Int. J. Electron. Commun.

(AEÜ) 171 (2023) 154873

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Int. J. Electron. Commun. (AEÜ)

journal homepage: www.elsevier.com/locate/aeue

Review

A review of electromagnetic sensing for healthcare applications✩

Adarsh Singh a , Debasis Mitra a , Bappaditya Mandal b ,∗, Partha Basuchowdhuri c ,
Robin Augustine b
a Department of Electronics & Telecommunication Engineering, Indian Institute of Engineering Science and Technology, Shibpur, India
b Microwaves in Medical Engineering Group, Division of Solid State Electronics, Department of Electrical Engineering, Angstrom Laboratory, Uppsala
University, 75103, Uppsala, Sweden
c
School of Mathematical and Computational Science, IACS, Kolkata, India

ARTICLE INFO ABSTRACT

Keywords: Recent breakthroughs in the fields of antennas, electromagnetic sensors, propagation, and advanced materials
Healthcare have unveiled new opportunities for body area sensing, disease detection, and continuous monitoring.
Microwave probe Traditional healthcare approaches not only incur substantial costs but also suffer from inherent drawbacks such
Microwave resonators
as ionizing radiation risks. A range of medical devices, including pacemakers, implants, endoscopy equipment,
Antennas
microwave imaging, and thermal ablation clinical apparatus have greatly benefited from the incorporation of
Radar
electromagnetic sensors and wireless body area networks. Electromagnetic sensors hold significant potential
to transform not only the healthcare sector but also the sports and wearable electronics industries, offering
myriad innovative applications. This comprehensive review paper provides an in-depth exploration of the
challenges and prospects associated with electromagnetic sensors, including but not limited to microwave
probes, resonators, and antennas. We aim to shed light on the potential of these emerging technologies and
provide a roadmap for their future development in the context of healthcare and beyond.

1. Introduction examples of the applications of this technology include heart and

In recent years, the majority of developed nations have struggled
with the expense of providing long-term health care and wellness
services. It has been reported by the World Health Organization (WHO),
the fraction of the global population older than 60 years has risen
to 1.4 billion in 2020. Projections show that the number of people
aged 60 and older will be doubled to 2.1 billion across the world by
2050. Furthermore, between 2020 and 2050, the number of people
aged over 80 years is expected to triple, reaching 426 million [1].
While this figure reflects a socioeconomic and medical triumph over
diseases, it also poses a significant challenge to the healthcare systems
around the world. Therefore, it is crucial to devise innovative plans
and policies, as well as new methods, in order to make effective
use of available resources while simultaneously satisfying the growing
demand for healthcare.
Recent advancements in portable, wireless, and sensing technolo-
gies based on electromagnetic sensors are opening up many exciting
research possibilities in body area sensing and treatment. These po-
tential sensors offer a unique opportunity to create a new field of
applications in healthcare, sports, gaming, and other fields. A few
respiration rate monitoring of athletes, remote monitoring of patients
and elderly individuals, and sensing of vital factors for those who suffer
from chronic conditions such as diabetes, asthma, brain disorders, and
cardiovascular diseases (CVDs).
There are several important requirements and substantial chal-
lenges that must be satisfied in the design of innovative technologies.
These include ensuring accurate and timely diagnosis, patient safety,
emergency response, and designing sensors with properties such as
bio-compatibility, and low profile nature that should be non-invasive
or minimally invasive to the body. These challenges can be over-
come through transformative technological advancements in antennas
and other electromagnetic sensors, which have the potential to rev-
olutionize the healthcare industry and the management of wellness
programs.
The objective of this review article is to provide a comprehensive
examination of electromagnetic sensors and their significant impact
on the field of healthcare. This review seeks to offer researchers,
clinicians, and engineers a comprehensive analysis of the most recent

✩ This research work acknowledges ‘‘AI-based Detection of Acute Respiratory Distress Syndrome (AI-DARDS)’’, a joint Indo-Swedish collaborative project by
DBT, India-Vinnova, Sweden under grants BT/PR41025/Swdn/135/9/2020 (for DBT, India) and 2020-03612 (for Vinnova, Sweden).
∗ Corresponding author.
E-mail address: bappaditya.kgec@gmail.com (B. Mandal).

https://doi.org/10.1016/j.aeue.2023.154873
Received 26 June 2023; Accepted 25 August 2023
Available online 30 August 2023
1434-8411/© 2023 The Author(s). Published by Elsevier GmbH. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
A. Singh et al. AEUE - International Journal of Electronics and Communications 171 (2023) 154873

Fig. 1. Electromagnetic sensors for healthcare applications.

advancements, obstacles, and future possibilities in the field of electro-

magnetic sensors. This will serve as a road map that enables a thorough
exploration of the extensive capabilities of these sensors, facilitating a
deeper understanding of their impact on improving patient care and
transforming the healthcare landscape.
This review suggests that the trajectory of trends in the near future
indicates a substantial expansion in the realm of research pertaining
to Electromagnetic sensors employed for the purpose of detecting and
monitoring internal organs.

2. Electromagnetic sensors
Fig. 2. Applications of Microwave Probe-based technique.

EM based systems are not only limited to communication purposes,

Electromagnetic sensors are also the most advantageous method for
monitoring bodily activities, behavioral patterns, and disease detection allows the EM signal to travel through the coaxial line and encoun-
in many organs. ters an impedance mismatch between the Microwave probe and the
Electromagnetic Sensor-based systems which are being used in the biological tissue, resulting in a reflection of the signal. The complex
healthcare domain can be mainly classified into three categories listed permittivity values of the tissue are then determined by measuring
below. the reflected signals at various frequencies. Despite its invasive nature,
the coaxial probe has been widely used for dielectric measurements
1. Microwave Probe
around the globe for an extended period. However, its invasive nature
2. Microwave Resonator
limits its application in the healthcare domain, but it is being used
3. Antennas
in minimally invasive or non-invasive applications for the detection of
(a) In Implantable mode various abnormalities in the human body and for measuring the dielec-
(b) In Wearable mode tric properties of various human tissues. In the forthcoming paragraphs,
(c) In Radar or Non-Contact mode we will present and review a few applications (as illustrated in Fig. 2)
of probe-based techniques for healthcare and related reported works,
In this article, we present and review electromagnetic sensors and their
showcasing the versatility of this technology.
applications in the healthcare domain, as illustrated in Fig. 1.

2.1. Microwave probe-based techniques 2.1.1. Dielectric measurement of biological tissues

The assessment of the dielectric characteristics of human tissues
The open-ended coaxial probe, with its elegant design, is con- through the employment of a coaxial probe is a significant application
structed from a truncated section of a transmission line. This probe that furnishes crucial insights into the electrical behavior of these

2
A. Singh et al.
tissues. Several studies have been conducted to estimate the dielectric
properties of tissue, a selection of which has been reviewed herein.
The first category contains pioneering research works [2–8] that
provide the characterization of biological tissue’s dielectric properties
for future research works on different applications, such as disease de-
tection or health monitoring. For example, Burdette [2] used a coaxial
probe to conduct in-vivo experiments on canine muscle, kidney cortical,
and fat tissue. After being compared to in-vitro data of canine and
human tissue, it revealed that the measured in-vivo permittivity values
in canine fat tissue were found to be 1.5 to 2 times greater than the in-
vitro permittivity values previously obtained by other researchers [3,
4]. This variance in dielectric characteristics was likely caused by
variations in moisture content, temperature, or genuine physiological
distinctions between living and non-living tissues [2]. Subsequently,
researchers provided in-vivo and ex-vivo dielectric characteristics of
various tissues such as skin, fat, muscle, spinal cord, long bone, skull
bone, and bone marrow in the microwave range of frequency [5–
7]. The dielectric behavior of human tissues with increasing age has
been well presented in [8], which serves as a foundation for new-age
researchers in the field of microwave for biomedical applications.
2.1.2. During hyperthermia and thermal ablation
The second category of research works [9–15] focuses on dielectric
estimation during thermal ablation or microwave thermal ablation
(MTA). Hyperthermia and thermal ablation are significant treatment
modalities for several disorders, most notably cancers, where heating
biological tissues above 40/◦ C is a well-established way of treatment.
Reliable computational simulations for preclinical planning require a
comprehensive understanding of tissue dielectric properties and their
frequency and temperature dependence. Researchers [9] measured di-
electric characteristics of ex-vivo bovine liver tissue at 915 MHz during
heating and observed that water and protein work together to raise
conductivity and permittivity by up to 100% and 5%, respectively, at
temperatures above 60 ◦ C. P. R. Stauffer [13] performed an experiment
on a thermal variation in Dielectric properties of porcine and bovine
liver. They also described human liver tissue thermal behavior with
the help of these two livers. Dielectric constant (bovine liver) varied
2.0%/◦ C during 10–90 ◦ C. Fresh human liver tissue in vitro was found
to be 7%–9% lower 𝜀𝑟 and 7%–14% lower 𝜎, respectively, than pig
and bovine liver tissues. Most recently, A. Bottiglieri [14] provided a
study for dielectric characterization of freshly extracted human adrenal
glands for MTA using a coaxial probe for 0.5 to 8 GHz frequency range.
In [15] authors performed a study on 13 samples from 7 fresh livers
(6 bovine and 1 porcine) for 37–60 ◦ C temperature range over an
ultrawideband frequency range of 0.5 to 20 GHz. Later, V. Lopresto [11,
12] provides a study about microwave thermal ablation in which they
described an overview of the variations in the physical characteristics
of tissues throughout MTA procedures, as well as its impact on MTA
outcomes (see Table 1).
2.1.3. Histology of cancerous tissue
The study of the microscopic structure of cells and tissues, known
as histology, plays a crucial role in identifying the different tissues or
cells present in a sample and their relative spatial distribution. This
is important particularly in the case of the measurement of dielectric
characteristics of a heterogeneous tissue sample, as the tissue types that
make up a sample define its dielectric properties. By characterizing the
dielectric values to the relevant tissue type through a histological study,
it is possible to gain a more detailed understanding of the sample.
Research in this field has revealed the significance of histology in
the characterization of various tissue types, particularly in the case of
breast cancer. In [16], Several hundred dielectric measurements have
been performed for the samples of healthy and malignant excised breast
tissue using an open-ended coaxial probe. The tissue composition was
evaluated over the whole three-dimensional sensing volume using two-
dimensional cross-sections, with qualified pathologists determining the
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
proportions of each tissue type, including fat, glandular, and fibrous
connective tissue, as well as cancerous or malignant tissue.
Other notable works [17,18,24] involve the dielectric characteriza-
tion of breast tissue (healthy and malignant) using the coaxial probe.
In [17], The complex permittivity of excised breast tissue samples was
evaluated using an open-ended coaxial probe. The objective of the
work was to determine the tissue’s effective permittivity by assuming
that each sample is a heterogeneous combination of cells with various
permittivity. In the work [18], The researchers performed Dielectric
measurements over 0.5 to 50 GHz frequency range for 222 distinct
breast tissue samples (156 healthy and 56 cancerous) collected through
breast surgery. This research presented a thorough analysis of a com-
prehensive database of observations on human breast tissues for the
very first time above 20 GHz. Most recently, In [19], The dielectric
characteristics of ex vivo intrathoracic lymph nodes collected from
lung cancer procedures were investigated by the researchers. These
qualities include permittivity and conductivity. The findings indicate
that the permittivity and conductivity of metastatic lymph nodes are
larger than those of normal lymph nodes over the frequency range of
1 MHz–4 GHz.
Overall, Histological investigation is crucial for identifying tissue
types and their spatial patterns, particularly in cases of breast can-
cer. The integration of dielectric measurements and histological ex-
amination enhances understanding of the sample and facilitates the
advancement of more efficacious treatments and therapies.
2.1.4. Determination of burn depth
The tragic event of a burn can have a devastating impact on an
individual’s life. Whether it is an accidental burn from flames or an
experimental burn from acid or chemicals, the depth of the burn is
crucial information for physicians to have. The use of a coaxial probe-
based technique has been proposed as a method for assessing burn
depth, as highlighted in several reported works [20–23].
In [20], a volunteer who had suffered a burn of hydrofluoric acid
on his face participated in a study where dielectric measurements
were performed on the skin during the healing process. The results
showed that skin damaged by hydrofluoric acid and heat has lower
dielectric dispersion and absorption than normal skin, and the dielectric
properties of skin damaged by heat appeared distinct from skin affected
by hydrofluoric acid. In [21], the authors discussed the applicability of
non-invasive dielectric measurement using probe-based techniques in
the case of experimental burns. These measurements provide a sensitive
and non-invasive way to assess tissue edema and distinguish between
partial- and full-thickness burns. Furthermore, in [22,23] the authors
performed dielectric measurement methods for burn depth on beef
meat, characterizing the behavior of the real and imaginary parts of
relative permittivity for 3 levels [22] and 6 levels [23] of burn depth.
Electromagnetic sensor-based systems, particularly the coaxial
probe, have demonstrated significant value in the healthcare sector
for evaluating and treating various human tissue conditions. Research
and data from these studies contribute to the progress of biomedical
technology and provide essential information for the development of
novel treatments and techniques. The healthcare sector is anticipated
to transform significantly and enhance patient outcomes due to the
expanding use of sensors, driven by technological and research devel-
opments. Although the coaxial probe is a valuable tool in healthcare,
it is crucial to understand its limitations and drawbacks. The invasive
nature of the coaxial probe restricts its use in certain healthcare
domains, representing a significant limitation. Additionally, Dielectric
measurements obtained by the probe can be affected by factors such
as temperature, water content, and physiological differences between
living and non-living tissues.
A. Singh et al. AEUE - International Journal of Electronics and Communications 171 (2023) 154873

Table 1
Comparative analysis of probe-based techniques for healthcare application.
Ref No Application Operating Frequency Tissue type Tissue state
[2] Comparison of in-vivo and in-vitro tissue dielectric 0.1 to 10 GHz Canine(Muscle, fat, In-vivo, in vitro
characteristics. kidney)
[5–7] The dielectric properties of biological tissues 10 MHz to 100 GHz Multiple human and In-vitro
animal tissue
[8] Dielectric behavior of human tissues with 10 MHz to 100GHz Pork tissues(fat, In vitro
increasing age Muscle, bone, etc.)
[9] Dielectric behavior of tissue during heating 915 MHz Bovine Liver In vitro
(Thermal Ablation).
[13] A thermal variation on Dielectric properties. 915 MHz porcine and bovine In-vivo and
liver in-vitro
[14] Dielectric characterization of freshly extracted 0.5 to 8 GHz Adrenal Glands Freshly excised
adrenal glands for MTA.
[15] Dielectric characteristics of animal liver tissue as a 0.5 to 20 GHz 6 bovine and 1 porcine Freshly excised
function of temperature at ultra-wideband liver
frequency range.
[16] Characterization of healthy, benign, and cancerous 0.5 to 20 GHz Breast tissue (normal Surgery
breast tissues for ultrawideband microwave and cancerous) extracted
frequency range.
[17] Complex Dielectric permittivities of breast tumor 0.5 to 20 GHz Breast tissue Freshly excised
tissues excised during cancer surgeries. (Cancerous)
[18] Dielectric Characterization of Breast Cancer 0.5 to 50 GHz Breast tissue (normal Surgery
Tissues. and cancerous) extracted
[19] Measurement of Dielectric Properties of Normal 1 MHz to 4 GHz human Lymph Nodes Ex-Vivo (Surgery
and Metastatic Lymph Nodes. (lung Tissues) Extracted)
[20] Microwave monitoring of the healing stages of 100 MHz to 10 GHz Human skin (face and In vivo
skin burns. hand)
[21] Applicability of non-invasive dielectric Pig In vivo
measurement in case of an experimental burn.
[22] Measurement of burn depth on biological tissues 0.9 to 2.6 GHz Beef meat In-vitro
by dielectric properties analysis.
[23] Examining the depth of burns on organs using a 2.4 GHz Beef meat In-vitro
microwave probe.

2.2. Microwave resonator-based technique

A microwave resonator consists of a transmission line segment

with either open or short ends. The resonators may be referred to
as stripline, microstrip line, slotline, or cavity resonators depending
on the kind of transmission line. When the resonator is utilized as a
sensor, the sample to be measured interacts with a portion of the EM
field generated by the resonator. Therefore, the object’s permittivity
influences the resonant frequency and quality factor. Due to the wide
range of possible structure designs, sensors can be made for a variety
of healthcare applications. Some of the key advantages of microwave
Fig. 3. Applications of microwave resonator-based technique.
resonators are the ability to monitor non-invasively, without contact,
from a close distance using penetrating waves. The technology’s non-
ionizing properties are also of main interest, which eliminates serious
health hazards brought on by other kinds of sensors, especially in utilized as biosensors to assess the dielectric properties of cells and de-
the healthcare sector. Disadvantages include the fact that microwave rive electromagnetic characteristics based on cell type, in the particular
measurements of materials usually require a lot of specialization and cancer cell stage. In [27], A proof-of-concept study using preserved ma-
can be affected by many factors at the same time, such as temperature, lignant cell lines proved that microwave resonant sensors can identify
density, moisture, structure, etc [25]. In this section of the review colorectal tumor cells by cell permittivity. Resonance frequency varia-
article, a few healthcare applications (see Fig. 3) are listed below tion was used to measure intracellular dielectric permittivity. In [28],
and associated microwave resonators for such applications have been The paper proposes a novel way to develop a biomedical metamaterial-
reviewed.
based sensor. The Metamaterial-based sensor comprises a circular split
ring resonator (SRR) with a Hilbert fractal curve to distinguish cancer
2.2.1. Histology of cancerous cells
cell lines by their dielectric properties. Most recently, [29]A circular
Detecting cancer cells early, when the tumor is small or sparse,
patch resonator was utilized to evaluate low- and high-aggressive os-
is difficult in cancer research. Early cancer detection is critical for
cancer prevention and reducing death rates, especially for malignancies teosarcoma and breast malignant cell lines (MCF-7 and MDA-MB-231,
with a poor recovery rate that impacts many individuals each year. respectively). Resonance frequency detection was particularly sensitive.
In 2020, it was responsible for nearly 10 million deaths, or about 1 The sensor could distinguish low- and high-metastatic cells, enabling
in 6 deaths [26]. Here, we review how microwave resonators may be noninvasive tissue diagnosis.

4
A. Singh et al.
2.2.2. Biosensing application
Bacterial infections are a common challenge in hospitals worldwide.
Every hour of antibiotic delay raises sepsis and septic shock mortality
by 7.6% [30]. Failure to detect early bacterial infections may be
lethal to a patient. Existing techniques for identifying infections and
conducting antibiotic susceptibility testing (AST) are time-consuming
and arduous, requiring 2–5 days to provide correct findings [31]. Mi-
crowave resonator devices offer biosensing potential. Electrical signals
with properties like resonant frequency and amplitude can be gener-
ated from variations in the dielectric properties of adjacent materials.
Authors [32] have analyzed the biosensing capacity, several benefits,
and applications of SRR-based biosensors for biomolecule detection.
Biotin and streptavidin were utilized to show SRR biosensing. In the
study [33], For real-time, long-term, contactless, and nonintrusive flow
rate monitoring in microfluidic environments, a portable microwave-
microfluidic flow sensor is presented. The research [34] presents a basic
model for analyzing bacteria concentration and growth in different
environments. Escherichia coli MG1655 bacteria are introduced into
the resonator’s microfluidic chip. Monitoring bacterial growth as a
function of time helps to analyze the sensor’s efficacy in detecting
bacteria proliferation in transitory situations (see Table 2).
2.2.3. Burn depth and muscle quality assessments
Recently, microwave resonators have begun to be used in very
novel ways for a variety of applications within the biomedical field.
In this article, the non-invasive approaches that are based on the idea
of microwave resonating are discussed two significant applications: the
measurement of burn depth and muscle quality. Burning injuries cause
180,000 fatalities yearly, making it a worldwide health hazard. Two-
thirds of incidents occur in Africa and South-East Asia [39]. Burns
can be caused by contact with hot surfaces, acids, electric shocks, fire
flames, etc. Burn depth analysis helps doctors determine the correct
therapy. In [35], The presented resonator-based Flexible, non-invasive,
and biocompatible sensor was developed using numerical modeling
that can detect burnt skin permittivity changes utilizing the sensitive
change in resonance frequency. Additionally, encapsulation using a
PDMS layer made the sensor biocompatible.
Sarcopenia causes loss of muscular mass, strength, and function in
patients. Sarcopenia reduces muscle mass and size first, then muscular
quality, and also hampers everyday activities, which may increase
health care expenses [40]. In [36], The article presents a microwave-
based method for measuring muscle bulk and quality. After clinical
experiments using a sensor prototype, the microwave signal’s low
penetration depth was found as a drawback but opened a research
area for microwave sensor development for this application. Therefore,
three novel sensors have been created, including two with integrated
waveguides and one with a band-stop filter.
2.2.4. Glucose monitoring
In recent years, glucose sensors have gained scientific interest.
Microwave techniques have been intensively researched due to their
precision, resilience, cost-effectiveness, simplicity of integration, con-
tinuous operation, and non-invasive characteristics, with selectivity
being one of their key concerns [41]. In this section, a few resonators
for glucose monitoring applications have been presented and reviewed.
In [37], the article describes the design, construction, and user-based
testing of a Dual frequency microwave resonant sensor for monitoring
blood glucose levels. Furthermore, 11 participants with blood glucose
levels from 89 to 262 mg/dL were measured invasively (glucometer)
and noninvasively (microwave resonator). Compared to a glucometer,
the suggested sensor has a maximum measurement error of 3% while
detecting glucose levels. Most recently, [38] A compact microwave sen-
sor has been created to facilitate noninvasive blood glucose monitoring.
The sensor uses nonreciprocal WGM waves emitted from a ferrite ring
resonator at sub-centimetre wavelengths to detect small variations in
electromagnetic properties due to varying glucose concentrations. The
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
Fig. 4. Applications of implantable antenna-based technique.
sensor’s detection capability was demonstrated in three experimental
measurements using WGM600 mode. The sensor showed increased
sensitivity, with values of around 0.07 MHz/[mg/dL]. The sensor can
monitor glucose levels in a closed capillary without direct contact with
the sample.
2.3. Implantable antenna-based technique
Different types of body-centric wireless communications include on-
body, off-body, and in-body communications. An implantable device
and an external health monitoring device constitute the in-body com-
munication system. In order to send data wirelessly from implants to
the outside world, implantable antennas are required. The patient’s
medical issues can be tracked and diagnosed using smart implants.
The majority of antenna radiation is absorbed by the body’s tissues
due to their different dielectric constants and their tissue composition.
So, it is a very big challenge to implant an antenna inside the human
body. The purpose of this section is to highlight the research issues
and challenges for implantable antenna and provide an overview of
emerging implantable antenna innovations for medical applications (as
illustrated in Fig. 4).
2.3.1. Continuous glucose monitoring
Today, diabetes mellitus, one of the most serious chronic diseases,
affects over 537 million individuals. The International Diabetes Fed-
eration (IDF) reported 6.7 million diabetes-related deaths in 2021.
Moreover, the prevalence of diabetes has increased significantly [42].
This section reviews some of these implantable sensors for continuous
body glucose level monitoring. In [43], A dual-band Implantable an-
tenna and its applicability for continuous glucose monitoring implants
have been presented. The presented Antenna operates in both MICS
(402 MHz) and ISM (2.45 GHz) and has been designed for switch-
ing between sleep and wake-up modes which enables the implant
to save energy and increase its lifespan. In [44], The biocompatible
material Silicon Carbide (SiC) has been used to create a continuous
glucose sensor that uses radio frequency (RF) signals. The sensing
method relies on a change in resonance frequency as a result of a
variation in blood glucose levels. The sensor’s in-vitro performance
highlighted a dependent response of resonance to glucose concen-
trations ranging from 120 mg/dl to 530 mg/dl. Blood mimicking
liquid and pig blood showed shifting of 40 MHz and 26 MHz, respec-
tively, in response to changes in blood glucose. In [45], A miniature
(8.5 × 8.5 × 1.27 mm3 ), wide-beamwidth CP implantable antenna is
developed as well as experimentally verified for implantable real-time
glucose monitoring applications in the ISM band (2.40–2.48 GHz).
In the article, A pork slab was subjected to an in vitro test, and
the impedance bandwidth was found to be 13%. (2.31–2.63 GHz).
Most Recently, [46] Researchers have proposed an electromagnetic
sensor that can be subcutaneously implanted to track small changes in
dielectric permittivity caused by fluctuations in blood glucose levels.
The proposed electromagnetic-based implant sensor was tested in a
controlled environment using swine and beagle subjects during an
intravenous glucose tolerance test (IVGTT), and its proof-of-concept
was successfully validated. Furthermore, the sensor interface module
has the ability to continuously measure data, which can be visualized
in real time through the Android mobile application.
A. Singh et al.
Table 2
Comparative analysis of microwave resonator-based techniques for healthcare application.
Ref No. Resonator Type (RT),
Operating Frequency
(OF),Application (A)
[27] (RT): Frequency-tunable
Microwave resonators.
(OF): 5 to 14 GHz.
(A): Discrimination of
colorectal cancer cell lines.
[28] (RT): A sensitive
metamaterial-based sensor
with a single circular split
ring resonator (SRR) and a
Hilbert fractal curve.
(OF): 2.45 GHz.
(A): Discriminate cancer
cell lines.
[29] (RT): Circular patch
resonator.
(OF): 0.001 to 3.000 GHz.
(A): Measuring Cancer Cell
Line Aggressiveness.
[32] (RT): Square split ring
resonator.
(OF): 10 GHz.
(A): Biosensing
[33] (RT): Open-ended
half-wavelength ring
resonator
(OF): 4 GHz
(A): Biosensing using Flow
rate monitoring in
microfluidic environments
2.3.2. Wireless telemetry for pacemaker
In today’s world, cardiac resynchronization treatment devices are
crucial since it save patients’ life. Currently, there are more than three
million pacemakers in use globally, and the number of people who
need them is rising as heart attack alone affects more than 25 million
people globally. According to reports, CVDs were responsible for 17.9
million deaths globally in 2019, accounting for 32% of all fatalities.
85% of these deaths were caused by heart attacks or strokes [47].
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
Ref No. Resonator Type (RT),
Operating Frequency
(OF),Application (A)
[34] (RT): A microstrip planar
ring resonator.
(OF): 2 to 3 GHz
(A): Analyzing bacteria
concentration and growth
in different
environments.
[35] (RT): Magnetically
coupled loop antenna
with a Spiral Resonator.
(OF): 1.5 to 1.71 GHz.
(A): Burn degree
assessment
[36] (RT): Split Ring
Resonator.
(OF): 2 to 3 GHz.
(A): Muscle mass and
quality Assessment.
[37] (RT): Cross-shaped
resonator with SIW
cavity.
(OF): 5.5 and 8.5 GHz.
(A): Blood glucose level
monitoring.
[38] (RT): Non-Reciprocal
Whispering-Gallery-Mode
Resonator.
(OF): 28 GHz.
(A): Continuous
noninvasive blood
glucose level monitoring.
Implantable antennas are now available in ultracompact forms because
of advancements in the technology of leadless cardiac pacemakers
(LCPs). In [48], An ultra-compact (3 × 4 × 0.5 mm3 ) antenna is designed
to operate in the 2.4 GHz ISM band. The spiral design of the proposed
antenna allows for better downsizing, less sensitivity to changes in
body tissue, and low SAR values for the seamless operation of LCPs.
In [49], For wireless cardiac pacemaker systems (WCPs), a small (3 ×
3 × 0.5 mm3 ), and thin implantable antenna was developed. Based on
A. Singh et al.
a review of the article, it was established that this design was indeed
the smallest among implantable antennas of the same category. The
antenna is optimized and loaded with a defective slotted layout, which
enhances the gain of the antenna and its overall working efficiency.
The antenna’s specific absorption rate is also examined and assessed.
The outcome demonstrates that in the incredibly small volume of the
wireless cardiac pacemaker system, this type of antenna is the best
option to implement wireless bio-telemetry transmission.
Another application of implantable antenna, in the form of rectenna
for self-charging pacemakers, has been explored and a few articles are
reviewed and presented in this section. Authors [50] have presented
a prototype implantable rectenna, recharging and pacing circuits, and
pacing electrodes for a leadless pacemaker (LP). A planar dipole an-
tenna is proposed with fractal geometry that is coupled inductively with
metallic strips. The Koch curve method is used in the fractal geometry
design to accomplish miniaturization. In [51], A CP monopole antenna,
a matching circuit, and a rectifier circuit comprise the implantable
rectenna that is proposed for charging the battery of pacemakers.
Impedance mismatch is reduced by the matching circuit between the
antenna and rectifier. To accomplish the desired CP performance, two
T-shaped slots are added to the antenna’s ground plane.
2.3.3. Endoscopy system
Wireless capsule endoscopy (WCE) is an innovative non-invasive
diagnostic device that can capture photographs of the gastrointestinal
(GI) tract and send biological data without the use of sedatives, sig-
nificantly lowering patient discomfort. The addition of an Implantable
antenna to the endoscopy system makes it WCE. It significantly re-
solves the issue that conventional endoscopy cannot precisely reach
some areas of the gastrointestinal lesion, enabling the doctor’s direct
examination of gastrointestinal abnormalities and the disease diagnosis.
In this article, a few conformal implantable antennas for WCE are
reviewed and shown. In [52], For the WCE application, a capacitance-
loaded wideband implanted antenna was developed. The bandwidth of
the simulated impedance in a single-layer skin phantom was found to
be 2.17–2.69 GHz (20.5%). Finally, the entire system, including the
antenna, battery, and camera, is enclosed in a polyetheretherketone
shell with an overall height of 11.0 mm with 𝜀𝑟 and 𝑡𝑎𝑛𝛿 values of
3.2 and 0.001, respectively. In [53], the authors proposed a compact
dual-band antenna with CP for a WCE system working in ISM bands
915 MHz and 2.45 GHz. The designed capsule device has standard
dimensions of 26 × 11 mm2 and is meant for deep-tissue implantation.
The suggested antenna’s main advantages include its CP properties in
both bands, adequate gain levels, and smaller volume (6.5 × 6.5 × 0.05 =
2.11 mm3 ).
2.3.4. Monitoring of bone fracture healing
From the time of the post-trauma surgery until the time the bone
has healed, there is a monitoring phase for bone fractures. Age, nutri-
tion, other medical conditions, size, location, number of injuries, and
recovery force may affect healing. These factors may cause delayed
fracture healing, a condition in which the intermediate callus does not
convert into healthy bone tissue, causing considerable discomfort, loss
of motion, and muscle weakening. Achieving appropriate bone recon-
struction with metal plates inserted through surgery can be challenging,
requiring regular monitoring to assess and treat fractures appropriately.
In recent times, the applicability of implantable antenna as a mon-
itoring tool for bone fracture healing is being explored. A few articles
targeting the mentioned application have been reviewed in this section.
In [54], A slotted waveguide antenna has been proposed by the authors
as an element of a wireless battery pack for the Echidna Pin bone
fixation implant devices. The antenna uses a thin Perspex plate to make
it circularly polarized. This implies that the transmitter antenna may
be put in any direction with respect to the implant and the receiver
Antenna can still receive the power effectively. In [55], An novel
approach for tracking severe bone fracture healing has been presented,
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
utilizing a pair of RF monopole antennas implanted in the fractured
bone. It is anticipated that the screws and external fixation required to
position and support the bone will function as monopole antennas also.
The power transferred from one monopole to another was recorded and
analyzed as a fracture healing indication. The authors of the article [56]
provided the study of the electromagnetic wave angle of incidence
on a multilayered human tissue model and proposed a monitoring
application for two kinds of bone fractures. The monitoring approach
evaluates the optimal EM wave angle outside the body. Furthermore,
The impact of implanted antenna miniaturization on monitoring is
examined using CST Microwave studio software. Animal model findings
are also experimentally verified (see Table 3).
2.3.5. Brain disease diagnosis
Brain implant technologies help brain disease patients, monitor
neurological states during therapy, and diagnose brain disorders early.
However, brain implant devices generally interface with external units
through cables, which may harm patients and limit their mobility.
Wireless brain implants are getting more attention and it has im-
plantable antennas as a key part of it, some of them are discussed
in this section. In [61], the authors proposed the application of an
implantable antenna as a part of brain-machine interference (BMI). The
presented Implantable antenna of 1 mm3 operates in the MICS band of
frequency (402–405 MHz). The authors investigated the effect of noise
temperature in the biomedical environment using absorption analysis.
It was the first time antenna noise analysis utilizing absorption-noise
models was explored for biomedical applications. Furthermore, this
research designs and characterizes telemetry antennas for wireless and
multi-channel implant brain recording devices. In [57], A connection
between an off-body loop antenna and a 3-D bowtie brain implantable
antenna with a volume of 0.9 mm3 is designed, modeled, and experi-
mentally verified. The implantable antenna is inserted in a human head
mimicking model’s cerebral spinal fluid to verify design reliability and
performance. In-vitro measurements of the manufactured prototypes
were performed in a pig’s head and piglet. Most recently, in [62],
A miniaturized implantable antenna with wide operating bandwidth
and a broadside radiation pattern is proposed. The suggested solution
addresses the omnidirectional pattern issue by optimizing the antenna
structure within a brain phantom containing seven-layer of skin, fat,
bone, dura, CSF, grey, and white matter. The antenna was integrated
into this seven-layer phantom developed in full-wave simulation soft-
ware. The optimized antenna has circular geometry of 10 mm diameter
with broadside radiation for 2.4 GHz. A Low-loss biocompatible PCB
material Taconic RF-35 (𝜀𝑟 3.5, 𝑡𝑎𝑛𝜎 0.0018) was utilized to fabricate the
design and verified in a brain phantom of seven-layer with semi-solid
ATE materials.
2.3.6. Stent implant
A pulmonary artery stent-based monitoring device measures pul-
monary diastolic pressure, oxygen levels, outflow, and hematologi-
cal markers. Heart failure diagnosis relies primarily on pulmonary
wedge pressure. Stents that serve as regular stents and implanted
antennas that communicate vital biological data to outside monitor-
ing devices have been investigated. In [58], the RF approach for
sensor-integrated ‘‘smart’’ stent implantation has been presented. This
micro-capacitive pressure sensor and 2-cm inductive antenna stent,
both made of medical-grade stainless steel, serve as a wireless resonant
pressure sensor to identify local variations in blood pressure. Further-
more, Wireless telemetry of the implanted devices in the vascular model
and graft is verified by measuring with power sources between 4 and
20 dBm. In [63], the Authors proposed a stent antenna made of several
rings with crowns and struts. Unlike a traditional stent, where each ring
has numerous connectors, the single connector prevents random elec-
trical current distribution and improves radiation. In order to achieve
good EM radiation performance, the implantable stent antenna operates
at 2 to 3 GHz with minimum tissue penetration loss and modified stent
A. Singh et al.
Table 3
Comparative analysis of implantable antenna-based techniques for healthcare application.
Ref No. Antenna Type (AT),
Operating Frequency (OF),
Antenna Size (AS) (mm3 ),
Application (A)
[45] (AT): A CSRR Loaded CP
Antenna
(OF): 2.4 GHz
(AS): 8.5 × 8.5 × 1.27
(A): Subcutaneous
Real-Time Glucose
Monitoring
[46] (AT): Conformal sensor
with Teflon core and
polyolefin cover.
(OF): 2.4 GHz
(AS): 8.5 × 8.5 × 1.27
(A): Subcutaneously
implanted Real-Time
Glucose Monitoring system
[49] (AT): The planar antenna
with a zigzag structure
(OF): 2.4 GHz
(AS): 3 × 3 × 0.5
(A): Wireless Telemetry for
wireless cardiac pacemaker
systems
[51] (AT): Circularly polarized
(CP) monopole antenna
(OF): 2.4 GHz
(AS): 10 × 10 × 0.3
(A): Implantable rectenna
for self-charging pacemaker
[53] (AT): Dual-band CP
antenna with U-shaped
with asymmetric slots
(OF): 915 and 2450 MHz
(AS): 6.5 × 6.5 × 0.05
(A): Capsule endoscopy
system
current distributions. In [59], the article describes a stent antenna sys-
tem for treating abdominal aortic aneurysms (AAA). The stent antenna
consists of several helical wires joined to form meshed rings with a
single feed wire, preventing random current distribution in the stent.
The designed stent antenna system has omnidirectional radiation, high
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
Ref No. Antenna Type (AT),
Operating Frequency
(OF), Antenna Size (AS)
(mm3 ), Application (A)
[56] (AT): Planar half-wave
dipole antenna
(OF): 0.9 GHz
(AS): 46 × 5 × 0.638
(A): monitoring of
femoral shaft fracture
healing
[57] (AT): Three-dimensional
(3-D) bowtie antenna
(OF): 400 MHz
(AS): 0.9
(A): Wireless Telemetry
for Brain Implantable
Medical Devices
[58] (AT): Inductive loop
stent
(AS): 𝜋 × 12 × 1
(A): Stainless-Steel-Based
Smart Antenna Stent for
Wireless Telemetry.
[59] (AT): Helical Stent
Antenna
(OF): 7201190 MHz,
20502560 MHz
(A): Endovascular
aneurysm repair (EVAR)
to Treat abdominal aortic
aneurysm (AAA)
[60] (AT): Meandered dipole
& PIFA
(OF): 433 and 915 MHz
(AS): 17.25 × 8 × 0.635 &
42 × 10 × 0.635
(A):An intraoral tongue
drive system
gain, excellent impedance matching, and multiband nature covering the
frequency range of 720–1190 MHz and 2050–2560 MHz.
2.3.7. Oral implant
Biomedical devices based on minimally invasive technology are
becoming one of the emerging techniques. These devices can be utilized
A. Singh et al.
Fig. 5. Applications of wearable antenna-based technique.
with minimally invasive surgery having low risk and quick recovery.
Biological sensors with micro-controlled ICs and an implanted antenna
build a wireless body area network (WBAN) for health monitoring
devices and record long-term health data. Few Studies [60,64,65] have
been examined and presented that specifically address such applica-
tions. In [64], A novel antenna for dental implants is proposed. To
monitor patient health, the suggested antenna may be connected to
minimally invasive biomedical equipment. This 3D folding antenna,
which uses the medical radio (MedRadio) band, was integrated into
a ceramic denture. To remove particular orientation dependency, an
omnidirectional radiation pattern was created. In [65], the authors
introduced a brand-new intraoral Tongue Drive System (iTDS) with
an arch form that fits into the buccal shelf of the user’s mouth. The
novel arch-shaped iTDS has a system-on-a-chip (SoC) that amplifies and
digitizes the unprocessed magnetic sensor data before transmitting it
wirelessly to an external TDS universal interface (TDS-UI) through a
planar inverted-F antenna. Most recently [60], Two dual-band antennas
are presented, a meandered dipole antenna and a meandered planar
inverted-F antenna (PIFA) for the intraoral tongue drive system (iTDS).
With the help of an intraoral tongue drive system (iTDS), paralyzed
persons may enhance their quality of life by using tongue gestures to
operate wheelchairs and access computers.
2.4. Wearable antenna-based technique
Over the course of the past few years, there has been a significant
rise in the demand for wearable devices. There are many different
uses for wearable technology in our everyday lives. Now, they are not
restricted to wristwatches, fitness bands, or glasses; rather, they span
a wide range of applications in the medical field. Wearable technology
is increasingly being employed in the medical industry to keep track of
patients’ vital signs and other important aspects of their health. Wear-
able health monitoring devices are gaining popularity, notably for their
ability to diagnose essential bodily functions non-invasively. Designing
antennas that may be worn as part of an individual’s clothing raises
several challenges. They have to be unobtrusive, flexible, and able to
function with the least amount of degradation when they are close to
the human body. Fabricating wearable antennas can be challenging
for a number of reasons, including space constraints on particular
body sites, the impacts of the body tissue’s dielectric properties, and
performance loss caused by structural deformation. These factors all
need to be taken into consideration during the design process. This
review will investigate future prospects for such wearable devices for
the most recent advancements in wearable antennas for healthcare
applications (as illustrated in Fig. 5), as well as their existing obstacles
and limitations.
2.4.1. Microwave imaging for anomaly detection
Microwave imaging has a long history in biomedical applications.
It all began with the concept of extending the diagnostic methods to
include diffracted radiation (at radio and microwave frequencies) that
were initially based on signal propagation. The goal of microwave
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
imaging is to provide qualitative or quantitative maps of the dielectric
characteristics of the object being examined by microwaves.
The diagnosis of breast cancer through medical imaging at mi-
crowave frequencies was one of the earliest applications proposed
for this technology. Despite the fact that researchers contradict each
other on the dielectric characterization of breast tissues and the severe
shortage of in-vivo measured data, numerous systems have been de-
signed with the intention of conducting clinical trials. Recent findings
have been discussed, analyzed, and contrasted in a number of in-depth
review studies, such as [66]. There are a few systems that have been
reviewed and discussed here. In [67] researchers presented a UWB
antenna that has the potential to be used in two important applications:
wireless body area networks (WBAN), and imaging breast cancer. The
robust time-reversal algorithm-reconstructed image [68] was utilized
to examine and assess the capabilities of the proposed antenna in both
on-body and off-body scenarios, as well as with and without tumors.
In [69], A miniaturized, dual-polarized, and multiple input-multiple
outputs (MIMO) wearable antenna has been presented. A tree-shaped
antenna with horizontal polarization and a leaf-shaped antenna with
vertical polarization are incorporated into a wearable bra that examines
a woman’s breasts to detect the presence of cancerous tumors.
Electromagnetic head imaging is also one of the prime applica-
tions of Microwave imaging for biomedical applications, Numerous
studies that have been conducted in the past have been reported
on this application. In [70], an innovative prototype was proposed
and demonstrated which was built on a simple architecture that uti-
lizes a minimum number of correctly placed antennas mounted on a
helmet. It uses a technique called differential imaging to provide three-
dimensional pictures of the stroke. Experiments have shown that the
technology could image targeted strokes in the form of a sphere with a
radius equal to 1.25 centimeters. Most Recently [71], authors presented
a head imaging system incorporated into a flexible (𝑅𝑇 𝑉 − Al2 O3
Substrate) wearable cap for applications like stroke detection and early-
stage tumor detection. A 24-element antenna array was arranged in two
elliptical rings in order to ensure the generation of a 3D image of the
brain (see Table 4).
2.4.2. Glucose monitoring
Non-invasive approach for continuous monitoring of any health
condition is growing significantly and the use of a wearable antenna for
glucose level monitoring is one of those innovative applications since
this technique is non-invasive, useful, and simple to use. The number
of people who have diabetes is rapidly rising daily. According to the
study [79], it is a common failure of diabetic patient communities
to comply with regular glucose monitoring as a consequence of the
discomfort caused by traditional methods of blood glucose monitoring,
such as finger pricking. Some of the glucose monitoring techniques
using wearable antennas are presented and reviewed in this section.
In [80], It has been demonstrated that a noninvasive wearable tech-
nique can be utilized to directly monitor the glucose level in blood by
relying on flexible sensors (a multiband slot antenna and a multiband-
reject filter), aligned with body curvatures. Since the method focuses
on the effective alteration of electromagnetic waves to monitor the
blood glucose level directly. Most recently, Researchers [75] proposed a
flexible wearable sensor embedded in socks to monitor the glucose level
of a diabetic person. The information that was collected and processed
includes the reflection coefficients from the proposed glucose sensors
as well as the data from the environmental and physiological sensors.
2.4.3. Respiratory monitoring
Studies [81,82] have demonstrated that regular monitoring of fun-
damental vital indicators, including blood pressure, pulse rate, temper-
ature, and breathing rates, is particularly helpful in detecting a wide
variety of medical disorders. respiration rate is an important factor that
needs to be monitored regularly in the case of patients with respiratory
disease. In this section, we have reviewed and discussed some articles
A. Singh et al. AEUE - International Journal of Electronics and Communications 171 (2023) 154873

Table 4
Comparative analysis of wearable antenna-based techniques for healthcare application.
Ref No. Antenna Type (AT), Ref No. Antenna Type (AT),
Operating Frequency (OF), Operating Frequency
Application (A) (OF), Application (A)

[69] (AT): Multiple [72] (AT): A metal watch

input-Multiple output strap-based wearable
(MIMO) wearable antenna antenna
(OF): 4.8-30 GHz (OF): 2.46 GHz
(A): Breast Cancer Imaging (A): as an Antenna for
the Wearable Systems

[70] (AT): Monopole antenna [73] (AT): Flexible MIMO Belt

(OF): 1 GHz Strap Antenna
(A): 3D Brain Stroke (OF): 2.58 and 5.68 GHz
Imaging
(A): In Intelligent
Internet of Medical
Things

[71] (AT): Conformal Antenna [74] (AT): UWB textile

with two multi-slot antenna with monopole
radiating elements. structure with parallel
(OF): 0.9-2.5 GHz slots.
(A): 3-D Electromagnetic (OF): 1.198 to
Head Imaging 4.055 GHz
(A): To monitor the
healing process of a
fractured bone

[75] (AT): Multi-band flexible [76] (AT): Textile slot loop

Microstrip antenna
quasi-antenna-array (OF): 0.7-1.7 GHz
(OF): 0.5 -4 GHz (A): Imaging for
(A): Non-invasive Glucose Knee-injury monitoring
monitoring

[77] (AT): A flexible [78] (AT): AMC plane-based

sinusoidal-shaped small printed monopole
half-dipole antenna dual-band antenna
(OF): 808 MHz (OF): 2.45 GHz and
(A): Respiration 5.8 GHz
monitoring (A): for Off-Body IoT
Devices for remote
patient Monitoring

using the wearable antenna as a cardio-respiratory monitoring tool.
In [83], Researchers have proposed a novel flexible antenna sensor em-
broidered into a cotton t-shirt for the noninvasive measurement of the
respiration rate. The sensor is formed from multi-material fibers that
are structured in the form of a spiral antenna with a fundamental fre-
quency of 2.45 GHz. The fundamental concept behind the application
was: changes in antenna shape caused by chest expansion and lung air
volume displacement shift antenna operating frequency. Similarly, [77]
A novel sinusoidal-shaped antenna sensor is presented for strain-sensing

10
A. Singh et al.
applications. The new antenna utilizes a conductive polymer material
MWCNT-PEV, which enhances flexibility and durability in comparison
to the previous generation of antenna sensors composed of glass-based
material. The new antenna sensor shows an almost 5-fold increase in
sensitivity compared to the previous versions.
2.4.4. Wireless telemetry for smart wearable
As the market for portable electronics continues to grow, so does
interest in wearable antenna designs. Designing wearable antennas has
a number of challenges, including the influence of the human body on
antenna performance, such as frequency shift, efficiency reduction, and
radiation deformation. Additionally, to handle the typical motions of
humans throughout the day, wearable antennas need to be somewhat
flexible and ergonomic also. In Healthcare applications, two types of
wearables are being widely used: Smart Wristwatches and smart belts.
Smart wristwatches are popular wearable devices. It can tell users
their position, time, steps, distance walked, weather forecast, physio-
logical characteristics, and more. However, Wristwatch antenna design
is difficult because of the small dimensions of the devices and the
packed layout of the interior part, particularly considering the an-
tenna’s significant interaction with the human body. In [72], a metal
watch strap antenna with a lot of air slots and square holes is proposed
for the smart wristwatch.
The belts are an excellent opportunity for wearable antenna designs
due to their metallic composition, bigger size, and also because of
their prevalence in everyday life. In [84], The proposed belt antenna
consists of a buckle, a metal top, and two arms to hold the metal cap in
place. Furthermore, to reduce radiation towards the body and enhance
antenna gain and performance, a conductive fabric Electromagnetic
Band-Gap (EBG) ground plane has also been added. Most Recently, a
flexible MIMO belt strap antenna [73] has been proposed, The design
of this antenna is distinct from that of belt bulk antennas due to the
fact that it is constructed on a belt strap. Additionally, the absorbing-
shielding layer is applied to the inner surface, where it serves both an
electromagnetic absorption and a shielding performance.
2.4.5. Bone related applications
The human body’s fundamental framework is made of its compo-
nent bones. When bones are affected in any manner, regular movement
becomes more difficult. X-ray is the monitoring method that is utilized
most frequently for this application. In recent times, the microwave
has emerged as a potential solution for the monitoring of bone-related
problems, particularly wearable microwave solutions. Here three main
applications related to bone health have been presented and reviewed.
In [74], A UWB monopole textile antenna for wearable microwave
imaging has been designed. Specifically, in this case, the antenna was
utilized to track the healing of a bone fracture by analyzing the reflec-
tion coefficient or 𝑆11 in the time domain. In [76], An electromagnetic
imaging system that can be worn as a textile brace was introduced as
a real-time onsite scanning device for knee injuries. Since the knee is a
weight-bearing joint with a complex structure, it is more prone to injury
than other joints. These traumas are not only limited to playing sports
on fields, but they may also happen during regular routine activities.
This system utilized a 12-antenna array and Knee image reconstruction
unit using a modified double-stage delay-multiply-and-sum (DSDMAS)
algorithm. Most Recently one of the important concerns related to bone
health, the Monitoring of bone density has been addressed in [85]. This
investigation was conducted with a finite-element approach contrast
source inversion algorithm (FEM-CSI).
2.4.6. Remote monitoring of patients and elder people
The primary goal of a Wireless Body Area Network, also known
as a WBAN, is to provide reliable connectivity between the many
body-centric devices that are used for communication and sensing. The
primary applications of wearable medical systems are as follows: it may
be helpful to monitor hospitalized patients’ activities; it may also be
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
Fig. 6. Applications of radar or non-contact based techniques.
helpful to monitor and operate home appliances that are helpful to
patients with diabetes, asthma, epilepsy, and cardiovascular disease.
Here some of the wearable antennas utilized for such applications are
presented and reviewed here.
In [86], A novel miniature mosaic antenna has been presented as a
means of cross-body communication and a Human Activity Recognition
system. The main Attractions of this antenna are its miniature size,
flexible structure, and its applicability with different sensors to make
Human Activity Recognition system virtually for no cost. In [78], a
compact printed monopole antenna with an artificial magnetic conduc-
tor (AMC) operating in dual-band, specially designed for the IoT-based
patient monitoring system has been presented. Most Recently, For the
purpose of a diagnostic health monitoring system, a unique hybrid
wearable on-body antenna [87] that is mechanically durable and is
inspired by Moore’s fractal-based geometry and traditional rectangular
loops has been presented which operates in dual-band.
2.5. Radar or non-contact based techniques
Radar is closely correlated with defense and military applications
such as ship and aircraft traffic detection and surveillance. However,
in recent times, radar has started to receive major attention in many
disciplines outside of defense and air-traffic control, which has opened
up new horizons in the field of radar. Emerging possibilities of radar
sensing include human-gesture recognition (to recognize the compli-
cated movements done by human users to interact with smart products
without touching displays or pushing buttons), as well as applications
(as illustrated in the Fig. 6) in the healthcare domain. When it comes
to healthcare applications, the majority of radar research has focused
on two primary areas:
• Estimate and monitoring of vital indicators such as rate of breath-
ing and heartbeat.
• Observation of daily activity patterns by means of radar data.
Here In this section, applications related to the healthcare domain
using Radar systems are listed and discussed below.
2.5.1. Respiratory monitoring
Abnormal breathing syndromes are abnormalities and modifica-
tions in the respiratory system that interfere with normal respiration
functions. These syndromes, which include tachypnea, bradypnea, and
central apnea, have the tendency to be lethal if they are not properly
addressed [88]. In addition to this, several chronic disorders, such as
chronic obstructive pulmonary disease (COPD), may be associated with
abnormal breathing disorders [89]. Radar has proven its applicability
in breath monitoring without disturbing any comfort of patients.
In [90], It has been demonstrated that a technology based on a
radar system integrated into the ceiling fans and deep learning can
detect breathing and other motions without interruption, as well as
the falls of patients. Furthermore, The sensor system incorporated a
simple model of a neural network that is able to differentiate between
a human and other moving objects in an indoor space. Recently,
A. Singh et al.
Table 5
Comparative analysis of radar or non-contact based techniques for healthcare application.
Ref No. Radar/Antenna Type (R/A
T), Operating Frequency
(OF), Application (A)
[90] (R/AT): FMCW radar with
U-Slot patch antenna
(OF): 6 GHz
(A): Breathing and Fall
Detection.
[92] (R/AT): Continuous-wave
radar
(OF): 24 GHz
(A): Monitoring of
premature infants’
breathing in the neonatal
ICU.
[94] (R/AT): Impulse-Radio
Ultra-Wideband (IR-UWB)
Radar
(A): contactless Heart Rate
Monitor
[96] (R/AT): FMCW radar
(OF): 4 to 9 GHz
(A): Heart Rate Monitoring
using Radars
[98] (R/AT): Asymmetric
monopole CPW-fed
antenna
(OF): 0.77 to 1 GHz,
(A): Early Stage Detection
of Congestive Heart
Failure.
Researchers [92] proposed An simple and effective frequency estimator
utilizing a contact-less radar system, and it investigates the harmonic
shape of the breathing signal of a preterm child. For the first time, dif-
ferent Neonatal intensive care unit (NICU) everyday routine scenarios
were studied, and the obstacles to monitoring in a real clinical setting
were tackled with the help of the signal processing framework.
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AEUE - International Journal of Electronics and Communications 171 (2023) 154873
Ref No. Radar/Antenna Type
(R/A T), Operating
Frequency (OF),
Application (A)
[91] (R/AT): side-slotted
Vivaldi Antenna (OF):
2.80 to 7.00 GHz (A):
Breast Tumor Detection
[93] (R/AT): Resonance-based
reflector (RBR) antennas
(OF): 0.83 to 1.9 GHz
(A): Three-Dimensional
Electromagnetic Torso
Scanner.
[95] (R/AT): Collimated Beam
FMCW Radar
(OF): 120 GHz
(A): Vital Signals
Monitoring of patients.
[97] (R/AT): Impulse-radio
ultrawideband (IR-UWB)
radar
(OF): Central frequency
8.748 GHz with a
bandwidth of 1.5 GHz
(A): Non-Contact
Sleep/wake Monitoring.
[99] (R/AT): Frequency
Modulation Continuous
Wave (FMCW) radars
(OF): 77 GHz and
60 GHz
(A): Patient activity
recognition
2.5.2. Heart rate monitoring
Over the course of the last decade, noncontact detection of human
vital signs using radar has gained a significant amount of attention. In
particular, it has demonstrated significant potential for use in monitor-
ing intensive care patients. Electrocardiography (ECG), pulse oximetry,
infrared sensors, pressure sensors, and novel wearable technologies all
A. Singh et al.
require skin contact with electrodes to measure heart rate continuously.
Physical contact with those devices limits patients’ mobility and may
cause skin problems and the spread of dangerous illnesses. In [94],
A novel contact-less Impulse-Radio Ultra-Wideband (IR-UWB) Radar
technique for heart rate monitoring has been proposed. Using an IR-
UWB radar and electrocardiography, 6 volunteers (18 samples) with
normal sinus rhythm (NSR) and 16 cases (36 samples) having atrial
fibrillation (AF) had their heartbeats monitored and compared. The
IR-UWB radar could properly monitor heart rate and distinguish AF
from NSR. Recently, A Differential enhancement (DE) method for Radar
systems for heart rate monitoring [96], was presented, and it has
the potential to efficiently reduce the impacts of respiratory harmonic
interference on Heart rate estimation.
2.5.3. Disease detection
Microwave Imaging is an emerging technology for disease detection
that can provide detailed information like the location and volume
of the anomaly inside the human body. MI involves several antennas
which create the image, antennas can be placed in two modes: wear-
able, and Non-contact mode. Antennas placed in non-contact mode
brings advantages and disadvantage with themselves. Several articles
have been reported for disease detection using non-contact antenna
systems, few have been reviewed here.
In [98], the design and development of an automated ultrahigh-
frequency microwave system for the diagnosis and monitoring of con-
gestive heart failure have been presented. Using a single antenna in
non-contact mode, the back-scattered signal was captured as a scatter-
ing parameter in the frequency domain. The next step was to convert
the signal to the time domain using a scaled inverse Fourier transform.
Radargram images were generated by integrating time domain traces
over a scan distance. In [91], Using UWB Directional Antenna array
in non-contact mode, a low-cost and portable microwave imaging
technique for breast tumor detection was presented. furthermore, the
mentioned IC-DAS imaging algorithm reconstructs the breast interior
images to diagnose tumors from backscattered data. Additionally, It
was suggested in the article that this technology could serve as a
viable option for breast cancer screening inside ambulances. Most
recently, In the article [93], A system for conducting electromagnetic
scans of the torso in three dimensions (3D) has been described. This
system intends to provide a complementary or alternative imaging
mechanism to the conventional imaging technologies, such as computer
tomography (CT), ultrasound scans, and magnetic resonance imaging
(MRI), for the purpose of diagnosing disorders in the chest area and
upper abdomen, such as respiratory abscess, liver disease, and cancer.
The system generates three-dimensional images utilizing an antenna
array of 14 resonance-based reflectors (RBR) based antennas, and a fast
frequency-based microwave imaging algorithm with slice interpolation
(see Table 5).
2.5.4. Patient activity monitoring
The current healthcare systems of the world are confronted with
two major challenges: the sharp rise in the elderly population and the
severe shortage of healthcare professionals [1]. These days, patients
are being monitored using a growing number of devices, which range
from advanced medical sensors to conventional IoT sensors. Many
smart surveillance systems, from home automation to patient health
monitoring tools, require indoor human activity identification. Instead
of video cameras, radar sensors are a suitable solution for indoor human
activity detection where privacy is an important factor. A few articles
targeting the mentioned applications have been reviewed here.
In [95], A proposed system for patient monitoring utilizes FMCW
radar and is real-time, non-contact, and non-obstructive. The results
show that the device can monitor important signals like heart rate
and breathing rate at distances higher than 1 m. In [97], The study
presented an examination of non-contact sleep and wake monitoring in
neonatal intensive care units using impulse-radio ultrawideband radar.
13
AEUE - International Journal of Electronics and Communications 171 (2023) 154873
The study enrolled four newborns, one premature and three mature,
who were in the NICU. Radar was utilized to evaluate their voluntary
movements and vital signs during the ages of two to twenty-seven
days. Concurrent data were recorded from a video recorder, aEEG, and
actigraphy to serve as a reference. A sleep-wake algorithm was applied
to analyze radar signals using respiratory signal analysis and movement
feature extraction. In [99], Using Frequency Modulation Continuous
Wave (FMCW) radars (77 GHz and 60 GHz), a camcorder, and machine
learning (ML) algorithms for indoor human activity recognition has
been demonstrated. The video camera was only applied for validation
and evaluation. Specifically, the system monitors patients or elders by
identifying various actions taking place within a hospital room through
the use of radar sensors.
3. Conclusion
In this review article, a detailed overview of electromagnetic sensors
utilized for biomedical applications is presented. Since Electromagnetic
Sensors can be broadly classified into three categories and healthcare
applications associated with these sensors (probes, resonators, and
antennas) are reviewed comprehensively.
Microwave techniques have emerged as a safe, user-friendly alterna-
tive to conventional diagnostic or monitoring techniques, and antenna
and sensor technologies are advancing every day. This article presents
a review that demonstrates the tremendous potential of microwaves
for use in healthcare on several vital organs of the human body, such
as the brain, lungs, heart, and bones. In contemporary biomedical
applications, such as the monitoring of glucose levels, it is notewor-
thy to observe that microwave-based methodologies have emerged as
strong competitors to conventional techniques. In the near future, it is
widely anticipated that microwave sensors and associated techniques
will prevail over conventional methodologies across a diverse range
of healthcare applications, with a particular focus on the challenging
examination of internal organs, including but not limited to the lungs,
heart, and liver.
Declaration of competing interest
The authors declare the following financial interests/personal rela-
tionships which may be considered as potential competing interests:
Debasis Mitra reports was provided by India Ministry of Science &
Technology Department of Biotechnology. Robin Augustine reports was
provided by Sweden’s Innovation Agency.
Data availability
The authors are unable or have chosen not to specify which data
has been used.
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