Electrical impedance spectroscopy and the diagnosis of bladder pathology: a pilot study.
Wilkinson BA., Smallwood RH., Keshtar A., Lee JA., Hamdy FC.
PURPOSE: Carcinoma in situ is an aggressive form of bladder cancer with a high propensity for invasion if left untreated. On cystoscopy these flat lesions cannot be differentiated from other erythematous, potentially benign areas and they require biopsy for definitive diagnosis. Other methods of detecting carcinoma in situ remain experimental. We assessed the effectiveness of electrical impedance spectroscopy, a method that measures the variation of electrical current flow with frequency through the mucosa, for differentiating various pathological changes in the urothelium. MATERIALS AND METHODS: We obtained 250 impedance measurements immediately after resection in 35 cystectomy specimens using a custom designed probe. Three consecutive readings were recorded per point to assess reproducibility and punch biopsy was done at the measurement site. RESULTS: Changes in the urothelium were classified histologically into 7 subgroups according to the degree of edema and inflammation. Electrical impedance spectroscopy measurements were able to separate benign and malignant changes when tested as a group (p <0.001), although some individual points overlapped. Edema also had a significant effect on tissue impedance (p <0.001). CONCLUSIONS: Using measurements we established patterns of electrical impedance in the human bladder. Early results suggest that this minimally invasive technique is able to differentiate benign and malignant bladder pathologies. However, it requires further refinement and evaluation at lower frequencies, where the greatest impedance difference in benign and malignant tissues is expected.