No abstract

Ultrasonography or fluoroscopy-guided needle injection has been used for intra-articular injection therapy against adhesive capsulitis and joint diseases. To improve the image-guided intra-articular injection therapy, electrical impedance measurement based positioning of the needle tip in the target tissue can be applied. The feasibility of the discrimination for the tissue layer at which the disposable monopolar injection needle tip position was investigated using the discrete Fourier transform (DFT)-based impedance measurement system and the ultrasound imaging device. The electrical impedance spectra of the pork tissue measured in the frequency range of 200 Hz to 50 kHz were characterized by designed equivalent circuit modeling analysis. The normalized impedance data of the tissue layers (dermis, hypodermis, and muscle) were significantly different from each other (p-value < 0.001). The DFT-based impedance measurement system with a monopolar injection needle can be complementary to the image-guided intra-articular injection therapy.

For successful intra-articular injection therapy, it is essential to accurately position the tip of the injection needle into the target joint area while administering the drug into the affected tissue. In this study, we investigated the feasibility of a monopolar injection needle and lock-in amplifier (LIA)-based impedance measurement system for detecting the tissue type where the needle tip is located. After positioning the monopolar injection needle tip into the dermis, hypodermis, or muscle layer of pork tissue, the electrical impedance was measured in the frequency range of 10 Hz to 10 kHz. We observed a difference in the results based on the tissue type where the needle was positioned (p-value < 0.01). Therefore, the monopolar injection needle with electrical impedance measurement can be used to improve intra-articular injection therapy through non-destructive and real-time monitoring of the needle position in the tissues.

Rheumatoid arthritis and osteoarthritis can be treated through specific drug injection into the intra-articular space. Several failures during drug injection attempts with conventional fluoroscopy and ultrasonography in a small area of the intra-articular space have been reported. In this work we present an innovative impedance measurement-based method/algorithm for needle tip positioning to enhance image-guided intra-articular vaccination treatment. A novel algorithm for detecting the intra-articular space in the elbow and knee joints of a live porcine model is reported. An impedance measurement system was developed for biological tissue measurement. The electrical impedance in the intra-articular space was monitored and the needle tip was examined by ultrasonography. The contrast dye was vaccinated and checked using fluoroscopy to confirm that the dye was properly inoculated in the cavity. The electrical impedance was estimated for various needle inclusion profundity levels in saline solution, which were broadly used to evaluate the proposed device for in vivo examinations. Good efficiency was observed in the impedance-based measurements using a monopolar injection needle for intra-articular therapy. To enhance the needle tip positioning for intra-articular therapy, the intended impedance measurement device with a monopolar injection needle can be used as a complement to existing modalities.