In developing a microwave tomography system, we started by examining the fundamental signal measurement challenges-i.e., how to interrogate the target while suppressing unwanted multi-path signals. Beginning with a lossy coupling bath to suppress unwanted surface waves, we have developed a robust and reliable system that is both simple and low profile. However, beyond the basic measurement configuration, the lossy coupling medium concept has also informed our choice of array antenna and imaging algorithms. The synergism of these concepts has produced a novel concept which is embodied in a system that has been successfully translated to the clinic.