Applied potential tomography: a new non-invasive technique for assessing gastric function

Review on Electrical Impedance Tomography: Artificial Intelligence Methods and its Applications

Electrical impedance tomography (EIT) has been a hot topic among researchers for the last 30 years. It is a new imaging method and has evolved over the last few decades. By injecting a small amount of current, the electrical properties of tissues are determined and measurements of the resulting voltages are taken. By using a reconstructing algorithm these voltages then transformed into a tomographic image. EIT contains no identified threats and as compared to magnetic resonance imaging (MRI) and computed tomography (CT) scans (imaging techniques), it is cheaper in cost as well. In this paper, a comprehensive review of efforts and advancements undertaken and achieved in recent work to improve this technology and the role of artificial intelligence to solve this non-linear, ill-posed problem are presented. In addition, a review of EIT clinical based applications has also been presented.

A realistic pelvic phantom for electrical impedance measurement

OBJECTIVE

To design and fabricate an anatomically and conductively accurate phantom for electrical impedance studies of non-invasive bladder volume monitoring.

APPROACH

A modular pelvic phantom was designed and fabricated, consisting of a mechanically and conductively stable boundary wall, a background medium, and bladder phantoms. The wall and bladders are made of conductive polyurethane. The background material is an ultrasound gel-based mixture, with conductivity matched to a weighted average of the pelvic cavity organs, bone, muscle and fat. The phantom boundary is developed using a computer tomography model of a male human pelvis. The bladder phantoms were designed to correlate with human bladder dimensions. Electrical impedance measurements of the phantom were recorded, and images produced using six different bladder phantoms and a realistic finite element model.

MAIN RESULTS

Five different bladder volumes were successfully imaged using an empty bladder as a reference. The average conductivity index from the reconstructed images showed a strong positive correlation with the bladder phantom volumes.

SIGNIFICANCE

A conductively and anatomically accurate pelvic phantom was developed for non-invasive bladder volume monitoring using electrical impedance measurements. Several bladders were designed to correlate with actual human bladder volumes, allowing for accurate volume estimation. The conductivity of the phantom is accurate over 50-250 kHz. This phantom can allow changeable electrode location, contact and size; multi-layer electrodes configurations; increased complexity by addition of other organ or bone phantoms; and electrode movement and deformation. Overall, the pelvic phantom enables greater scope for experimentation and system refinement as a precursor to in-man clinical studies.

Towards the development of a wearable Electrical Impedance Tomography system: A study about the suitability of a low power bioimpedance front-end

Wearable systems for remote monitoring of physiological parameter are ready to evolve towards wearable imaging systems. The Electrical Impedance Tomography (EIT) allows the non-invasive investigation of the internal body structure. The characteristics of this low-resolution and low-cost technique match perfectly with the concept of a wearable imaging device. On the other hand low power consumption, which is a mandatory requirement for wearable systems, is not usually discussed for standard EIT applications. In this work a previously developed low power architecture for a wearable bioimpedance sensor is applied to EIT acquisition and reconstruction, to evaluate the impact on the image of the limited signal to noise ratio (SNR), caused by low power design. Some anatomical models of the chest, with increasing geometric complexity, were developed, in order to evaluate and calibrate, through simulations, the parameters of the reconstruction algorithms provided by Electrical Impedance Diffuse Optical Reconstruction Software (EIDORS) project. The simulation results were compared with experimental measurements taken with our bioimpedance device on a phantom reproducing chest tissues properties. The comparison was both qualitative and quantitative through the application of suitable figures of merit; in this way the impact of the noise of the low power front-end on the image quality was assessed. The comparison between simulation and measurement results demonstrated that, despite the limited SNR, the device is accurate enough to be used for the development of an EIT based imaging wearable system.

Nerve localization techniques for peripheral nerve block and possible future directions

BACKGROUND

Ultrasound guidance is now a standard nerve localization technique for peripheral nerve block (PNB). Ultrasonography allows simultaneous visualization of the target nerve, needle, local anesthetic injectate, and surrounding anatomical structures. Accurate deposition of local anesthetic next to the nerve is essential to the success of the nerve block procedure. Due to limitations in the visibility of both needle tip and nerve surface, the precise relationship between needle tip and target nerve is unknown at the moment of injection. Importantly, nerve injury may result both from an inappropriately placed needle tip and inappropriately placed local anesthetic. The relationship between the block needle tip and target nerve is of paramount importance to the safe conduct of peripheral nerve block.

METHODS

This review summarizes the evolution of nerve localization in regional anesthesia, characterizes a problem faced by clinicians in performing ultrasound-guided nerve block, and explores the potential technological solutions to this problem.

RESULTS

To date, technology newly applied to PNB includes real-time 3D imaging, multi-planar magnetic needle guidance, and in-line injection pressure monitoring. This review postulates that optical reflectance spectroscopy and bioimpedance may allow for accurate identification of the relationship between needle tip and target nerve, currently a high priority deficit in PNB techniques.

CONCLUSIONS

Until it is known how best to define the relationship between needle and nerve at the moment of injection, some common sense principles are suggested.

Single acquisition electrical property mapping based on relative coil sensitivities: A proof-of-concept demonstration

PURPOSE

All methods presented to date to map both conductivity and permittivity rely on multiple acquisitions to compute quantitatively the magnitude of radiofrequency transmit fields, B1+. In this work, we propose a method to compute both conductivity and permittivity based solely on relative receive coil sensitivities ( B1-) that can be obtained in one single measurement without the need to neither explicitly perform transmit/receive phase separation nor make assumptions regarding those phases.

THEORY AND METHODS

To demonstrate the validity and the noise sensitivity of our method we used electromagnetic finite differences simulations of a 16-channel transceiver array. To experimentally validate our methodology at 7 Tesla, multi compartment phantom data was acquired using a standard 32-channel receive coil system and two-dimensional (2D) and 3D gradient echo acquisition. The reconstructed electric properties were correlated to those measured using dielectric probes.

RESULTS

The method was demonstrated both in simulations and in phantom data with correlations to both the modeled and bench measurements being close to identity. The noise properties were modeled and understood.

CONCLUSION

The proposed methodology allows to quantitatively determine the electrical properties of a sample using any MR contrast, with the only constraint being the need to have 4 or more receive coils and high SNR. Magn Reson Med 74:185-195, 2015. © 2014 Wiley Periodicals, Inc.

Improvements and artifact analysis in conductivity images using multiple internal electrodes

Electrical impedance tomography is an attractive functional imaging method. It is currently limited in resolution and sensitivity due to the complexity of the inverse problem and the safety limits of introducing current. Recently, internal electrodes have been proposed for some clinical situations such as intensive care or RF ablation. This paper addresses the research question related to the benefit of one or more internal electrodes usage since these are invasive. Internal electrodes would be able to reduce the effect of insulating boundaries such as fat and bone and provide improved internal sensitivity. We found there was a measurable benefit with increased numbers of internal electrodes in saline tanks of a cylindrical and complex shape with up to two insulating boundary gel layers modeling fat and muscle. The internal electrodes provide increased sensitivity to internal changes, thereby increasing the amplitude response and improving resolution. However, they also present an additional challenge of increasing sensitivity to position and modeling errors. In comparison with previous work that used point sources for the internal electrodes, we found that it is important to use a detailed mesh of the internal electrodes with these voxels assigned to the conductivity of the internal electrode and its associated holder. A study of different internal electrode materials found that it is optimal to use a conductivity similar to the background. In the tank with a complex shape, the additional internal electrodes provided more robustness in a ventilation model of the lungs via air filled balloons.

Monitoring retroperitoneal bleeding model of piglets by electrical impedance tomography

To investigate continuous monitoring capacity of electrical impedance tomography (EIT) for retroperitoneal bleeding, studies were carried out on six anesthetized piglet's bleeding model produced by injecting anticoagulated blood into renal region. For each subject, total blood of about 200 ml was injected within time periods ranging from tens of minutes to several hours. The simulated bleeding processes were detected and monitored by EIT system with sixteen electrodes at a rate of one image per second. EIT images were reconstructed by dynamic back-projection algorithm. The results showed that impedance changes caused by bleeding could be revealed by EIT images.

Comparison of methods for optimal choice of the regularization parameter for linear electrical impedance tomography of brain function

Electrical impedance tomography has the potential to provide a portable non-invasive method for imaging brain function. Clinical data collection has largely been undertaken with time difference data and linear image reconstruction methods. The purpose of this work was to determine the best method for selecting the regularization parameter of the inverse procedure, using the specific application of evoked brain activity in neonatal babies as an exemplar. The solution error norm and image SNR for the L-curve (LC), discrepancy principle (DP), generalized cross validation (GCV) and unbiased predictive risk estimator (UPRE) selection methods were evaluated in simulated data using an anatomically accurate finite element method (FEM) of the neonatal head and impedance changes due to blood flow in the visual cortex recorded in vivo. For simulated data, LC, GCV and UPRE were equally best. In human data in four neonatal infants, no significant differences were found among selection methods. We recommend that GCV or LC be employed for reconstruction of human neonatal images, as UPRE requires an empirical estimate of the noise variance.

Image monitoring for an intraperitoneal bleeding model of pigs using electrical impedance tomography

Current medical imaging techniques are not effective for timely detection of internal hemorrhage when the bleeding is slow and in small quantities. In this study, electrical impedance tomography (EIT) was applied to monitor the intraperitoneal bleeding of an animal model. Five healthy pigs three months old were used. The process of intraperitoneal bleeding was simulated with the injection of anticoagulated blood which was controlled by an electronic syringe pump. The injected rate was no more than 100 ml h(-1) and the total injection volumes ranged from 300 ml to 500 ml. Sixteen electrodes were attached to the abdomen and used for electrical current excitation and surface voltage measurement. Dynamic changes in impedance distribution within the abdomen were calculated by the back-projection algorithm and a series of EIT images were displayed in a unified range. The monitoring was performed with EIT at a rate of one frame per second and continued for at least 4 h. Intraperitoneal blood volume changes could be identified by inspection of consecutive EIT images during the progression of blood injection. 30 ml of blood in the peritoneum could be detected. EIT was shown to be a promising technique for continuous monitoring of intraperitoneal bleeding over periods of time.

Use of statistical parametric mapping (SPM) to enhance electrical impedance tomography (EIT) image sets

Use of statistical parametric mapping (SPM), which is widely used in analysis of neuroimaging studies with fMRI and PET, has the potential to improve quality of EIT images for clinical use. Minimal modification to SPM is needed, but statistical analysis based on height, not extent thresholds, should be employed, due to the 20-80% variation of the point spread function, across EIT images. SPM was assessed in EIT images reconstructed with a linear time difference algorithm utilizing an anatomically realistic finite element model of the human head. Images of the average of data sets were compared with those produced using SPM over 10-40 individual image data sets without averaging. For a point disturbance, a sponge 15% of the diameter of an anatomically realistic saline-filled tank including a skull, with a contrast of 15%, and for visual evoked response data in 14 normal human volunteers, images produced with SPM were less noisy than the average images. For the human data, no consistent physiologically realistic changes were seen with either SPM or direct reconstruction; however, only a small data set was available, limiting the power of the SPM analysis. SPM may be used on EIT images and has the potential to extract improved images from clinical data series with a low signal-to-noise ratio.

Validation of a finite-element solution for electrical impedance tomography in an anisotropic medium

Electrical impedance tomography is an imaging method, with which volumetric images of conductivity are produced by injecting electrical current and measuring boundary voltages. It has the potential to become a portable non-invasive medical imaging technique. Until now, implementations have neglected anisotropy even though human tissues such as bone, muscle and brain white matter are markedly anisotropic. We present a numerical solution using the finite-element method that has been modified for modelling anisotropic conductive media. It was validated in an anisotropic domain against an analytical solution in an isotropic medium after the isotropic domain was diffeomorphically transformed into an anisotropic one. Convergence of the finite element to the analytical solution was verified by showing that the finite-element error norm decreased linearly related to the finite-element size, as the mesh density increased, for the simplified case of Laplace's equation in a cubic domain with a Dirichlet boundary condition.

Bioimpedance tomography (electrical impedance tomography)

Electrical impedance tomography (EIT) is a relatively new imaging method that has evolved over the past 20 years. It has the potential to be of great value in clinical diagnosis; however, EIT is a technically difficult problem to solve in terms of developing hardware for data capture and the algorithms to reconstruct the images. This review looks at the development of EIT and how it has evolved. It focuses on its clinical applications, examining hardware for the collection of data and reconstruction algorithms to generate images. Finally, this review looks at future developments that are evolving from EIT. These new variations use mixed modalities that may produce interesting new clinical imaging tools.

Electrical Impedance Tomography's Correlation to Lung Volume is Not Influenced by Anthropometric Parameters

STUDY OBJECTIVES

Electrical impedance tomography (EIT) is able to reflect physiological parameters such as real-time changes in global and regional lung volume. EIT can aid in the assessment of lung recruitment, and its use has been validated in preliminary studies monitoring mechanical ventilation at the bedside. ICU patients vary widely in their body habitus, and obesity is becoming more prevalent. Our primary research purpose was to establish whether anthropometric parameters influence EIT's reliability. Our secondary question was whether body position alters its correlation to spirometric measurements.

SUBJECTS

22 healthy adult volunteers (12 male, 10 female) with broadly variable anthropometric parameters.

INTERVENTIONS

Simultaneous measurements of changes in lung volume using EIT imaging and a pneumotachograph were obtained with two breathing patterns (quiet and deep breathing) and in four body positions (standing, sitting, semi-reclining and supine).

MEASUREMENTS AND RESULTS

Correlation between measurements of changes in lung volume using EIT imaging and a pneumotachograph was excellent. Variations attributable to anthropometric measurements accounted for at most a 1.3% difference.

CONCLUSIONS

Anthropometric variability and body position do not adversely influence the EIT estimation of changes in lung volume. These data suggest EIT could be used to monitor critically ill mechanically ventilated adults with variable body habitus regardless of position.

Electrical impedance tomography of human brain function using reconstruction algorithms based on the finite element method

Electrical impedance tomography (EIT) is a recently developed technique which enables the internal conductivity of an object to be imaged using rings of external electrodes. In a recent study, EIT during cortical evoked responses showed encouraging changes in the raw impedance measurements, but reconstructed images were noisy. A simplified reconstruction algorithm was used which modelled the head as a homogeneous sphere. In the current study, the development and validation of an improved reconstruction algorithm are described in which realistic geometry and conductivity distributions have been incorporated using the finite element method. Data from computer simulations and spherical or head-shaped saline-filled tank phantoms, in which the skull was represented by a concentric shell of plaster of Paris or a real human skull, have been reconstructed into images. There were significant improvements in image quality as a result of the incorporation of accurate geometry and extracerebral layers in the reconstruction algorithm. Image quality, assessed by blinded subjective expert observers, also improved significantly when data from the previous evoked response study were reanalysed with the new algorithm. In preliminary images collected during epileptic seizures, the new algorithm generated EIT conductivity changes which were consistent with the electrographic ictal activity. Incorporation of realistic geometry and conductivity into the reconstruction algorithm significantly improves the quality of EIT images and lends encouragement to the belief that EIT may provide a low-cost, portable functional neuroimaging system in the foreseeable future.

Three-dimensional electrical impedance tomography of human brain activity

Regional cerebral blood flow and blood volume changes that occur during human brain activity will change the local impedance of that cortical area, as blood has a lower impedance than that of brain. Theoretically, such impedance changes could be measured from scalp electrodes and reconstructed into images of the internal impedance of the head. Electrical Impedance Tomography (EIT) is a newly developed technique by which impedance measurements from the surface of an object are reconstructed into impedance images. It is fast, portable, inexpensive, and noninvasive, but has a relatively low spatial resolution. EIT images were recorded with scalp electrodes and an EIT system, specially optimized for recording brain function, in 39 adult human subjects during visual, somatosensory, or motor activity. Reproducible impedance changes of about 0.5% occurred in 51/52 recordings, which lasted from 6 s after the stimulus onset to 41 s after stimulus cessation. When these changes were reconstructed into impedance images, using a novel 3-D reconstruction algorithm, 19 data sets demonstrated significant impedance changes in the appropriate cortical region. This demonstrates, for the first time, that significant impedance changes, which could form the basis for a novel neuroimaging technology, may be recorded in human subjects with scalp electrodes. The final images contained spatial noise and strategies to reduce this in future work are presented.

Electrical conductivity imaging via contactless measurements

A new imaging modality is introduced to image electrical conductivity of biological tissues via contactless measurements. This modality uses magnetic excitation to induce currents inside the body and measures the magnetic fields of the induced currents. In this study, the mathematical basis of the methodology is analyzed and numerical models are developed to simulate the imaging system. The induced currents are expressed using the A-phi formulation of the electric field where A is the magnetic vector potential and phi is the scalar potential function. It is assumed that A describes the primary magnetic vector potential that exists in the absence of the body. This assumption considerably simplifies the solution of the secondary magnetic fields caused by induced currents. In order to solve phi for objects of arbitrary conductivity distribution a three-dimensional (3-D) finite-element method (FEM) formulation is employed. A specific 7 x 7-coil system is assumed nearby the upper surface of a 10 x 10 x 5-cm conductive body. A sensitivity matrix, which relates the perturbation in measurements to the conductivity perturbations, is calculated. Singular-value decomposition of the sensitivity matrix shows various characteristics of the imaging system. Images are reconstructed using 500 voxels in the image domain, with truncated pseudoinverse. The noise level is assumed to produce a representative signal-to-noise ratio (SNR) of 80 dB. It is observed that it is possible to identify voxel perturbations (of volume 1 cm3) at 2 cm depth. However, resolution gradually decreases for deeper conductivity perturbations.

Quantification of blood volume by electrical impedance tomography using a tissue-equivalent phantom

An in vivo electrical impedance tomography (EIT) system was designed to accurately estimate quantities of intra-peritoneal blood in the abdominal cavity. For this it is essential that the response is relatively independent of the position of the high conductivity anomaly (blood) in the body. The sensitivity of the system to the introduction of blood-equivalent resistivity anomalies was assessed by using a cylindrical tissue-equivalent phantom. It was found that a satisfactorily uniform response of the system in both radial (transverse) and axial (longitudinal) directions in the phantom could be achieved by filtering resistivity profile images obtained by EIT measurement, and by using extended electrodes to collect data. Post-processing of single impedance images gave rise to a quantity denoted the resistivity index. A filter was then used to remove the remaining radial variation of the resistivity index. It was calculated by evaluating the resistivity index of a number of theoretically calculated images, and constructing a correction filter similar to those used to remove lens imperfections, such as coma, in optical components. The 30% increase in the resistivity index observed when an anomaly was moved to the maximum extent allowed by the filter calculation (0.75 of the phantom radius) was reduced by the filter to 6%. A study of the axial dependence observed in the resistivity index using electrodes extended in the axial direction by +/-5 cm found that the variation in resistivity index with axial position was about half of that observed using small circular electrodes similar to those used in the Sheffield mark I system.

Gastric emptying of solids measured by means of magnetised iron oxide powder

The aim of this study was to develop a radiation-free method to measure gastric emptying. Such a method would be useful e.g. for patients who need repeated measurements and in pregnancy. Ferrimagnetic particles (gamma-Fe2O3), ingested within a solid test meal (pancakes), were magnetised by an applied magnetic field. After magnetisation, the remanent magnetic field was measured with fluxgate magnetometers outside the stomach (anterior and posterior). The intragastric contents was estimated from the strength of the remanent field. The procedure was repeated 18 times over a period of up to 2 h postprandially. The test meal was chosen to correspond to a radiolabelled test meal that had previously been used in a scintigraphic study with (other) healthy persons. In vivo measurements were carried out on 16 healthy male volunteers. The estimated retained magnetic tracer in the stomach after the 2 h measurement time was 31 +/- 12% (mean +/- SD) and the lag phase time was 31 +/- 11 min. The corresponding scintigraphic curve (from the previous study) from 16 males showed 40 +/- 14% retained isotope after 2 h. The early part of the mean emptying curve decreased slightly faster than the corresponding scintigraphic one, but the similarity of the two seems promising enough for further development of the present method.

Electrical impedance tomography

Electrical impedance tomography (EIT) is a technique which allows cross-sectional images related to the local electrical impedance within an object to be reconstructed from sets of measurements made on its surface. The main drive behind the development of EIT has been its possible application in medical imaging, as biological tissues are known to exhibit a wide range of electrical impedance and many physiological events are accompanied by electrical impedance changes. This article reviews the technical aspects of EIT as a medical imaging modality, and considers the range of applications over which it might be employed. Existing technical limitations and future developments are discussed. It is concluded that the future of EIT as a clinical diagnostic tool is likely to lie in the area of functional monitoring, where the capability of performing image-guided localized electrical impedance measurements with high acquisition speed, good sensitivity and no hazard can be exploited.

Subsurface electrical impedance imaging: measurement strategy, image reconstruction and in vivo results

In conventional cross-sectional electrical impedance tomography, most of the spatial information is concentrated at the periphery of the image, close to the measurement electrodes. Increasing the number of electrodes tends not to increase the poor resolution at the centre of the cross-sectional image due to the physics of three-dimensional current flow. In this work an alternative approach. INSEIT (imaging near the surface by electrical impedance tomography), is explored in which the image plane lies at a selected depth in the object parallel to a surface electrode array. This approach has been investigated using a prototype data measurement system. The preliminary in vivo results include subsurface images of respiration, the gastro-intestinal tract and limb blood flow.

Variations in in vivo electrical impedance tomography images due to inaccuracy in boundary representation

A comparison of in vivo image results is performed for five image-reconstruction programs, featuring an increase in accuracy of boundary modelling from a simple 2-D disk to a true boundary shape with each current drive field individually calculated. Variations are found both in the positions of imaged features and their appearance, but reasonable consistency in reconstructed impedance changes is obtained for both phantom and in vivo data. In terms of quantitative measurements, the programs based on the simpler boundary assumptions generally perform more reliably than the more complex versions. It is concluded that the quantitative use of EIT with simple boundary assumptions is not compromised by body contour variations between patients, provided that the appropriate regions of interest can be correctly identified.

Data processing techniques for serial EIT spectroscopy images: a review of some preliminary results

Mutlifrequency EIT imaging should allow specific organs within the body to be identified by their impedance spectrum, and the use of parametric imaging should lead to a much greater freedom from movement artefacts. This will make EIT more attractive as a monitoring technique, but the data rate will require automated processing of the images. The application of dynamic regions of interest, generated on a frame by frame basis, is described, with examples from the imaging of neonatal lungs and adult stomach. The lung can be objectively identified on a single frame from the fRSC, SC and RC images, but the stomach could only be identified on the dynamic images.

A real-time electrical impedance tomography system for clinical use--design and preliminary results

An instrument is described which produces images of the electrical impedance distribution within the body at a rate of 25 frames per second, allowing lung ventilation and lung perfusion to be observed in real time. The instrument makes impedance measurements using an array of 16 electrodes on the surface of the body, and reconstructs the images using a weighted backprojection technique. The design of the data acquisition electronics and the reconstruction and display processor are described. Some preliminary in vitro and in vivo results from the system are presented.

Electrical impedance tomography: a review of current literature

Electrical impedance tomography (EIT) is a relatively new imaging technique that has been developed during the past decade. The electrical properties of tissues are imaged by injecting small currents and measuring the resultant voltages. These voltages are then converted into a tomographic image using a reconstructing algorithm. The method has no known hazards and is relatively inexpensive. There are many possible clinical applications of this technique but apart from gastric emptying, most are still at the research stage as there are various technical and practical problems to be overcome. This paper describes the basic principles of EIT and reviews the English literature to try to assess its potential in clinical imaging.

Transport of gastric contents

A planar array of electrodes has been used to provide a longitudinal section of the stomach. Impedance changes at the gastric frequency of 0.05 Hz can be detected. The changes are mainly located around the periphery of the stomach image, suggesting that they are the result of movement of the stomach wall. The generation of a vector histogram of wall movement gives a non-invasive method which appears to quantify the peristaltic waves which produce transport in the stomach.

Clinical applications of electrical impedance tomography

This article is a preliminary review of the possible clinical applications of electrical impedance tomography (EIT). The applications to, for example, the central nervous, respiratory, cardiovascular and digestive systems are covered. It is concluded that the area of greatest potential application of EIT is monitoring cardiopulmonary function, but that studies on much larger groups of patients than have been carried out hitherto are required to fully assess the potential of EIT as a clinical tool.

An adaptive current tomography using voltage sources

This paper describes the development of an adaptive electric current tomography system which contains a novel front-end analog architecture. Programmable voltage sources have been used to deliver currents into the study object and to avoid the difficulties of obtaining high quality current sources. Through inverting an admittance matrix, the system is capable of achieving a desired current drive pattern by applying a computed voltage pattern. The tomograph, operating at 9.6 kHz, comprises 32 driving electrodes and 32 voltage measurement electrodes. The study of system noise performance shows high SNR in the data acquisition which is enhanced by a digital demodulation scheme. In vitro reconstruction images have been obtained with the data collected by the tomograph.

Detection of cerebral ischaemia in the anaesthetised rat by impedance measurement with scalp electrodes: implications for non-invasive imaging of stroke by electrical impedance tomography

The possible use of impedance measurement with scalp electrodes to detect cerebral ischemia non-invasively was investigated in the anaesthetised rat. Global cerebral ischaemia was induced by diathermy of both vertebral arteries and reversible occlusion of the carotid arteries. Impedance was measured at 50 kHz by a four electrode method. With cortical electrodes in various positions, reversible impedance increases of 15 - 60% were recorded during episodes of cerebral ischaemia which lasted for 5 - 30 min. With electrodes placed in overlying positions in the scalp, impedance increases had a similar time course but their amplitudes were about 10 - 20% of the increases measured on the cortex. These were not due solely to changes in temperature which accompanied cerebral ischaemia or local changes in the scalp. These findings suggest that it may be possible to image cerebral ischaemia in human subjects non-invasively with Electrical Impedance Tomography and scalp electrodes.

Applied potential tomography. Noninvasive method for measuring gastric emptying of a solid test meal

Applied potential tomography (APT) is a new noninvasive, nonradioactive method of measuring gastric emptying, which generates profiles of emptying of liquids that are similar to those obtained simultaneously by scintigraphy and dye dilution. This study validates the ability of APT to measure emptying of a solid beefburger test meal from the stomach by comparing the results obtained with those obtained simultaneously by scintigraphy. When acid secretion was inhibited, there was a significant correlation between the two methods for the time taken for half the meal to empty from the stomach and the amount of meal emptied at different time intervals. Furthermore, the profiles of gastric emptying obtained by APT resembled those obtained by scintigraphy in most studies. If acid secretion was not inhibited, there was no correlation between values obtained by the two methods.

The effect of short-term dietary supplementation with glucose on gastric emptying in humans

In order to test whether gastric motility can adapt to changes in nutrient load, gastric emptying of hyperosmotic glucose and protein drinks was measured by applied potential tomography in two groups of ten volunteers following dietary supplementation with 400 g glucose/d for 3 d. The half emptying time for the glucose test meal was significantly faster after the standard diet had been supplemented with glucose compared with the standard diet alone (median and range, 20.7 (4.6-36.8) v. 29.1 (19.8-38.4) min; P less than 0.05), while the emptying of the protein drink (Oxo; Brooke Bond Ltd) was unchanged (median and range, 18.0 (12.5-23.6) v. 16.1 (9.6-22.7) min). These results suggest that rapid and specific adaptation of the small intestinal regulatory mechanisms for gastric emptying of nutrient solutions can occur in response to increases in dietary load. This adaptation may be explained by desensitization of nutrient receptors or by a reduction in the area of receptor field exposed to nutrients caused by increased absorption of glucose in the upper small intestine.

Quantification in impedance imaging

Applied potential tomography (APT) is a technique for producing tomographic images of the distribution of electrical resistivity within electrically conducting objects. Human tissues exhibit a wide range of resistivities and images of resistivity within the body should show good contrast. The data used to reconstruct such images are measurements of the voltages developed on the surface of the object when various patterns of current are passed through the object. The reconstruction problem is much harder than for other tomographic modalities but we have shown that provided we restrict ourselves to imaging changes in resistivity, it is possible to reconstruct images from data collected in vivo. We describe some possible clinical uses of the technique.

A regularised electrical impedance tomography reconstruction algorithm

The Newton-Raphson algorithm is an effective reconstruction method. However, it exhibits degraded performance for ill-conditioned problems, especially in the presence of measurement error. This paper uses the regularisation method to improve the system's conditioning, which stabilises the reconstruction method. It shows that the [[ p'' ]] penalty form yields superior images, as compared to the [[ p ]] penalty form.

Comparison of applied potential tomography and impedance epigastrography as methods of measuring gastric emptying

Two new non-invasive methods of measuring gastric emptying, impedance epigastrography (IE) and applied potential tomography (APT) have been compared. Measurements in vitro showed that there is a good correlation between the square of the radius of a glass rod placed in the centre of a tank and values obtained by IE or APT. However, if the rod is moved anteriorly in the tank IE values increase markedly, whereas APT values are unchanged. Both APT and IE can be used to follow gastric emptying of liquid meals; however, the results obtained using APT are more reproducible and have a better correlation with those obtained simultaneously by scintigraphy. Neither method was able accurately to follow gastric emptying unless gastric acid secretion was inhibited by cimetidine.