Exploring Prospects and Hurdles in Microwave-Based Medical Sensing and Imaging
Abstract—Widely used medical imaging systems in clinics cur-
rently rely on X-rays, magnetic resonance imaging, ultrasound,
computed tomography, and positron emission tomography. The
aforementioned technologies provide clinical data with a variety
of resolution, implementation cost, and use complexity, where
some of them rely on ionizing radiation. Microwave sensing and
imaging (MSI) is an alternative method based on non-ionizing
electromagnetic (EM) signals operating over the frequency range
covering hundreds of MHz to tens of GHz. The advantages of
using EM signals are low health risk, low cost implementation,
low operational cost, ease of use, and user friendliness. Advance-
ments made in microelectronics, material science, and embedded
systems make it possible for miniaturization and integration into
portable, handheld, mobile devices with networking capability.
MSI has been used for tumor detection, blood clot/stroke detec-
tion, heart imaging, bone imaging, cancer detection, and localiza-
tion of in-body RF sources. The fundamental notion of MSI is
that it exploits the tissue dependent dielectric contrast to
reconstruct signals and images using radar-based or
tomographic imaging techniques. This paper presents a
comprehensive overview of the active MSI for various medical
applications, for which the motivation, challenges, possible
solutions, and future directions are discussed.
Index Terms—Microwave Medical Imaging, Microwave Sens-
ing, Microwave Tomography, Biomedical Engineering
I. INTRODUCTION
M EDICAL imaging is an important tool for visualizing
the interior of the body for clinical analysis and identi-
fying any abnormality usually in a noninvasive way. It can be
used to investigate human anatomy and physiology for both
healthy and diseased cases. Medical imaging has been widely
used in all phases of cancer management [1], identifying bone
fracture, and tumors, to name a few applications. Medical
imaging systems currently used in medical care facilities
usually rely on x-rays, magnetic resonance imaging (MRI),
computed tomography (CT), ultrasound (US), and positron
emission tomography (PET). These different methods provide
clinical data with a variety of resolution, implementation cost,
and use complexity, where some of them rely on ionizing
radiation. For example, MRI provides good resolution, but
is an expensive procedure. Further, internal body movements
such as heartbeat can produce measurement artifacts in an
MRI image. CT has a good spatial resolution, but is less
informative when it comes to imaging soft tissues [2]. Further,
it uses X- rays which can ionize the tissues and hence poses a
health risk. PET can provide good information on the soft
tissues, but suffers from poor spatial resolution [2]. Moreover,
there may also be a chance of a false alarm when using these
imaging techniques for detection of tumor. For example, X-
rays are used in mammography for breast tumor detection
where a
high false negative rate (4 − 34%) and high false positive rate
(70%) have been reported [3]. Moreover, due to less variation
between the contrast of a tumor tissue and healthy tissue at X-
ray frequencies, detection becomes challenging. Furthermore,
the systems based on these imaging methods are usually not
portable.
Using non-ionizing electromagnetic (EM) waves at mi-
crowave frequencies for sensing and imaging for medical
diagnosis is emerging as a low cost and low health risk
alterna- tive to the aforementioned imaging technologies.
Microwave sensing and imaging (MSI) offers a noninvasive
way for the diagnosis of functional and pathological tissue
conditions [2], [4]. Sensing applications of microwave involve
single point applications wherein microwave signals
transmitted by an antenna are received by the same or a
different antenna after reflection or scattering by tissues. In
such a case, no two-dimensional (2-D) or three-dimensional
(3-D) images are formed. Examples of such cases can be
heartbeat detection or changes in the microwave signal caused
because of the pathological accumulation of water in the brain
called cerebral edema [5]. In the imaging applications, a map
or an image either in 2-D or 3-D is formed, that shows
different tissue electrical properties or the location of a
strong scatterer that is usually a tumor inside the body. MSI
systems are usually portable and low-cost and hence, can offer
the initial diag- nosis of various life threatening conditions
like brain-strokes while patients are still being on the way to a
hospital in an ambulance [6]. The hardware of an MSI system
generally consists of a microwave signal transmitter and a
receiver such as a vector network analyzer, an antenna array,
and a radio- frequency switch that switches between different
antennas [7]. As mentioned by a commercial MSI company
EMTensor [8], such a hardware for MSI can be produced at a
fraction of the price of other diagnostic equipment, resulting
in a low cost of the MSI system. Low cost of the MSI system
can facilitate the diagnosis of patients in developing
economies, where other costly imaging modalities are out of
reach of large masses.
 Feasibility studies and proof-of-concept of MSI for various
medical applications have been reported in the literature.
Some of the early work reported for MSI were by Larsen
and Jacobi [9] for imaging of perfused canine kidney. One
of the limitations mentioned in their work was the long
acquisition time of the used setup. Further, this early work
used intensity modulation of a raster scanned display to
convert measured scattering parameters into an image. Over
the years, different data acquisition setup with linear
arrangements of antennas [10] or more faster cylindrical
arrangements [11] were proposed. Apart from the
development of various recon- struction algorithms, MSI has
moved from simple imaging of organs to application specific
imaging for various pathological conditions. To this end,
applications as respiration and heart- beat detection [12], [13],
imaging brain for strokes [4] and cerebral edema [5], breast
cancer [14], bone imaging [15], [16], heart imaging [17]-[21],
and joint tissues [23], have been investigated. The working
principle of the MSI is based on the difference between the
electrical properties (relative permittiv- ity and conductivity)
of different tissues. A malignant tissue has usually different
electrical properties than the surrounding normal and healthy
tissues which can be differentiated in the image. As for
imaging techniques, both quantitative and qual- itative
imaging algorithms have been developed. Quantitative
imaging algorithms give a map or the image of the distribution
of the various tissues with the values of electrical properties
in the body. They are usually based on the inverse scattering
problem. On the other hand, qualitative imaging algorithms
use radar like techniques for image generation to differentiate
the malignant tissues from the normal tissues as the malignant
tissues are usually strong scatterer than the normal tissues.
Initial clinical trials have been reported for MSI systems,
especially for breast cancer [7], [24], [25] and brain stroke
detection [6]. However, there are still many challenges, which
have to be overcome and require further research for MSI
systems to be practically implemented in a clinical setting.
Currently, MSI systems face challenges both at system level
like the requirement of a high dynamic range system to
successfully measure weak scattering fields and also at the
modeling level like the requirement of 3-D computationally
efficient imaging algorithms which can model the effect of
antennas, and feeding network for large biological bodies
[26]. Challenges still remain open at experimental level where
there is a need to efficiently couple the microwave power to
the biological tissues, proper frequency for good resolution as
well as penetration depth, and development of suitable
contrast agents [26].
The main objective of this paper is to present an exhaustive
literature review of the MSI for various medical applica-
tions which may provide a comprehensive study material for
researchers in the field regarding current trend and future
directions in MSI. It should be noted that the paper focus on
the active microwave sensing and imaging where the tissues
are illuminated with microwave energy, unlike the passive
microwave imaging approach as used in thermography [27].
The paper further discusses the principle behind medical
MSI techniques by highlighting various medical applications,
challenges and possible solutions. It is arranged in following
order. Section II discusses the electrical properties of the
tissues, both normal and malignant, that is used as a basis for
MSI systems. Section III presents different imaging methods
used for MSI. Section IV provides an overview along with
the imaging results of various medical MSI applications.
Open issues, challenges and future directions are discussed
in Section V. Finally, Section VI concludes the paper.
II. ELECTRICAL PROPERTIES OF THE TISSUE
Different types of tissues, including both normal and malig-
nant tissues of the same kind, have distinct electrical
properties (relative permittivity and conductivity). This
difference, pri- marily due to differences in the water content
[32], results in the variation in the scattered field by different
tissues which is the basis of MSI. An early review of the
electrical properties of the human tissues is presented in [28].
A summary of measure- ments for various healthy tissues is
provided by Gabriel et al. in [29]. The measured electrical
properties of various healthy
and the malignant tissues from 50 − 900 MHz is presented
in [30]. For some tissues, the difference between the normal
and the malignant tissue might be low. Further, the presence
of multiple tissues with different properties result in a
complex scattering environment. To solve these challenges,
either use of a high dynamic system is required to capture the
small difference in the scattered field or the use of contrast
agents is proposed to enhance the electrical properties of the
malignant tissues (discussed later in Section V). Another
challenge is the frequency dispersion of electrical properties
of the tissues that results in the distortion of the wideband
pulses used in the radar-based imaging methods. To model
the frequency dispersive nature of the tissues, one can either
use the Debye model or the Cole-Cole model [31]. The
attenuation of the microwave signal also increases with the
frequency due to increase in the conductivity resulting in a
lower penetration depth. Hence, choice of frequency is critical
for imaging.
Apart from the difference in the water content in healthy
and malignant tissues [32], a variety of other factors have
been ex- plored which explains the difference in electrical
properties be- tween healthy tissues and malignant tissues.
These are necrosis and inflammation causing breakdown of
cell membrane [33], charging of the cell membrane [34],
change in the dielectric relaxation time [35], and difference in
the sodium content [33]. Fig. 1 shows the percentage change
in the electrical properties of the different malignant tissues
(colon, kidney, liver, lung, and breast) with respect to the
healthy tissue from 50 MHz to 900 MHz based on the
measurement data presented in [30]. As can be seen from Fig.
1(a), the relative permittivity can either increase, as for breast,
colon, and liver, or can even decrease, as for lung and kidney,
for the malignant type. The increase was highest in the case
of breast, whereas for the kidney, low difference was
measured. For the conductivity [Fig. 1(b)], breast tissues
have the biggest difference and kidney have the least
difference. To this end, various research about the electrical
properties difference between healthy and malignant tissue
have been done, especially for breast tissues [36]-[38], liver
[39], lymph nodes [40], skin [41] and bone [42], and heart
for myocardial ischemia and infarction [43].
 300
Colon Kidney Liver Lung Breast
250
∆ε (%)
200
r

20
0
−20
0 200 400 600 800
Frequency (MHz)
(a)
Fig. 2. Basic setup for microwave imaging in a two dimensional case when
one antenna (TX) transmits the signal and all other antennas (RX) are in
600 receiving mode. The imaging domain D contains the heterogeneous body to
be imaged. The measurement domain S contain the transmit and the receive
antennas. The whole system is in a homogeneous medium that acts as a
550
∆σ (%)

matching medium.
40

20

0 harmonic dependence exp(jωt) with j2 = −1, and ω = 2πf

0 200 400 where f is frequency, is assumed. The scattered field on S is
600 800
Frequency (MHz)
defined by the following data equation:
(b)

Fig. 1. Percentage change in the electrical properties of malignant tissues

with respect to the healthy tissue from 50 MHz to 900 MHz: (a) percentage
change in the relative permittivity (b) percentage change in the conductivity E
∫
scatt (p) = k2
b G (p, r′)χ(r)Etotal(r)dv(r′), (1)
[30]. D

III. IMAGING METHODS

Microwave sensing applications such as heartbeat, respira-
tion, and vital signs sensing do not generate an image in the
traditional sense, but a graph between different parameters
and may be equivalent to sensor based methods such as
electrocardiography (ECG). As for 2-D and 3-D imaging
both quantitative and qualitative imaging algorithms have been
developed. This section provides an overview of such methods
that are summarized in Table I highlighting their positive and defined for the purpose: the incident field Einc on D , the total
negative aspects.
where p ∈ S , r′, and r are position vectors. kb is the
wavenum- ber of the matching medium, G is the Green’s
function that has a different expression for transverse
magnetic (TM), transverse
electric (TE) or 3-D full vectorial case [44].
χ(r) is the contrast function containing the permittivity ε(r)
of the body and is defined as:
ε (r) − ε b
χ(r) = . (2)
εb
field Etotal in D , and the scattered field Escatt on S . A time

A. Quantitative Imaging
Quantitative imaging methods, also called microwave to-
mography, generates the image based on the values of electri-
cal properties, both the relative permittivity and the conductiv-
ity, of various tissues of the body. The generated image shows
how tissues with different electrical properties are distributed
inside the body. The body to be imaged is surrounded by
a number of transmit and receive antennas. Each transmitter
antenna illuminates the body with the microwave signal at a
time and the scattered signal by the body is collected by all
the receive antennas. Usually this complete setup is immersed
in a homogeneous medium with permittivity εb which acts
as a matching medium for coupling the microwave energy
transmitted to the body, reducing any reflection that may have
occurred at the air-body interface in its absence. The body,
that has to be imaged, lies within a bounded domain D and
the antennas are located on measurement domain S as shown
in Fig. 2. The microwave tomography problem is generally
formulated in terms of electric fields. Three electric fields are
The total electric field Etotal satisfies the domain equation in
D:
∫
Etotal(r) = Einc(r)+k2 G (r, r′)χ(r′)Etotal(r′)dv(r′). (3) b
D

The objective of the inverse scattering problem is to de-

termine χ(r) in D by solving the equations (1) and (3) for
known Einc and measured Escatt on S . This inverse
problem is ill-posed. Further, the dependency of Escatt on χ(r)
is nonlinear and hence solving it without iteration is
computa- tionally expensive. It should be noted that this
dependency can be made linear if Born or Rytov
approximation [45] is valid, which usually is the case when
the contrast between different tissues is low. However, this
condition is usually not valid in practical biomedical bodies
due to a large difference between the dielectric properties of
the tissues [45]. Hence, a wide variety of iterative
reconstruction algorithms have been proposed [44]-[54].
Usually, the domain D is discretized into N cells where the
contrast is assumed to be constant within the cells and the
algorithm estimates the contrast of these N cells. These
algorithms can be grouped into either Newton- type iterative
algorithms [44], [46]-[52] or Modified Gradient (MGM)
[53], [54] and Contrast Source Inversion (CSI) [55]
depending upon the cost-function used. The cost-function
for
Newton-type algorithms is of least-squares form:
Σ However, as discussed earlier in Section II, the electrical
tscatt scatt S 2
meas,t properties of the tissues have frequency dispersive nature and
t ||E −E ||
CNewton = , (4)
Σ S frequency dispersion by
hence reconstruction using thethat
algorithm Debye Model
takes intoinaccount
the contrast
the
scatt
||E ||
2 meas,t
t has been developed in [60]. Time-domain instead of frequency
where the summation is done over the transmit antennas,
domain inversion algorithm has also been developed [61] for
Escatt is the computed scattered field at all the receive anten-
t a wideband pulse.
nas from the data and the domain equations for a particular
transmit antenna t, and Escatt is the measured scattered field
meas,t
for that transmit antenna. The cost function is minimized B. Qualitative Imaging
iteratively by updating the contrast as χn+1 = χn+νn∆χn, νn In some medical applications, such as breast tumor de-
being the appropriate step length and ∆χn being the correction tection, the aim of imaging is not to obtain the electrical
at the nth iteration. As the cost function is nonlinear in χ and is properties of the tissues, but to detect and localize the tumor.
ill-posed, it is regularized before performing the minimization. Hence, for such cases, solving computationally intensive iter-
A most common regularization method is Tikhonov regular- ative quantitative algorithms can be avoided. As discussed in
ization [49]. Newton-Kontorovich [44], Gauss-Newton inver- Section II, the tumor usually has higher dielectric properties
sion [52], Distorted Born Iterative method [46], Levernberg- than normal tissues which makes it a strong scatterer. Various
Marquadt [49], and Log-Magnitude and Phase Reconstruction radar imaging algorithms can then be used to focus the tumor,
(LMPF) [51] are some of the Newton-type algorithms that such as confocal microwave imaging [3], beamforming [62],
have been used for microwave imaging of human body parts. and tissue sensing adaptive radar [63]. In these techniques,
Though Newton-type algorithms converge in less number ultra-wideband (UWB) signal is used to have a good time-
of iterations, the data equation or the forward equation has resolution. The setup is same as that of the quantitative
to be solved at each iteration resulting in high computational imaging as shown in Fig. 2. However, each antenna transmits
demand, that may limit the applicability in a full 3-D vectorial a short pulse at a time (UWB in frequency domain) and the
case [55], [56]. Hence, alternative to Newton-type algorithms, backscatter response is received by the same antenna.
MGM and CSI methods have been proposed without solving In the confocal microwave imaging, the backscatter re-
the forward equation by formulating the cost-function in sponse consists of incident waveform, tumor backscatter, the
terms of unknown contrast and unknown contrast sources. scattered signal from the skin, and other backscatter response
The contrast source is defined as w(r) = χ(r)Etotal(r) [55]. known as clutter from other tissues inside the body. Signal
Consequently, the cost function is written as [55]: processing is done to remove the scattered signal from the
skin [3], [64] to get the response from the tumor and the
Σ meas,t — GS (wt)|| S
scatt 2
clutter. The processed backscattered waveform at each of
||
CCSI = t Σ the antennas is integrated over time to obtain Bt integrated
+
Σ E || E scatt
meas,t S2
|| waveforms where t is the number of the transmit antennas.
t
||χEinc − wt + χGD The reconstructed image is then created by time-shifting and
(wt)||2
t D
t Σ summing data points from these integrated waveforms for
, (5) each synthetic focal point r in the imaged body. The intensity
||χE t ||D
inc 2

t
where GS and GD are Green function’s operator in S and D , I(r) of a pixel in the image at r is the
Σsquares of the
2
respectively. The minimization of the cost-functional itera- coherently summed values [3]: I(r) = t ctBt(τt(r)) ,
tively constructs sequences of the contrast sources and the cially in the conductivity where the data obtained at one fre-
contrast. At each iteration step, each sequence is updated, quency are used as a starting point for the other frequency [59].
assuming the other one as constant. The cost-function is often
multiplied by a regularization term and the algorithm is called
multiplicative regularized contrast source inversion (MR-
CSI). The MGM is similar to CSI where the fields and the
contrast is updated in each step. Avoiding the forward
problem in each iteration in CSI and MGM leads to a large
number of unknowns. Moreover, they take a larger number of
iterations to converge [57]. However, in spite of these
difficulties, MR- CSI has been shown to be computationally
less demanding than the Newton-type algorithms [55].
The reconstruction algorithms can be applied at a single
frequency or at multiple frequencies in a frequency hopping
manner [58]. Ignoring the frequency dispersion of the tissues,
frequency hopping can be used to remove the artifacts, espe-
where τt(r) = 2|r − rt|/(V ∆T ) is the time delay from
the tth antenna at rt to the synthetic focal point at r in
the body. V is the propagation velocity of the signal
inside the
body, assuming a homogeneous medium and ct are
weights to compensate for the radial spreading of the
cylindrical waves as it propagates outward from the transmit
antenna. Similar to confocal approach, another algorithm
called tissue sensing adaptive radar (TSAR) [63] has also
been developed which assigns more weight to antennas
closest to the focal point. Further, TSAR algorithm includes
compensation term for the distance traveled within the body
and spreading of the waveform.
The time-shifting and the summation of the backscattered
signal done in the confocal imaging may not compensate for
frequency-dependent propagation effects that are associated
with an UWB signal. Moreover, it has limited ability to dis-
criminate against artifacts and noise [62]. Hence, microwave
imaging via space time beamforming has been proposed
[62]
which can spatially focus the backscattered signals to discrim-
inate against clutter and noise while compensating for fre-
quency dependent propagation effects. To achieve the spatial
focus, time shifting of the received signal is done to align
the backscattered signal from a hypothesized scatterer at a
probable location of the strong scatterer. This time aligned
signals are then passed through a bank of finite-impulse re-
sponse (FIR) filters, for each antenna location, whose weights
are chosen using the least square method. This ensures that the
components of the backscattered signal originating from the
probable strong scatterer location passes the beamformer with
unit gain while compensating for the frequency-dependent
propagation effect [62]. Further, the beamformer output is
time gated to the time interval which would contain the
backscattered signal from the probable strong scatterer loca-
tion. The beamformer is scanned to different locations inside
the body by appropriately changing the time shifts, gating,
and FIR filter coefficients and the energy at each location
energy is calculated [62]. The reconstructed image shows the
backscattered signal energy at different locations.
C. Sensing
One of the most commonly employed methods for mi-
crowave sensing applications, especially for heartbeat and
respiration is based on the Doppler radar. In such a method,
the radar transmits the microwave signal of wavelength λ that
is then reflected by the moving human body parts as the chest-
wall. The reflected signal is received by another antenna. The
phase of the reflected signal changes according to the Doppler
theorem. The change in the phase ∆φ of the received signal
at time t is related to the displacement of the moving body
x(t) and is given by [13]: ∆φ = 4πx(t)/λ. x(t) contains
displacement both due to heartbeat and respiration. Holding
of breath may result in the displacement which is just due to
the heartbeat. The heartbeat signal can also be extracted by
use of a low pass filter which can filter out high frequency
respiration signal.
Other sensing applications may involve sending microwave
signal from an antenna towards the body and recording the
reflected or the transmitted signal from another or the same
antenna. Due to changes in the electrical properties of the
tissues during pathological conditions, the reflected signal will
be different from what it would be for a normal healthy case.
Based on this, pathological conditions can be detected. For
such a purpose, usually ultra-wideband (UWB) radar are used
as they can penetrate the body and also have a good temporal
resolution [65].
IV. APPLICATIONS
This section gives the overview of the different medical
applications where MSI has been studied.
A. Medical Sensing Applications
1) Heartbeat Detection: Heartbeat extraction using the
Doppler radar is a common sensing application. The
advantage of using the Doppler radar is that it is a non-
contact method
leading to comfort of patients. In [12], the Doppler radar was
used at different frequencies, 2.4 GHz, 5.8 GHz, and 10 GHz,
and different power levels for heartbeat extraction. In [13], a
comparison between different preprocessing methods for the
demodulation of the received signal using the data collected
by the Doppler radar for heartbeat and respiration monitoring
is presented. Fig. 3 shows the phase of the heartbeat signal
obtained with the Doppler radar with different preprocessing
technique presented in [13]. The plot of the ECG that corre-
lates well with the extracted heartbeat is also shown.
2) Blood Flow and Pressure: Microwave sensing can also
be used for detection in changes of blood flow and blood
pressure. For example, in [66], it is shown that microwave
sensing has potential for detection of 0.3 − 0.5% changes
in extremity blood flow and about 2.5% change in elevated
compartment pressure using the experiments done on a pig’s
hind leg. Changes in the amplitude of the microwave signal
at 2.5 GHz transmitted through the pig’s thigh on reduction
in the blood flow is shown in Fig. 4. In [67], an experimental
investigation is done on a phantom and a human subject using
an UWB radar to estimate the radius and changes in the radius
of the aorta that is related to the blood pressure.
3) Fluid or Water Accumulation: Another sensing appli-
cation is detection of fluid or water accumulation in various
organs. The detection and monitoring of cerebral edema are
presented in [5]. A head phantom was used that consti-
tute of separate compartment of water and ethanol inside a
glass sphere to stimulate the head tissues (water for cerebral
fluid and ethanol for brain tissues). The microwave signal at
2.4 GHz from one side of the head phantom was transmitted
and received from the other side. The received signal was
compared with the reference signal. The amplitude and phase
of the received signal are related to the variable amounts of
excess water. It was found that 2◦ in phase change was related
to 10 ml of addition of water and 1◦ phase changes was
related to 10 ml change in the ethanol volume. Similar to this
principle, water accumulation in the body using an UWB
radar is presented in [68] where it was found that the reflected
signal from the bladder with water had different received
signal than without water.
A microwave stethoscope for monitoring vital signs and
changes in lung water content is presented in [69]. A coplanar
waveguide operating at 915 MHz and 920 MHz was used to
measure the reflection coefficient on a phantom as well as on
the humans. From the measured reflection coefficient, various
vital signs like respiration rate, heart rate and changes in the
lung water content was successfully extracted using signal
phase of
heart-beat signal
(diff. est. methods)
ECG
35 40 45
Time (s)
Fig. 3. Phase of the received signal for heartbeat after filtering out the
respiration signal [13].
 TABLE I
SUMMARY OF SENSING AND IMAGING METHODS

Method Theoretical Basis Techniques/Algorithm [ref.] Positive Aspects Negative Aspects Frequency Remarks
Quantitative Iteratively solving Newton Methods: Less number of itera- Computationally Single frequency, 2-D or 3-D image with di-
(Section III-A) inverse EM scat- Newton-Kantorovich [44] tions required to con- demanding, multiple electric properties. Newton
tering problem. Gauss-Newton [52] verge, Limited 3-D ap- frequency methods are similar if
Levenberg-Marquadt [49] Lower number of un- plicability or wideband same regularization
Distorted Born [46] knowns. technique is applied.
Log-Magnitude and Phase Recon-
struction [51]
Contrast Source Inversion [55] Computationally less Larger number of
Modified Gradient Method [53] demanding unknowns, more
(than Newton Meth- iterations required
ods), 3-D applicabil- for convergence.
ity
Qualitative Strong scatterer Confocal Imaging [3] Avoids inverse prob- Detection UWB Image of backscattered en-
(Section III-B) detection using Tissue Sensing Adaptive Radar lem, computationally challenging ergy
radar techniques [63] Space-Time Beamforming very less demanding in low contrast
[62]
Sensing Change in ampli- Doppler Radar [13] Simple setup Motion artifacts, Single frequency No image but 2-D plot
(Section III-C) tude and/or phase Transmission/Reflection [6] reference needed or UWB

results in a blood clot or a blood pool within the brain. Due

Microwave Signal Amplitude

to the difference between the electrical properties of normal

Time (s)
Fig. 4. Changes in the amplitude of the microwave signal transmitted
through the pig’s thigh at 2.5 GHz. Baseline flow is uncompromised blood
flow, whereas 1st flow reduction represent when the blood flow was reduced
by certain amount. The plot of the ECG is also shown which correlates
well with the uncompromised blood flow [66] ( ⃝c Institute of Physics and
Engineering in Medicine. Reproduced by permission of IOP Publishing. All
rights reserved).
processing techniques.
4) Brain Stroke: In [6], Persson et al. presented a working
prototype using microwaves in 0.3 − 3 GHz for detection
of the strokes for which clinical testing was done. It uses
measured scattered data of the different transmission channels
for different subjects with known conditions in a supervised
learning based detection algorithm based on a subspace clas-
sifier method. The algorithm was able to differentiate stroke
patients from healthy volunteers.
5) Brain Edema and Duct Obstruction: There are
other sensing applications using radio-frequency-identification
(RFID) technology for monitoring of brain edema and duct
obstruction [70]. However, these uses implanted self-sensing
tags and require invasive surgery. This paper focuses on
noninvasive MSI applications. Therefore, these are out of
scope.
B. Brain Imaging
The objective of brain imaging is to detect and locate
the area of the damaged brain tissues due to injuries or
conditions such as ischemic or hemorrhagic stroke. These
brain tissues and the blood, the stroke can be detected using
microwave imaging. Brain imaging for stroke detection and
monitoring is investigated in [4], [64], [71]-[74]. Quantitative
methods used so far includes a Newton-type iterative scheme
for 2-D tomography [4], Born iterative method [71], and a
multiplicative regularized Gauss-Newton inversion [75].
These investigations have been done numerically using a
simple brain model with stroke as in [4], or on a
numerical anatomi- cally real head phantom [71]. Further,
they have used single
frequency in the range of 0.5 − 2.5 GHz. The stroke can
be observed in the reconstructed quantitative image having
different electrical properties than the normal brain tissues as
can be seen in Fig. 5(b) where a 2 cm acute stroke area
in the image was successfully detected. The difference in
the contrast of the stroke with the normal brain tissues also
makes the stroke a significant scatterer and hence, qualitative
approach as confocal imaging has shown to detect stroke [64],
[72]. Confocal imaging of the brain in 1 − 4 GHz frequency
band was done on a physical head phantom in [72] using a
microwave imaging setup shown in Fig. 6. The stroke in the
image obtained through confocal imaging can be identified
as a region having significant backscattered energy as shown
in Fig. 7. This method detected an ellipsoid stroke of size
2 × 1 × 0.5 cm3 with a localization accuracy within a few
millimeters.
C. Breast Imaging
The objective of breast imaging is to detect breast cancer
or tumor. It is one of the most widely investigated medical
applications of MSI. One of the reasons for this, as discussed
in Section II, is because of the relatively high contrast of
the breast tumor compared to the prominent fat tissue in a
breast. Hence, such a high contrast makes the breast tumor
a significant scatterer where radar-based techniques can be
effectively applied to locate the tumor as reported in [3], [62],
[63], [76]-[82]. Moreover, the tomographic methods can also
be used where the tumor can be distinguished easily from the
 (a) (b)
Fig. 5. (a) Numerical brain phantom with tumor (b) Reconstructed relative
permittivity showing the encircled tumor [4]
Fig. 6. A measurement setup for brain imaging using a physical head
phantom and the Vivaldi antenna [72].
rest of the fat tissues in the reconstructed image as discussed
in [52], [86]-[91]. A review of extensive research work done
for breast cancer imaging is provided in [14] and [92].
Different radar-based approaches that have been used for
breast imaging are confocal imaging [3], [78], [79], the TSAR
algorithm [63], [80], [25], space-time beamforming [81], and
a two stage Capon beamforming called multistatic adaptive
microwave imaging [82]. An UWB confocal algorithm is de-
veloped and investigated on a 2-D anatomically realistic MRI-
derived breast model [Fig. 8(a)] in [78]. It was extended to
3-D cases in [3]. In [79], a signal processing technique called
delay-multiply-and-sum is used with confocal imaging where
the backscattered signals were time shifted, multiplied in pair,
and the products were summed to form a synthetic focal point.
This resulted in an improvement in the usual confocal imaging
in which just delay-and-sum of the backscattered signal is
done. The TSAR algorithm used in [63] for breast cancer
detection used simple tumor models using an experimental
setup. In [80], a signal processing algorithm based on the
Bayesian estimator is used to enhance the tumor response
in the TSAR data by suppressing late-time clutter. Space-
time beamforming in [81] used experimental backscattered
data of multilayer breast phantoms for the tumor detection.
A two stage Capon beamforming called multistatic adaptive
microwave imaging that has higher resolution, and better
noise and interference rejection capability, is presented in [82]
for an early breast cancer detection. These radar-based
qualitative
approaches used UWB, 3.1 − 10.6 GHz for confocal imaging
in [78], [3], 1 − 10 GHz for the TSAR algorithm in [63],
and 1 − 11 GHz for the space-time beamforming [81]. The
Fig. 7. Reconstructed image using the confocal method [72] showing position
of stroke at two different locations. The true position of the stroke is shown
by an ellipse.
depth (cm)
span (cm)
(a)
depth (cm)
span (cm)
(b)
Fig. 8. (a) Numerical breast phantom with tumor model and (b) Recon-
structed image using a qualitative confocal method [78] showing position of
detected tumor.
detection of a tumor of size as small as 2 mm diameter
at a depth of 3.1 cm from the top surface of the breast
has been shown using 2-D confocal imaging [78] as shown
in in Fig. 8(b). However, using the 3-D confocal imaging,
the detected tumor size was of 6 mm diameter [3]. The
TSAR algorithm detected a tumor of size 1 cm [63] whereas
Bayesian estimator used with the TSAR algorithm detected
a smaller tumor of diameter 3 mm. There are other radar-
based approaches which do not aim to construct an image
of the breast with the scatterer or the tumor, but to present
the likelihood of the presence of a tumor [83], [84] or to
classify a lesion as benign or malignant [85]. In [83], tumor
of size 2 mm is detected based on generalized likelihood test
and in [84], a 10 mm tumor is detected with a detection
accuracy up to 92% with a support vector machine classifier,
a machine learning classification algorithm. The work in [85]
demonstrated that characteristic morphological features of the
lesion can be identified with relatively high rates up to 87%
of correct classification.
Tomographic imaging approaches that have been used for
breast imaging are Newton-type iterative algorithms [86],
[87], Newton-type conjugate gradient method [88], the
Gauss-
 y (cm)
y (cm)

(a) (b)

Fig. 10. Reconstructed images of the left leg and the right leg of a
patient affected by injury in the left leg through a Newton method with soft-
x (cm) x (cm) regularization (a) relative permittivity (b) conductivity. Left side is for the left
leg and right side images are for the right leg [16].
(a) (b)

applications require the electrical properties of the bone to

be known and thus, the approach has to be quantitative. The
y (cm)
y (cm)

possibility of using Levenberg-Marquardt method for

detection of the leukemia in the bone marrow is discussed in
[15] where the authors were able to reconstruct the
proliferated cells in the marrow using a simple 2-D
x (cm) x (cm) cylindrical model of the leg at 800 MHz. In [16], microwave
(c) (d) imaging at 1300 MHz using the Gauss-Newton iterative
method with soft regularization
Fig. 9. Numerical breast phantom (a) relative permittivity (b) conductivity. decreases the conductivity up to a factor of 2. Both of these
Reconstructed contrast with MR-CSI (c) real part (d) imaginary part [91].

Newton reconstruction [89], the distorted Born iterative

method [90], and the CSI method [91]. These approaches
reconstruct the breast electrical properties where a tumor
region can be identified by having an apriori knowledge of
the electrical properties of the tumor. Moreover, these
approaches use different single frequencies from 0.3 GHz
up to 5 GHz. A clinical prototype where a Newton-type
iterative algorithm was employed is reported in [86]. The
imaging was done on 5 volunteers using the prototype. Based
on the measurement, it was found that the average relative
permittivity of the breast as a whole may correlate with
radiological breast density categorization. Other than this
investigation that has been done on actual humans, the rest are
numerical investigations. For example, a feasibility study
using 2-D breast models with the tumor using a Newton-type
iterative algorithm is done in [87] and using a Newton-type
conjugate gradient method in a numerical breast model is
presented for a 3-D case in [88]. An example of a
reconstructed quantitative image of a numerical breast model
with a tumor of radius 4 mm using the CSI method [91] is
shown in Fig. 9.
Most of the breast cancer imaging setups use a cylindrical
or a hemispherical antenna array. A hemispherical
measurement setup is presented in [93] and an improved
version of this setup used for clinical trials is presented in [7].
However, the planar configuration of the antenna arrays,
where the breast is com- pressed between two planar arrays of
the antennas, similarly to that of X-ray mammography, has
also been investigated in [3], [94], [95].

D. Bone Imaging
Bone Imaging using microwave has been done for appli-
cations like detecting the leukemia in the bone marrow [15],
and to determine the bone density for detection of osteoporo-
sis [16]. Leukemia causes the cellular population in the bone
to increase that in turn increases the relative permittivity and
was done to acquire 2-D and 3-D images of the calcaneus
bone of two patients. Their one leg was immobilized for at
least six weeks during recovery from a lower leg injury. The
reconstructed images are shown in Fig. 10. A good
correlation was observed between the recovered electrical
properties of the injured calcaneus bone by microwave
imaging and the CT Hounsfield density measure. Hence,
microwave imaging of the bone can also help in determining
the bone density for detection of osteoporosis [16].

E. Soft Tissues and Joint Imaging

Microwave can image the soft tissues which might also
get injured when bone fracture happens. The injured soft
tissues are not detected by the X-rays [2]. This is a
challenging task as the high dielectric contrast between bone
and soft tissues may obscure less pronounced contrast
between soft tissue abnormality. In [66], a feasibility study
using a Newton and the MR-CSI method for functional
imaging of the extremity soft tissues of a pig’s hind leg is
presented at 1 GHz.
A feasibility study of the TSAR technique [63] for
imaging of the knee joint is presented in [23]. The objective
was to detect lesions of clinically relevant sizes and shapes in
the menisci, ligaments, and tendons in the knee. Both
numerical simulations and measurements were done, and
data were
collected in 50 MHz−13.51 GHz. Bovine patellar tendons
were used for measurements. Images were reconstructed
with
and without the model of the meniscal tear in the knee. A
tear thin as 1.3 mm×8 mm was detected in the difference
image (but not in the reconstructed image) and two tears
separated by a minimum distance of 9 mm were detected as
illustrated in Fig. 11. High permittivity lesions were
simulated by inserting
a small water filled plastic plug in the tendon and a low
permittivity scar-tissue defect by inserting a material whose
permittivity varies from 48 to 27 in the measured frequency
range. In this case too, the differential image was able to
detect the lesions. It was concluded that since, the detection
is based on the differential imaging, there might be a
challenge to obtain the reference image (for the healthy
case) and hence, a more promising clinical application of this
technique could be for monitoring and healing of a lesion.

y (mm)
x (mm)
Fig. 11. Differential image when two tear are present in meniscus. The
differential image is obtained by subtracting images obtained by the TSAR
imaging algorithm, with and without the tear. The meniscus on which
measurements were done is shown in inset with the positions of the antennas
marked with ’*’ [23].
F. Heart Imaging
Heart imaging is done to detect any pathological conditions
as myocardial infarction [19] as the electrical properties of
myocardial tissue have a strong dependence on coronary
blood flow. It can also be used to obtain the temporal
images of a beating heart for heartbeat extraction [22] due to
millisecond temporal resolution. However, the heart is
located inside an anatomically complex and highly
electromagnetically scatter- ing structure of the thorax, that
make microwave imaging of the heart a challenging task
[2]. Moreover, there might be strong reflections from the
air-filled lungs that might make the detection of potentially
weak field scattered by the heart challenging [20]. Hence,
heart imaging requires minimum SNR of 30 dB and a
dynamic range of 150 dB or more [20]. In [17], Semenov et
al., reconstructed the quantitative im- ages of an excised
canine perfused heart in a static as well as in a beating
case using a modified Rytov approximations at 2.45 GHz.
In [18], authors were able to successfully reconstruct the
internal structure of an excised canine heart including the
left and the right ventricles using the 3-D MGM and in [19]
for the detection of the myocardial infarction. In [20],
using the same 3-D gradient method, authors were able to
reconstruct the heart in an intact swine at 0.9 GHz. Further,
measurements were done with and without the heart
in the thorax, and it was found that the presence of the heart
changes the amplitude of EM field by 10 − 20% and a change
of 7 − 10 degrees in the phase was observed.
An UWB radar-based approach to image the human heart in
real time is presented in [21], [22]. An UWB switched array
body-contact radar was used and a back-projection imaging
algorithm was used. The frequency utilized was 0.8 − 3 GHz.
The purpose of imaging was to obtain the heartbeat rate.
Successive images were reconstructed of the beating heart
of a male subject with a frame rate of 25 Hz. Using the
reconstructed image, heartbeat waveforms were extracted. It
was concluded that using this approach, different moving
parts of the heart can be observed and may provide the basis
for an online diagnosis.
G. Thermal Therapy Monitoring
One of the ways to treat subcutaneous cancer of the soft
tissue is through thermal therapy using microwaves as in
hyperthermia [96] or thermal ablation [97]. These require
temperature monitoring so that the temperature of the can-
cerous tissue is elevated to a proper level for its destruction.
The electrical properties of the soft tissues are sensitive to
the change in temperature primarily due to changes in the
electrical properties of the water with temperature. The
change in electrical properties of the animal liver tissue is
reported with temperature in [98]. For example, it was
observed that the properties change approximately 1% per ◦C
between 28◦C and 53◦C at 915 MHz. The idea of microwave
imaging for remote thermal sensing was used in an early
work [99]. This has been reconsidered in recent works
[100]-[102]. In [101], tomographic images over the
frequency range of
300 − 1000 MHz of the pig abdomen were generated where
the recovered conductivity was found to vary linearly with the
controlled temperature values. In [102], a real-time
microwave imaging system at 915 MHz to image differential
temperature based on the change in the electrical properties of
water with the goal of achieving noninvasive temperature
monitoring of thermal therapy systems was developed, and
tested on a simple breast phantom. Hence, exploiting
temperature sensitivity of the tissues, MSI can also be used for
noninvasive thermal therapy monitoring.
H. Miscellaneous Biomedical Body Imaging
There are many other studies which have been done for
imaging the biomedical bodies that does not fit into any afore-
mentioned applications. However, these shows the potential
fields where MSI can be utilized. Some of them are briefly
summarized here.
The potential to image the human arm is shown using
the CSI method in [103]. In [104], the Newton-Kantorovich
algorithm is used to obtain a quantitative permittivity image of
a numerical human thorax and a real human arm at 434 MHz.
In [105], the author of this paper used the Levernerg-
Marquadt method presented in [49] for imaging the human
torso at the level of small intestine in the 403.5 MHz
MedRadio band. The reconstructed image was then used as a
basis for the lo- calization of wireless capsule endoscopes.
Using this method, a localization accuracy within a centimeter
was obtained. The possibility to image the whole body using
microwave imaging is shown in [106] where measurements
were done on a dog and a 3-D gradient based iterative
algorithm was used to invert the data. In [45], comparisons
between different quantitative image reconstruction methods
are done on the experimental data of a phantom and a pig’s
hind leg in the frequency range
0.9−2.05 GHz. These methods are Newton based 2-D method
and 3-D gradient method, and MR-CSI both for 2-D and 3-D
cases. These research shows the feasibility of imaging large
biological bodies using quantitative approaches and opens up
opportunities in terms of several new application areas where
MSI can be used.
I. Summary of the Applications
Table II summarizes the various applications of MSI
studied in this paper. It mentions that the study in the literature
was done whether on the numerical (Num.) or the
experimental data (Exp.) and at what frequencies. Moreover,
it also mentions
 TABLE II
SUMMARY OF MSI APPLICATIONS

Application Algo. [ref] Num. Exp. Human/Animal Clinical Trial Freq.

Heartbeat (Section IV-A1) Doppler Theorem [12], [13] No Yes Yes No 2.4 GHz, 5.8 GHz, 10 GHz
Blood Flow/Pressure (Section IV-A2) Tranmission meas. [66], [67] Yes Yes Yes No 2.5 GHz, 0.1-5 GHz
Cerebral Edema (Section IV-A3) Transmission meas. [5] No Yes No No 2.4 GHz
Water Accumulation (Section IV-A3) Reflection meas. [69], [68] Yes Yes Yes No 915 MHz, 920 MHz, 3.1-10.6 GHz
Brain Stroke (Section IV-A4) Transmission meas. [6] No Yes Yes Yes 0.3-3 GHz
Brain Imaging (Section IV-B) Newton-type [4], [48] Yes No No No Diff. single freq. in 0.5-2.5 GHz
Born Iterative [71] Ye No No No 600, 850, 1000 MHz
Gauss-Newton [75] s No No No 1 GHz
Confocal [64], [72] Ye Yes No No 1-4 GHz
s
Yes
Breast Imaging (Section IV-C) Confocal [78], [79] Yes No No No 3.1-10.6 GHz
TSAR [63], [80], [25] Ye Ye Yes Ye 1-10 GHz, 50 MHz-15 GHz
Space-time Beamforming [81] s s No s 1-11 GHz
Two stage Capon Beamforming [82] No Ye No No UWB
Newton-type [86], [87] Ye s Yes No Single freq. in 300-900 MHz, 2 GHz
Conjugate Gradient Method [88] s No No Ye 2, 3.5, 5 GHz
Gauss-Newton [75] No Ye No s 1 GHz
DBIM [90] Ye s No No 0.5-3.5 GHz
CSI [91] s No No No 1 GHz
Ye No No
s No No
Ye No
s
Yes
Bone Imaging (Section IV-D) Levenberg-Marquadt [15] Yes No No No 800 MHz
Gauss-Newton [16] Yes Yes Yes No 1.3 GHz
Soft-Tissue (Section IV-E) Newton/MR-CSI [66] No Yes Yes No 1 GHz
TSAR [23] Yes Yes No No 50 Mz - 13.51 GHz
Heart Imaging (Section IV-F) MGM [18], [20] Yes Yes Yes No 0.9 GHz
Back-Projection [21], [22] Yes Yes Yes No 0.8-3 GHz
Thermal Therapy (Section IV-G) LMPF [101] No Yes Yes No Diff. single freq. in 300-1000 MHz
Born Approximation [102] Yes Yes No No 915 MHz
Arm Imaging (Section IV-H) CSI [103] No Yes Yes No 0.8, 1, 1.2 GHz
Gauss-Newton [75] No Yes Yes No 2.33 GHz
Newton-Kantorovich [104] No Yes Yes No 434 MHz
Thorax (Section IV-H) Newton-Kantorovich [104] Yes No No No 434 MHz
Localization (Section IV-H) Levenberg-Marquadt [105] Yes No No No 403.5 MHz
Whole-Body (Dog) (Section IV-H) 3-D Gradient [106] No Yes Yes No 0.9 GHz
Leg (Pig) (Section IV-H) Newton Gradient, MR-CSI [45] No Yes Yes No 0.9-2.05 GHz

that if the experimental data were collected on human/animal signal to the body. Due to a high difference in the electrical
and whether clinical trials have been performed. Clinical trials properties of the medium in which the antenna is placed
are initial testing of the MSI devices where prior approval
has to be taken from the health and ethical committee of the
country concerned. Moreover, many subjects either patients
or healthy volunteers participate after giving their written
consent.

V. CHALLENGES, OPEN TOPICS AND FUTURE RESEARCH

DIRECTIONS
The above section showed that MSI has many promising
medical applications. So far, the feasibility studies for many
applications have been mostly done through numerical simu-
lations. The ultimate objective of any MSI system is to be
used in a clinical setting as a cost-effective alternative to
the existing sensing and imaging modalities. To meet this
objective, the MSI system should be developed beyond theory
and simulations into working prototypes that can be used for
clinical trials. However, there are many technical challenges
and open topics that needs to be solved before going for
clinical trials providing the future research directions for MSI.
Some of them are discussed in this section.

A. Effective Coupling of Microwave Signal

For tomographic as well as sensing system, there is a
challenge to effectively couple the transmitted microwave
and the body, strong reflection occurs at the tissue-medium
boundary, leaving a weak signal to penetrate the body which
is further attenuated by the lossy tissues. This leaves very
weak scattered signal to be used for imaging and
requires a system with very large dynamic range [26], [20].
An approach to reduce the reflections is using water as a
coupling medium or matching medium. However, water has
high loss at imaging frequencies. A low loss coupling
medium made of sodium meta silicate gel is proposed for
2.45 GHz in [107]. Similarly, development of a low loss
coupling medium at other frequencies is required. Another
method to reduce the loss and effectively couple the signal is
to design an antenna suitable in shape, size, and efficiency
that could be placed very close to the body. In [95], design of
such an UWB antenna is presented for breast cancer
detection that can be placed close to the body and can couple
90% of the microwave power to the tissues.

B. Contrast Agents
A significant difference in the electrical properties of the
malignant tissue and the healthy tissues of the same kind is
used as a basis for detection of such malignant tissues. How-
ever, if any healthy tissue having a very small difference in
the electrical properties with this malignant tissue is present
in a close proximity, microwave imaging may fail to
distinguish between these two kinds of tissues. As for
example, there exist a large contrast between the breast
cancerous and the healthy fatty tissues. This difference is
small when the cancerous tissue is compared with the
healthy glandular or the fibro-connective breast tissue [36].
Hence, the detection of the cancerous tissue

(a) (b)
Fig. 12. Effect of varying concentration of contrast agent, single-walled
carbon nantotube (SWCNT), on tissue-mimicking material (a) relative per-
mittivity (b) conductivity, measured from 0.6 GHz to 20 GHz [110].
in a close vicinity of the glandular tissue may be a challenging
task with microwave imaging. One of the methods proposed
to tackle this challenge is to use contrast agents that can
enhance the contrast of the cancerous tissue [108]-[111]. The
idea is to administer a contrast agent to the body by methods
like intravenous injection. Some volume of the contrast agent
will then reach and bind the cancerous tissues enhancing
their electrical properties. In [108], a computational study
using 3-D realistic numerical breast phantoms is presented
using assumed effects of two contrast agents, microbubles and
carbon nanotubes. Differential imaging was done by taking
the difference between the image with and without the
contrast agent effect and was concluded that small tumors,
even below the resolution limit of the tomography system, can
be detected. In [109], a feasibility study is done using
microbubbles and single-walled carbon nanotubes (SWCNT)
as contrast agents in an UWB breast imaging to classify a
lesion as malignant or benign. This is done by analyzing the
complex natural resonances of the differential backscatter
responses before and after application of the contrast agents at
the suspicious site. Similarly, [110] uses carbon nanotube for
contrast enhancing of the breast tumors. It was shown that
0.22% of SWCNTs concentration by weight can increase the
average relative per- mittivity by 37% and the conductivity by
81% of tissue mim- icking material. The measured
enhancement in the contrast of the tissue mimicking material
is shown in Fig. 12 [110]. Use of magnetic nanoparticles as
the contrast agent is discussed in [111] for microwave
breast cancer imaging. The method is based on
reconstruction of the magnetic contrast induced by the
magnetic nanoparticles using the differential scattered signal
obtained at the receive antenna in the presence and the
absence of the polarizing magnetic field. These research have
shown that the challenge of small contrast between the
cancerous tissue and any healthy tissue can be addressed,
but there still remain several open challenges that need to
be addressed. For example, increasing the concentration level
of the contrast agents within the pathological tissues [26] as
only a low volume of contrast agent can reach the pathological
tissues [111]. The contrast agent may also distort the lesion
border profile that may be used in classification of lesions as
benign and malignant [109]. Hence, development of effective
contrast agents can be a possible future direction.
C. Imaging Algorithms
As discussed before, the quantitative microwave imaging
algorithms are known to have inherit challenges of an in-
verse problem like the non-linearity and the ill-posedness.
Though several methods have been proposed to attack the
problem [45], they still suffer from several limitations. For
example, oscillations occur in the estimated electrical prop-
erties at the boundary of the high dielectric contrast tissues
with both Newton and MR-CSI methods though employing
different regularization methods [45]. It was suggested that
an adaptive-density grid and regularization schemes for both
the EM field and the electrical properties might overcome
this problem [45]. Moreover, a 2-D based imaging algorithm
may not work for a 3-D biological object, and 3-D imag-
ing algorithms are computationally demanding. Moreover, as
listed in Table I, each of the imaging algorithms has its
own limitations. Selecting a particular algorithm for a given
application, depends upon available computational resources.
Hence, further in-depth studies are required for development
of a computationally efficient and more accurate inversion
algorithm. Adoption of the algorithm for parallel computing
can reduce the time complexity to some extent [45].
D. Signal Processing
For sensing applications as the heartbeat detection, removal
of the motion and respiration artifacts of a patient, and the
background clutter remains an open challenge to effectively
extract the heartbeat from the reflected signal [13]. Hence, a
robust signal processing algorithm is required for such cases
to remove such artifacts from the received signal. Moreover,
qualitative imaging approaches use backscattered data for
breast tumor or brain stroke detection. In such cases, signal
processing is required to remove the skin backscatter and late
time clutter response to effectively focus the tumor or the
stroke. Towards this end, some signal processing algorithms
have been developed to tackle skin reflections [64] and clutter
response [80].
E. Antennas and Measurement System
To relax the non-uniqueness and the ill-posedness of
nonlin- ear inverse problems to some extent, large number of
antennas have to be used so that the scattered field data set
from which the electrical properties are retrieved is large [49].
However, the number of antennas that can be used is limited
by their finite size. Moreover, placing the antennas too close
to each other may result in high mutual coupling between the
antennas introducing error in the measured scattered field.
Other errors that might get introduced in a measurement setup
are cable losses, phase shifts, or mismatch at the connectors
[112]. Further, it is the electric field that is required in the
inversion, and using a vector network analyzer based
measurement system would measure the path-gain between
the transmit and the receive antennas. Hence, calibration of
the measured data is required. A calibration process to remove
some of these errors is suggested in [112], [113]. Further,
[112] provides a method to avoid the frequencies where the
coupling is large enough to
prevent successful imaging in a wideband measurement setup.
Another method to avoid coupling is to use a virtual array to
scan the body, but at a cost of increased scan-time. Therefore,
the design of a measurement setup having an optimum scan-
time, low error, and also a better antenna design having a
minimal mutual coupling can be a future research direction.
Moreover, further research on effective calibration methods of
the measured data is also needed.
The error may also occur in the EM system model for the
nonlinear optimization problem due to the presence of nonac-
tive antennas if a fixed antenna array is used for microwave
imaging. Typically, the perturbations caused in the scattering
field due to the presence of these non-active antennas are
not taken into account in the EM system model. Moreover,
an error may also get introduced due to the assumption of
infinite matching medium. Hence, calibration methods as well
as a proper measurement system which introduces less error
are required. A compensation method for nonactive antennas
is discussed in [114]. A formulation that provides a way to
compensate the perturbations resulting from the presence of
an array of antennas around the imaging body is proposed
in [115]. Mojabi et al. in [116] proposes a measurement setup
using a rotatable conductive enclosure using a minimal
antenna array. It is discussed that such a setup will reduce
errors due to the assumption of infinite matching medium as
the boundary conditions that can be easily modeled.
Moreover, lesser number of the antennas used in the setup will
further reduce any error because of the presence of many
nonactive antennas.
F. Frequency Band and Resolution
Another open issue in MSI is choosing a suitable imaging
frequency. As discussed in Section IV, different applications
or even for the same application, different frequencies have
been used. A choice of suitable frequency band is a tradeoff
between the penetration depth and the resolution. It is well
known that the penetration depth decreases with the
frequency due to increased attenuation in the tissues,
however, the resolution increases with the frequency.
Moreover, a frequency used for imaging one body part may
not be optimal for another body part due to the difference in
the size and the tissue compositions. Hence, further
investigations are required for developing a standard with an
optimum frequency and an acceptable resolution.
G. Electromagnetic Interference and Noise
A clinical environment is an environment where EM inter-
ference abounds. Hence, using an MSI system in a clinical
environment is a challenging task as it will be susceptible to
EM interference and noise resulting in error in the measured
data. The sources of such interference and noise in a clinical
environment are RF emissions from wireless devices like
mobile phones, medical telemetry, wireless local area network
and other devices as radiology equipments, electrocautery
equipments, fluorescent lights and computers [117]. Further,
noisy electrical power supplies and grounding (earth), mag-
netic fields (static and alternating), and surges (static
discharge,
lightning) may also contribute to interference and noise in a
medical facility [118]. Thus, development of MSI system that
is robust to these EM interference is required. Furthermore,
the MSI system must not be a source of interference to other
wireless systems. It should follow the appropriate regulations
and standards set for medical devices.
H. Commercial Challenge
Apart from aforementioned technical challenges, one of
the non-technical challenge that would be faced by the MSI
systems to be embraced by clinician is competition from
other well established imaging modalities like MRI, CT or
ultrasound. As mentioned earlier, though the MSI system
has advantages such as low risk, mobility, time resolution,
and cost-effectiveness, it lacks especially in spatial resolution
compared to CT or MRI, that may be desired for a clear in-
terpretation of the reconstructed images in some applications.
However, in spite of these limitations, there have been start-
up companies based on MSI technology as EMTensor [8]
and Medfield Diagnostics [119] for stroke diagnosis, and
Micrima [120] for breast imaging, making a mark in the
medical imaging industry that has been so far dominated by
MRI or CT modalities. The success of such companies based
on MSI technology would certainly depend upon how well
MSI overcomes the technical as well as commercial
challenges from other well established modalities.
I. Other Future Directions
Some of the other future research work will naturally
follow the ways and means to improve the signal excitation,
detection, and the reconstruction techniques to obtain high
quality, low noise signals and images. In addition, novel
approaches like using multiple-input-multiple-output (MIMO)
techniques can be considered for reducing the complexity of
imaging systems [121] or improving the image by increasing
the signal to clutter ratio when compared with a bistatic or a
monostatic configuration [122]. Moreover, 3-D reconstruction
with temporal information in real time will be useful for new
applications like obtaining temporal images of a beating heart.
Another direction that can be explored for MSI is com-
pressive sensing. Compressive sensing is a method by which
signals can be reconstructed by sampling them at a rate
much lower than the Nyquist rate. However, for such a
reconstruction, following criteria have to be met: “sparse”
representation of the unknown signal in some domain, and
“incoherence” of the signal used for measurement with respect
to the unknown signal. Compressed sensing has been shown
to substantially improve the performance of ranging with an
UWB medical radar in comparison with more conventional
methods in scenarios with low signal-to-noise-ratio [123].
VI. CONCLUDING REMARKS
Microwave imaging and sensing (MSI) opens new oppor-
tunities in the field of medical imaging. MSI is shown to be
low-risk due to the non-ionizing EM signal used, low-cost,
portable, and have a good temporal resolution. This paper
presented an exhaustive summary of various quantitative and
qualitative imaging methods for medical MSI. It was
discussed that the physical basis of these quantitative and
qualitative imaging methods is the difference in the electrical
properties of different tissues. Quantitative methods solve the
ill-posed inverse EM problem through different iterative
schemes to minimize the error between the measured and the
modeled scattered field to obtain the electrical properties.
Qualitative methods avoid solving ill-posed inverse problem
by using radar-based techniques, and can be used in cases
where the objective is the detection of the strong scatterer like
the tumor. Various medical imaging applications using
microwaves for which proof-of-concept have been shown
were discussed. These applications include heartbeat, brain
imaging for stroke and edema detection, bone imaging for
density measures, breast cancer detection, heart imaging, and
soft tissue imaging. Apart from these applications, MSI has
shown to work for anatomical imaging of different body parts
like arms, torso, and also full-body. The feasibility studies of
MSI for these various applications shows the potential MSI
has to be used as a low-risk and a low cost alternative to the
currently used imaging modalities like MRI and CT-scan.
Successful initial clinical trials, especially for breast cancer
imaging and stroke detection using MSI have been done.
Commercial start-up companies using MSI technology like
Micrima [120] (for breast cancer), EMtensor [8] and Medfield
Diagnostics (for brain stroke) are involved in clinical studies.
However, for many other applications as listed in Table II,
MSI is still far from maturity as many open challenges remain
that have to be addressed before MSI can be used in a
clinical setting. The paper discussed these open topics and
gave some insight on what could be the probable solutions and
future research directions for MSI.
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