Mucosal Impedance Spectroscopy for Objective Real-time Assessment of Mucosal Health

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1016/j.tige.2023.03.007

Priyanka Arora , Jaspreet Singh , Anuraag Jena , Surinder Kumar , Viren Sardana , Siddhartha Sarkar , Lileswar Kaman , Arunanshu Behera , Divya Dahiya , Ritambhra Nada , Cherring Tandup , H.S. Jatana , Usha Dutta

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Abstract

Background and Aims

There is a need for a real-time objective tool to assess the mucosal health of the gastrointestinal (GI) tract during endoscopy. Our aim was to develop, design, and validate a low-cost mucosal impedance (MI) device and determine its role in differentiating diseased mucosa from normal mucosa.

Methods

A biocompatible catheter was designed and developed after multiple iterations. It was validated with a commercially available catheter and histopathological analysis in a blinded manner. Patients undergoing resection of the GI tract were recruited after consent, and the resected specimens were analyzed ex vivo for MI within 10 minutes of resection. An average of 3 MI readings of the visually diseased segment and adjacent normal segment were analyzed. MI values of diseased and non-diseased mucosa were compared.

Results

The in-house catheter was validated with a commercially available impedance measuring device. It showed a high degree of positive correlation (rho = 0.616; P < 0.001). Two hundred and thirty-two patients (age 46 ± 15 years; 68% females) (180 inflammatory and 52 malignant pathology) who were undergoing abdominal surgery were enrolled. The median impedance value of diseased segments was significantly lower than that of the adjacent normal segments of gut in 130 paired samples [1832(727)Ω vs 2604(1295)Ω; P < 0.001]. The MI value of segments containing malignant tissue (n = 50) and inflamed tissue (n = 80) was significantly lower than the MI value of adjacent normal segments of the GI tract [1880(977)Ω vs 2583(1431)Ω; P < 0.001 and 1787(557)Ω vs 2515(1244)Ω; P < 0.001, respectively]. There was a 24% reduction in visually diseased segments [median reduction 712(661)Ω] from adjacent normal segments. A biocompatible endoscopic catheter (3-mm diameter) has been developed and tested in 3 patients and was found to differentiate diseased from normal mucosa.

Conclusion

Impedance spectroscopy is an effective real-time, simple, objective tool to differentiate diseased gut mucosa from healthy mucosa.

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用于客观实时评估粘膜健康的粘膜阻抗谱

背景和目的需要一种实时客观的工具来评估内窥镜检查期间胃肠道的粘膜健康状况。我们的目的是开发、设计和验证一种低成本的粘膜阻抗（MI）设备，并确定其在区分病变粘膜和正常粘膜中的作用。方法经过多次迭代，设计并开发了一种生物相容性导管。通过市售导管和盲法组织病理学分析对其进行了验证。在同意后招募接受胃肠道切除的患者，并在切除后10分钟内对切除的标本进行MI的离体分析。分析视觉病变节段和邻近正常节段的平均3 MI读数。比较病变和非病变粘膜的MI值。结果使用市售阻抗测量装置对内部导管进行了验证。它显示出高度的正相关（rho=0.616；P<；0.001）。232名正在接受腹部手术的患者（年龄46±15岁；68%的女性）（180名炎症和52名恶性病理）被纳入。在130个配对样本中，病变节段的阻抗中值显著低于相邻正常肠段的阻抗值[1832（727）Ωvs 2604（1295）Ω；P<；0.001]。含有恶性组织（n=50）和炎症组织（n=80）的节段的MI值显着低于相邻正常胃肠道节段的心肌梗死值[1880（977）Ωvs2583（1431）Ω；P<；0.001和1787（557）Ω对2515（1244）Ω；P<；0.001）。视觉病变节段与相邻正常节段相比减少了24%[中值减少712（661）Ω]。开发了一种生物相容性内窥镜导管（直径3毫米），并在3名患者身上进行了测试，发现它可以区分病变粘膜和正常粘膜。结论阻抗谱是一种实时、简便、客观、有效的鉴别病变肠黏膜和健康肠黏膜的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.