Electrical impedance spectroscopy and the diagnosis of bladder pathology

  • Keshtkar A
  • Smallwood R
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Abstract

Bladder pathology is usually investigated visually by
cystoscopy. At present, definitive diagnosis of the bladder
can be made by biopsy only, usually under general anaesthesia.
This is a relatively high-cost procedure in terms of both time
and money and is associated with discomfort for the patient
and morbidity. Thus, we used an electrical impedance
spectroscopy technique for differentiating pathological
changes in the urothelium and improving cystoscopic detection.
For ex vivo study, a whole or part of the patient's urinary
bladder was used to take the readings less than half an hour
after excision at room temperature, about 27 degrees C, using
the Mk3.5 Sheffield System (2-384 kHz in 24 frequencies). In
this study, 145 points (from 16 freshly excised bladders from
patients) were studied in terms of their biopsy reports
matching to the electrical impedance measurements. For in vivo
study, a total of 106 points from 38 patients were studied to
take electrical impedance and biopsy samples. The impedance
data were evaluated in both malignant and benign groups, and
revealed a significant difference between these two groups.
The impedivity of the malignant bladder tissue was
significantly higher than the impedivity of the benign tissue,
especially at lower frequencies (p < 0.001). In addition, the
receiver operating characteristic (ROC) curve for impedance
measurements indicated that this technique could provide
diagnostic information (individual classification is
possible). Thus, the authors have investigated the application
of bio-impedance measurements to the bladder tissue as a novel
and minimally invasive technique to characterize human bladder
urothelium. Therefore, this technique, especially at lower
frequencies, can be a complementary method for cystoscopy,
biopsy and histopathological evaluation of the bladder
abnormalities.

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Authors

  • A Keshtkar

  • A Keshtkar

  • R H Smallwood

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