The clinical application of electrical impedance technology in the detection of malignant neoplasms: a systematic review

Abstract

Background Electrical impedance technology has been well established for the last 20 years. Recently research has begun to emerge into its potential uses in the detection and diagnosis of pre-malignant and malignant conditions. The aim of this study was to systematically review the clinical application of electrical impedance technology in the detection of malignant neoplasms. Methods A search of Embase Classic, Embase and Medline databases was conducted from 1980 to 22/02/2018 to identify studies reporting on the use of bioimpedance technology in the detection of pre-malignant and malignant conditions. The ability to distinguish between tissue types was defined as the primary endpoint, and other points of interest were also reported. Results 731 articles were identified, of which 51 reported sufficient data for analysis. These studies covered 16 different cancer subtypes in a total of 7035 patients. As the studies took various formats, a qualitative analysis of each cancer subtype’s data was undertaken. All the studies were able to show differences in electrical impedance and/or related metrics between malignant and normal tissue. Conclusions Electrical impedance technology provides a novel method for the detection of malignant tissue, with large studies of cervical, prostate, skin and breast cancers showing encouraging results. Whilst these studies provide promising insights into the potential of this technology as an adjunct in screening, diagnosis and intra-operative margin assessment, customised development as well as multi-centre clinical trials need to be conducted before it can be reliably employed in the clinical detection of malignant tissue.

Tissue Characterization Using an Electrical Bioimpedance Spectroscopy-Based Multi-Electrode Probe to Screen for Cervical Intraepithelial Neoplasia

“…In previous studies, the measurements of the impedance spectra of cervical tissue using a four-electrode probe showed the feasibility of assessing the progress of cervical dysplasia [ 10 , 24 ]. However, the sensitive region of the four-electrode measurement method was limited to a local region due to the size of the electrodes.…”

“…Brown et al reported that the electrical impedance spectra on the cervix could separate normal and CIN [ 9 ]. Thus, bioimpedance spectroscopy can potentially facilitate cancer screening [ 10 ], thereby reducing the incidence of cervical cancer among women in developing countries. Subsequently, many studies have evaluated whether CIN can be diagnosed based on the electrical properties of cervical tissues [ 9 , 10 , 11 , 12 ].…”

“…Thus, bioimpedance spectroscopy can potentially facilitate cancer screening [ 10 ], thereby reducing the incidence of cervical cancer among women in developing countries. Subsequently, many studies have evaluated whether CIN can be diagnosed based on the electrical properties of cervical tissues [ 9 , 10 , 11 , 12 ]. In addition, clinical studies using four electrodes with colposcopy have been performed to measure the bioimpedance spectra of suspected local regions of the cervix [ 13 , 14 , 15 , 16 ].…”

Electrical Impedance Analysis for Lung Cancer: A Prospective, Multicenter, Blind Validation Study

“…Bioimpedance has been valuable in detecting various cancers, including skin, thyroid, liver, cervix, and breast cancers (5)(6)(7)(8)(9)(10)(11)(12), with breast cancer being the most extensively studied bioimpedance technology (9)(10)(11)(12). It is well known that cancerous tissue has distinctly different electrical properties from non-cancerous tissue (13). This has been attributed to the high water and sodium content within cancerous tissues, altered membrane composition, the nucleus-to-cytoplasm ratio, and cellular composition and density (14)(15)(16).…”

Correlation between electrical characteristics and biomarkers in breast cancer cells

“…The conductivity (σ) and permittivity (ε) of different biological tissues not only vary in terms of frequency, but also change with their physiological and pathological states; therefore, these can be used as indicators for biomedical or clinical applications to detect and diagnose diseases 4 . Although certain frequency ranges of electrical properties have been linked to pathological states of tissues, reports correlating σ and ε with physiological and pathological characteristics of cells are rare 5 . However, for realizing clinical applications of σ and ε, it is critical to understand these correlations.…”