1 S/m, at 2.45 GHz).

Management of adreno-cortical adenomas using microwave ablation: study of the effects of the fat tissue.

BACKGROUND AND OBJECTIVES: Adrenocortical neoplasms are the main causes of secondary hypertension and related comorbidities including hypokalemia and cardiovascular diseases. Conventional techniques for the management of this condition are often invasive and not resolutive. Recent studies proposed microwave thermal ablation (MWA) to eradicate adrenocortical adenomas arising in proximity to sensitive structures. This study explores a new MWA approach to selectively direct the electromagnetic energy into the target and shield the surrounding tissues. The new solution relies on the anatomical and dielectric characteristics of the adrenal gland and the surrounding fat capsule. METHODS: A 3 D model of the adrenal gland is developed, and a cooled microwave applicator is placed parallel to the interface between the fat and adrenal tissue. Numerical simulations are conducted at 2.45 GHz accounting for two energy delivery settings, two orientations of the applicator and blood perfusion of the tissues. Ex vivo and in vivo ablation procedures are conducted on ovine adrenal glands. Histology analysis completes the experimental studies. RESULTS: Numerical results show asymmetric ablation profiles in ex vivo and in vivo conditions. The asymmetry ratio is influenced by the procedure settings and orientation of the applicator. Ablation zones obtained experimentally agree with those predicted by the numerical simulations. Histology analysis confirms irreversible cellular changes only in the adrenal tissue close to the applicator. CONCLUSIONS: The outcomes show that the dielectric contrast between the fat layer and tissue target can be a tool in MWA to shape ablation zones to protect the surrounding structures from excessive temperature increases.

Incoherent Radar Imaging for Breast Cancer Detection and Experimental Validation against 3D Multimodal Breast Phantoms.

In this paper we consider radar approaches for breast cancer detection. The aim is to give a brief review of the main features of incoherent methods, based on beam-forming and Multiple SIgnal Classification (MUSIC) algorithms, that we have recently developed, and to compare them with classical coherent beam-forming. Those methods have the remarkable advantage of not requiring antenna characterization/compensation, which can be problematic in view of the close (to the breast) proximity set-up usually employed in breast imaging. Moreover, we proceed to an experimental validation of one of the incoherent methods, i.e., the I-MUSIC, using the multimodal breast phantom we have previously developed. While in a previous paper we focused on the phantom manufacture and characterization, here we are mainly concerned with providing the detail of the reconstruction algorithm, in particular for a new multi-step clutter rejection method that was employed and only barely described. In this regard, this contribution can be considered as a completion of our previous study. The experiments against the phantom show promising results and highlight the crucial role played by the clutter rejection procedure.

Numerical Sensitivity Analysis for Dielectric Characterization of Biological Samples by Open-Ended Probe Technique.

Dielectric characterization of biological tissues has become a fundamental aspect of the design of medical treatments based on electromagnetic energy delivery and their pre-treatment planning. Among several measuring techniques proposed in the literature, broadband and minimally-invasive open-ended probe measurements are best-suited for biological tissues. However, several challenges related to measurement accuracy arise when dealing with biological tissues in both ex vivo and in vivo scenarios such as very constrained set-ups in terms of limited sample size and probe positioning. By means of the Finite Integration Technique in the CST Studio Suite® software, the numerical accuracy of the reconstruction of the complex permittivity of a high water-content tissue such as liver and a low water-content tissue such as fat is evaluated for different sample dimensions, different location of the probe, and considering the influence of the background environment. It is found that for high water-content tissues, the insertion depth of the probe into the sample is the most critical parameter on the accuracy of the reconstruction. Whereas when low water-content tissues are measured, the probe could be simply placed in contact with the surface of the sample but a deeper and wider sample is required to mitigate biasing effects from the background environment. The numerical analysis proves to be a valid tool to assess the suitability of a measurement set-up for a target accuracy threshold.

Exploiting Tissue Dielectric Properties to Shape Microwave Thermal Ablation Zones.

The dielectric characterization of tissue targets of microwave thermal ablation (MTA) have improved the efficacy and pre-procedural planning of treatment. In some clinical scenarios, the tissue target lies at the interface with an external layer of fat. The aim of this work is to investigate the influence of the dielectric contrast between fat and target tissue on the shape and size of the ablation zone. A 2.45 GHz monopole antenna is placed parallel to an interface modelled by fat and a tissue characterized by higher dielectric properties and powered at 30 and 60 W for 60 s. The performances of MTA are numerically investigated considering different interface scenarios (i.e., different widths of fat layer, shifts in the antenna alignment) and a homogeneous reference scenario. Experiments (N = 10) are conducted on ex vivo porcine tissue to validate the numerical results. Asymmetric heating patterns are obtained in the interface scenario, the ablation zone in the target tissue is two-fold to ten-fold the size of the zone in the adipose tissue, and up to four times larger than the homogenous scenario. The adipose tissue reflects the electromagnetic energy into the adjacent tissue target, reducing the heating in the opposite direction.

Multimodal Breast Phantoms for Microwave, Ultrasound, Mammography, Magnetic Resonance and Computed Tomography Imaging.

The aim of this work was to develop multimodal anthropomorphic breast phantoms suitable for evaluating the imaging performance of a recently-introduced Microwave Imaging (MWI) technique in comparison to the established diagnostic imaging modalities of Magnetic Resonance Imaging (MRI), Ultrasound (US), mammography and Computed Tomography (CT). MWI is an emerging technique with significant potential to supplement established imaging techniques to improve diagnostic confidence for breast cancer detection. To date, numerical simulations have been used to assess the different MWI scanning and image reconstruction algorithms in current use, while only a few clinical trials have been conducted. To bridge the gap between the numerical simulation environment and a more realistic diagnostic scenario, anthropomorphic phantoms which mimic breast tissues in terms of their heterogeneity, anatomy, morphology, and mechanical and dielectric characteristics, may be used. Key in this regard is achieving realism in the imaging appearance of the different healthy and pathologic tissue types for each of the modalities, taking into consideration the differing imaging and contrast mechanisms for each modality. Suitable phantoms can thus be used by radiologists to correlate image findings between the emerging MWI technique and the more familiar images generated by the conventional modalities. Two phantoms were developed in this study, representing difficult-to-image and easy-to-image patients: the former contained a complex boundary between the mammary fat and fibroglandular tissues, extracted from real patient MRI datasets, while the latter contained a simpler and less morphologically accurate interface. Both phantoms were otherwise identical, with tissue-mimicking materials (TMMs) developed to mimic skin, subcutaneous fat, fibroglandular tissue, tumor and pectoral muscle. The phantoms' construction used non-toxic materials, and they were inexpensive and relatively easy to manufacture. Both phantoms were scanned using conventional modalities (MRI, US, mammography and CT) and a recently introduced MWI radar detection procedure called in-coherent Multiple Signal Classification (I-MUSIC). Clinically realistic artifact-free images of the anthropomorphic breast phantoms were obtained using the conventional imaging techniques as well as the emerging technique of MWI.

Using microwave thermal ablation to develop a subtotal, cortical-sparing approach to the management of primary aldosteronism.

Objective: To investigate the feasibility and efficacy of localized, subtotal, cortical-sparing microwave thermal ablation (MTA) as a potential curative management for primary aldosteronism. The study investigated with equal importance the selected ablation of small volumes of adrenal cortex while sparing adjacent cortex. Method: An in-vivo study was carried out in swine (n = 8) where MTA was applied under direct visualization, to the adrenal glands at 45 W or 70 W for 60 s, using a lateral, side-firing probe and a non-penetrative approach. Animals were survived for 48 h post-procedurally. Animals were investigated for markers of histological, immunohistochemical and biochemical evidence of adrenal function and adrenal damage by assessing samples drawn intra-operatively and at the time of euthanasia. Results: Selected MTA (70 W for 60 s) successfully ablated small adrenocortical volumes (∼0.8 cm3) characterized by coagulative necrosis and abnormal expression of functional markers (CYP11B1 and CYP17). Non-ablated, adjacent cortex was not affected and preserved normal expression of functional markers, without increased expression of markers of heat damage (HSP-70 and HMGB-1). Limited adrenal medullary damage was demonstrated histologically, clinically and biochemically. Conclusion: MTA offers potential as an efficient methodology for delivering targeted subtotal cortical-sparing adrenal ablation. Image-guided targeted MTA may also represent a safe future modality for curative management of PA, in the setting of both unilateral and bilateral disease.

Microwave bone imaging: a preliminary scanning system for proof-of-concept.

This Letter introduces a feasibility study of a scanning system for applications in biomedical bone imaging operating in the microwave range 0.5-4 GHz. Mechanical uncertainties and data acquisition time are minimised by using a fully automated scanner that controls two antipodal Vivaldi antennas. Accurate antenna positioning and synchronisation with data acquisition enables a rigorous proof-of-concept for the microwave imaging procedure of a multi-layer phantom including skin, fat, muscle and bone tissues. The presence of a suitable coupling medium enables antenna miniaturisation and mitigates the impedance mismatch between antennas and phantom. The three-dimensional image of tibia and fibula is successfully reconstructed by scanning the multi-layer phantom due to the distinctive dielectric contrast between target and surrounding tissues. These results show the viability of a microwave bone imaging technology which is low cost, portable, non-ionising, and does not require specially trained personnel. In fact, as no a-priori characterisation of the antenna is required, the image formation procedure is very conveniently simplified.

Beamforming and holography image formation methods: an analytic study.

Beamforming and holographic imaging procedures are widely used in many applications such as radar sensing, sonar, and in the area of microwave medical imaging. Nevertheless, an analytical comparison of the methods has not been done. In this paper, the Point Spread Functions pertaining to the two methods are analytically determined. This allows a formal comparison of the two techniques, and to easily highlight how the performance depends on the configuration parameters, including frequency range, number of scatterers, and data discretization. It is demonstrated that the beamforming and holography basically achieve the same resolution but beamforming requires a cheaper (less sensors) configuration..

Breast cancer detection using interferometric MUSIC: experimental and numerical assessment.

PURPOSE: In microwave breast cancer detection, it is often beneficial to arrange sensors in close proximity to the breast. The resultant coupling generally changes the antenna response. As an a priori characterization of the radio frequency system becomes difficult, this can lead to severe degradation of the detection efficacy. The purpose of this paper is to demonstrate the advantages of adopting an interferometric multiple signal classification (I-MUSIC) approach due to its limited dependence from a priori information on the antenna. The performance of I-MUSIC detection was measured in terms of signal-to-clutter ratio (SCR), signal-to-mean ratio (SMR), and spatial displacement (SD) and compared to other common linear noncoherent imaging methods, such as migration and the standard wideband MUSIC (WB-MUSIC) which also works when the antenna is not accounted for. METHODS: The data were acquired by scanning a synthetic oil-in-gelatin phantom that mimics the dielectric properties of breast tissues across the spectrum 1-3 GHz using a proprietary breast microwave multi-monostatic radar system. The phantom is a multilayer structure that includes skin, adipose, fibroconnective, fibroglandular, and tumor tissue with an adipose component accounting for 60% of the whole structure. The detected tumor has a diameter of 5 mm and is inserted inside a fibroglandular region with a permittivity contrast εr-tumor/εr-fibroglandular < 1.5 over the operating band. Three datasets were recorded corresponding to three antennas with different coupling mechanisms. This was done to assess the independence of the I-MUSIC method from antenna characterizations. The datasets were processed by using I-MUSIC, noncoherent migration, and wideband MUSIC under equivalent conditions (i.e., operative bandwidth, frequency samples, and scanning positions). SCR, SMR, and SD figures were measured from all reconstructed images. In order to benchmark experimental results, numerical simulations of equivalent scenarios were carried out by using CST Microwave Studio. The three numerical datasets were then processed following the same procedure that was designed for the experimental case. RESULTS: Detection results are presented for both experimental and numerical phantoms, and higher performance of the I-MUSIC method in comparison with the WB-MUSIC and noncoherent migration is achieved. This finding is confirmed for the three different antennas in this study. Although a delocalization effect occurs, experimental datasets show that the signal-to-clutter ratio and the signal-to-mean performance with the I-MUSIC are at least 5 and 2.3 times better than the other methods, respectively. The numerical datasets calculated on an equivalent phantom for cross-testing confirm the improved performance of the I-MUSIC in terms of SCR and SMR. In numerical simulations, the delocalization effect is dramatically reduced up to an SD value of 1.61 achieved with the I-MUSIC in combination with the antipodal Vivaldi antenna. This shows that mechanical uncertainties are the main reason for the delocalization effect in the measurements. CONCLUSIONS: Experimental results show that the I-MUSIC generates images with signal-to-clutter levels higher than 5.46 dB across all working conditions and it reaches 7.84 dB in combination with the antipodal Vivaldi antenna. Numerical simulations confirm this trend and due to ideal mechanical conditions return a signal-to-clutter level higher than 7.61 dB. The I-MUSIC largely outperforms the methods under comparison and is able to detect a 5-mm tumor with a permittivity contrast of 1.5.