A Clinically Feasible Electrode Array for 3D Intraoperative Electrical Impedance Tomography-Based Surgical Margin Assessment in Robot-Assisted Radical Prostatectomy.

Abstract

A novel small form factor circular electrode array was designed specifically for electrical impedance tomography (EIT) based assessment of surgical margins during robot assisted radical prostatectomy (RARP). The electrode array consists of 33 gold-plated electrodes arranged within a 9.5mm diameter circular footprint on the end of a surgical probe that can be introduced through a standard 12mm laparoscopic port used during RARP. The electrode array contains 8 larger, low-contact impedance outer electrodes dedicated for current drive and an internal grid of 25 smaller electrodes for simultaneous voltage measurement. Separating electrode geometry by function is designed to improve current delivery, speed, and resolution while reducing hardware requirements. Simulations demonstrated that 1mm diameter hemispherical prostate cancer inclusions could be localized within regions of adipose and benign prostate tissue; 1.5mm diameter inclusions were required for localization within muscle tissue. A 2.38mm diameter aluminum rod in 0.2 S/m saline could be localized throughout the imaging domain with a position error of less than 2.5mm for depths from the electrode array surface of up to 1.7mm. Ex vivo tissue experiments with a bovine model demonstrate visual congruence of muscle and adipose tissue locations between the sample and reconstructed images. Simulation and experimental results indicate good detection and location of inclusions. These results suggest the proposed electrode array design can provide sufficient accuracy in the detection and localization of prostate cancer against clinically relevant background tissues for use during RARP.