Multi-frequency imaging and modelling of respiratory related electrical impedance changes

Electrical impedance tomography monitoring in adult ICU patients: state-of-the-art, recommendations for standardized acquisition, processing, and clinical use, and future directions

Electrical impedance tomography (EIT) is an emerging technology for the non-invasive monitoring of regional distribution of ventilation and perfusion, offering real-time and continuous data that can greatly enhance our understanding and management of various respiratory conditions and lung perfusion. Its application may be especially beneficial for critically ill mechanically ventilated patients. Despite its potential, clear evidence of clinical benefits is still lacking, in part due to a lack of standardization and transparent reporting, which is essential for ensuring reproducible research and enhancing the use of EIT for personalized mechanical ventilation. This report is the result of a four-day expert meeting where we aimed to promote the consistent and reliable use of EIT, facilitating its integration into both clinical practice and research, focusing on the adult intensive care patient. We discuss the state-of-the-art regarding EIT acquisition and processing, applications during controlled ventilation and spontaneous breathing, ventilation-perfusion assessment, and novel future directions.

An Electrical Resistance Diagnostic for Conductivity Monitoring in Laser Powder Bed Fusion

With the growing interest in metal additive manufacturing using laser powder bed fusion (LPBF), there is a need for advanced in-situ nondestructive evaluation (NDE) methods that can dynamically monitor manufacturing process-related variations, that can be used as a feedback mechanism to further improve the manufacturing process, leading to parts with improved microstructural properties and mechanical properties. Current NDE techniques either lack sensitivity beyond build layer, are costly or time-consuming, or are not compatible for in-situ integration. In this research, we develop an electrical resistance diagnostic for in-situ monitoring of powder fused regions during laser powder bed fusion printing. The technique relies on injecting current into the build plate and detecting voltage differences from conductive variations during printing using a simple, cheap four-point electrode array directly connected to the build plate. A computational model will be utilized to determine sensitivities of the approach, and preliminary experiments will be performed during the printing process to test the overall approach.

A Review on Electrical Impedance Tomography Spectroscopy

Electrical Impedance Tomography Spectroscopy (EITS) enables the reconstruction of material distributions inside an object based on the frequency-dependent characteristics of different substances. In this paper, we present a review of EITS focusing on physical principles of the technology, sensor geometries, existing measurement systems, reconstruction algorithms, and image representation methods. In addition, a novel imaging method is proposed which could fill some of the gaps found in the literature. As an example of an application, EITS of ice and water mixtures is used.

Reconfigurable bioimpedance emulation system for electrical impedance tomography system validation

This paper presents a novel bioimpedance emulation method designed for electrical impedance tomography system validation. The proposed method can emulate the impedance frequency characteristics of various biological samples from user configurations. The bioimpedance emulation system is realized in a hardware prototype comprising current sensing circuitry, voltage generating circuitry, a USB controller and a field-programmable gate array (FPGA) for reconfigurable digital control of emulated impedance. Experimental validation shows that the emulation system exhibits good accuracy ( > 97% at 1 kOhm magnitude) in the frequency range 1 kHz to 1 MHz. The digitally configurability offers advantages in flexibility, repeatability, and cost-efficient compared to more traditional approaches, simplifying the validation process of electrical impedance tomography systems.

Design of a novel digital phantom for EIT system calibration

This paper presented the design method of a novel digital phantom for electrical impedance tomography system calibration. By current sensing, voltage generating circuitry and digital processing algorithms implemented in FPGA, the digital phantom can simulate different impedances of tissues. The hardware of the digital phantom mainly consists of current sensing section, voltage generating section, electrodes switching section and a FPGA. Concerning software, the CORDIC algorithm is implemented in the FPGA to realize direct digital synthesis (DDS) technique and related algorithms. Simulation results show that the suggested system exhibits sufficient accuracy in the frequency range 10 Hz to 2 MHz. With the advantages offered by digital techniques, our approach has the potential of speed, accuracy and flexibility of the EIT system calibration process.

Factorization method and its physical justification in frequency-difference electrical impedance tomography

Time-difference electrical impedance tomography (tdEIT) requires two data sets measured at two different times. The difference between them is utilized to produce images of time-dependent changes in a complex conductivity distribution inside the human body. Frequency-difference EIT (fdEIT) was proposed to image frequency-dependent changes of a complex conductivity distribution. It has potential applications in tumor and stroke imaging since it can visualize an anomaly without requiring any time-reference data obtained in the absence of an anomaly. In this paper, we provide a rigorous analysis for the detectability of an anomaly based on a constructive and quantitative physical correlation between a measured fdEIT data set and an anomaly. From this, we propose a new noniterative frequency-difference anomaly detection method called the factorization method (FM) and elaborate its physical justification. To demonstrate its practical applicability, we performed fdEIT phantom imaging experiments using a multifrequency EIT system. Applying the FM to measured frequency-difference boundary voltage data sets, we could quantitatively evaluate indicator functions inside the imaging domain, of which values at each position reveal presence or absence of an anomaly. We found that the FM successfully localizes anomalies inside an imaging domain with a frequency-dependent complex conductivity distribution. We propose the new FM as an anomaly detection algorithm in fdEIT for potential applications in tumor and stroke imaging.

Comparison of a new integrated current source with the modified Howland circuit for EIT applications

Multi-frequency electrical impedance tomography (MF-EIT) systems require current sources that are accurate over a wide frequency range (1 MHz) and with large load impedance variations. The most commonly employed current source design in EIT systems is the modified Howland circuit (MHC). The MHC requires tight matching of resistors to achieve high output impedance and may suffer from instability over a wide frequency range in an integrated solution. In this paper, we introduce a new integrated current source design in CMOS technology and compare its performance with the MHC. The new integrated design has advantages over the MHC in terms of power consumption and area. The output current and the output impedance of both circuits were determined through simulations and measurements over the frequency range of 10 kHz to 1 MHz. For frequencies up to 1 MHz, the measured maximum variation of the output current for the integrated current source is 0.8% whereas for the MHC the corresponding value is 1.5%. Although the integrated current source has an output impedance greater than 1 MOmega up to 1 MHz in simulations, in practice, the impedance is greater than 160 kOmega up to 1 MHz due to the presence of stray capacitance.

A method for modelling and optimizing an electrical impedance tomography system

Electrical impedance tomography (EIT) image reconstruction is an ill-posed problem requiring maximum measurement precision. Recent EIT systems claim 60 to 80 dB precision. Achieving higher values is hard in practice since measurements must be performed at relatively high frequency, on a living subject, while using components whose tolerance is usually higher than 0.1%. To circumvent this difficulty, a method for modelling the electronic circuits of an EIT system was developed in order to optimize the circuits and incorporate the model in the reconstruction algorithms. The proposed approach is based on a matrix method for solving electrical circuits and has been applied to the scan-head which contains the front-end electronic circuits of our system. The method is used to simulate the system characteristic curves which are then optimized with the Levenberg-Marquardt method to find optimal component values. A scan-head was built with the new component values and its simulated performance curves were compared with network analyser measurements. As a result of the optimization, the impedance at the operating frequency was increased to minimize the effects of variations in skin/electrode contact impedance. The transconductance and gain frequency responses were also reshaped to reduce noise sensitivity and unintended signal modulation. Integrating the model in the reconstruction algorithms should further improve overall performance of an EIT system.

Dielectric behavior of pulmonary edema induced in the rat lung

The dielectric properties (conductivity, kappa and relative permittivity, epsilon) of excised rat lung are modified by lung air and water content. The measurements of these quantities were made over the frequency range of 10 kHz to 100 MHz with an open-ended coaxial probe. The following relationships were analyzed in an oleic acid-induced pulmonary edema model using 18 animals: the spectra of kappa, epsilon and the loss tangent as a function of lung air and water content. Secondly, an isolated-perfused lung system was produced to induce a gradual increase in lung water. The time course of kappa, epsilon and the loss tangent for one excised lung was analyzed. The principal findings were: (i) a decrease in kappa and epsilon with increasing air content, (ii) an increase in kappa and epsilon with increasing water content, and (iii) a good correlation between lung water content and maximum loss tangent that was insensitive to changes in air content. We conclude that this technique could provide a quantitative assessment of lung water during pulmonary edema formation.

Excitation patterns in three-dimensional electrical impedance tomography

Electrical impedance tomography (EIT) is a non-invasive technique that aims to reconstruct images of internal electrical properties of a domain, based on electrical measurements on the periphery. Improvements in instrumentation and numerical modeling have led to three-dimensional (3D) imaging. The availability of 3D modeling and imaging raises the question of identifying the best possible excitation patterns that will yield to data, which can be used to produce the best image reconstruction of internal properties. In this work, we describe our 3D finite element model of EIT. Through singular value decomposition as well as examples of reconstructed images, we show that for a homogenous female breast model with four layers of electrodes, a driving pattern where each excitation plane is a sinusoidal pattern out-of-phase with its neighboring plane produces better qualitative images. However, in terms of quantitative imaging an excitation pattern where all electrode layers are in phase produces better results.

Serial changes in nasal potential difference and lung electrical impedance tomography at high altitude

Recent work suggests that treatment with inhaled beta(2)-agonists reduces the incidence of high-altitude pulmonary edema in susceptible subjects by increasing respiratory epithelial sodium transport. We estimated respiratory epithelial ion transport by transepithelial nasal potential difference (NPD) measurements in 20 normal male subjects before, during, and after a stay at 3,800 m. NPD hyperpolarized on ascent to 3,800 m (P < 0.05), but the change in potential difference with superperfusion of amiloride or isoprenaline was unaffected. Vital capacity (VC) fell on ascent to 3,800 m (P < 0.05), as did the normalized change in electrical impedance (NCI) measured over the right lung parenchyma (P < 0.05) suggestive of an increase in extravascular lung water. Echo-Doppler-estimated pulmonary artery pressure increases were insufficient to cause clinical pulmonary edema. There was a positive correlation between VC and NCI (R(2) = 0.633) and between NPD and both VC and NCI (R(2) = 0.267 and 0.418). These changes suggest that altered respiratory epithelial ion transport might play a role in the development of subclinical pulmonary edema at high altitude in normal subjects.

Electrical impedance tomography (EIT) in applications related to lung and ventilation: a review of experimental and clinical activities

This review article is a summary of the publications dealing with the pulmonary applications of electrical impedance tomography (EIT). Original papers on EIT lung imaging published over 15 years are analysed and several aspects of the performed EIT measurements summarized. Information on the type of the EIT device and electrodes used, the studied transverse thoracic planes, the data acquisition rate, the number of studied animals, normal subjects or patients, the kind of lung pathology, the performed ventilatory manoeuvres and other interventions, as well as the applied reference techniques, is given. The type of the generated pulmonary EIT images and the quantitative analysis of the EIT data are described. Finally, the major results achieved are presented, followed by an analysis of the perspectives of EIT in clinical applications. A comparative analysis of the EIT hardware and the quality of the evaluation tools was not performed.

Electrical impedance imaging at multiple frequencies in phantoms

We have recently built and tested a 32 channel, multi-frequency (1 kHz to 1 MHz) voltage mode system to investigate electrical impedance spectroscopy (EIS) imaging. We completed a series of phantom experiments to define the baseline imaging performance of our system. Our phantom consisted of a plastic circular tank (20 cm diameter) filled with 0.9% aqueous NaCl solution. Conductors and nonconductors of decreasing width (W5: 3.4 cm, W4: 2.54 cm, W3: 0.95 cm, W2: 0.64 cm and WI: 0.32 cm) were positioned at various distances from the tank edge (1 cm, 2 cm, 4 cm and 8 cm). The results suggest that the detection of objects less than 1 cm in width is limited to the first 1 to 2 cm from the tank edge for absolute images, but this depth can extend to 8 cm in difference images. Larger 3.4 cm wide objects can be detected in absolute images at depths up to 8 cm from the tank edge. Generally, conductor images were clearer than their nonconductor counterparts. Not only did electrode artefacts lessen as the frequency increased, but the system's maximum resolution was attained at the highest operating frequencies. Although the system recovered the value of the electrical conductivity at the correct order of magnitude, it tended to smooth out large property discontinuities. The calculated electrical permittivity in these phantom studies was inconclusive due to the presence of electrode artefacts.

Diuretic induced change in lung water assessed by electrical impedance tomography

Monitoring patients with left ventricular failure can be difficult. Electrical impedance tomography (EIT) produces cross-sectional images of changes in the impedance of the thorax. We measured changes in the electrical impedance of the lung in nine volunteers following a diuretic challenge. The hypothesis was that lung impedance would increase with diuretic induced fluid loss. Heart rate, blood pressure and urine output were also recorded. After diuretic the mean urine output was 1220 ml compared with 187 ml after placebo. Following diuretic administration, mean thoracic impedance increased by 13.6% (p < 0.01) and lung impedance increased by 7.8% (p < 0.05). Taken as a group there was a correlation between overall impedance change and total urine output. However, for each individual, the time course of change in impedance and urine output did not correlate significantly. Our findings show that EIT may offer a better guide to the response of the lung to diuretic treatment than simply measuring urine output. The urine output is neither specific nor sensitive in the assessment of lung water. Mean lung impedance, however, is largely determined by lung water. The study showed that lung impedance can be recorded at supra-normal values. EIT may help in the management of patients with excess lung water.

A comparison of modified Howland circuits as current generators with current mirror type circuits

Multi-frequency electrical impedance tomography (EIT) systems require stable voltage controlled current generators that will work over a wide frequency range and with a large variation in load impedance. In this paper we compare the performance of two commonly used designs: the first is a modified Howland circuit whilst the second is based on a current mirror. The output current and the output impedance of both circuits were determined through PSPICE simulation and through measurement. Both circuits were stable over the frequency ranges 1 kHz to 1 MHz. The maximum variation of output current with frequency for the modified Howland circuit was 2.0% and for the circuit based on a current mirror 1.6%. The output impedance for both circuits was greater than 100 kohms for frequencies up to 100 kHz. However, neither circuit achieved this output impedance at 1 MHz. Comparing the results from the two circuits suggests that there is little to choose between them in terms of a practical implementation.

A multichannel continuously selectable multifrequency electrical impedance spectroscopy measurement system

There is increasing evidence that alterations in the electrical property spectrum of tissues below 10 MHz is diagnostic for tissue pathology and/or pathophysiology. Yet, the complexity associated with constructing a high-fidelity multichannel, multifrequency data acquisition instrument has limited widespread development of spectroscopic electrical impedance imaging concepts. To contribute to the relatively sparse experience with multichannel spectroscopy systems this paper reports on the design, realization and evaluation of a prototype 32-channel instrument. The salient features of the system include a continuously selectable driving frequency up to 1 MHz, either voltage or current source modes of operation and simultaneous measurement of both voltage and current on each channel in either of these driving configurations. Comparisons of performance with recently reported fixed-frequency systems is favorable. Volts dc (VDC) signal-to-noise ratios of 75-80 dB are achieved and the noise floor for ac signals is near 100 dB below the signal strength of interest at 10 kHz and 60 dB down at 1 MHz. The added benefit of being able to record multispectral information on source and sense signal amplitudes and phases has also been realized. Phase-sensitive detection schemes and multiperiod undersampling techniques have been deployed to ensure measurement fidelity over the full bandwidth of system operation.

Monitoring patients with left ventricular failure by electrical impedance tomography

Acute left ventricular failure (LVF) is a common medical emergency but detection and monitoring of pulmonary oedema remains problematic. Fluid is an important determinant of tissue impedance. Electrical impedance tomography (EIT) is a non-invasive technique allowing localisation of impedance changes within tissue. We have investigated the relationship between LVF and the electrical impedance of lung tissue. Twenty patients with a clinical diagnosis of acute left ventricular failure were compared with 30 normal subjects. Patients were monitored using serial chest radiographs and electrical impedance tomography measurements of lung impedance during hospital admission. Radiographs were graded according to the severity of pulmonary oedema by two independent radiologists. Lung impedance was significantly (P<0.0001) lower than normal in patients with left ventricular failure. Values returned towards the normal range as LVF resolved. There was a similar improvement in the score of the chest radiographs. The electrical impedance of the lung is low in left ventricular failure and increases following treatment.

A comparison of neonatal and adult lung impedances derived from EIT images

An objective method of extracting respiratory data from lung images is presented, together with a technique for automatically generating regions of interest delineating the anterior and posterior regions of the lungs. The method is used to extract data on the change in lung impedance with frequency, and on calculated Cole parameters, from 19 normal neonates (gestational age 32 to 42 weeks) and 8 normal adults (age 21 to 82 years). A comparison of the impedance properties of neonatal and adult lungs was made. The variation of lung impedance with frequency in neonates, as derived from EIT images, is significantly different from that found for adults. The implications for a model of the electrical impedance of lung tissue are discussed.

An electrically isolated balanced wideband current source: basic considerations and design

At relatively high frequencies, the application of an alternating current through the body or a body segment results in electromagnetic stray fields which reduce the amount of current actually injected into the tissue under study. This radiation effect can be reduced by use of a symmetrical configuration current source. The symmetry of such an arrangement, however, depends on the stray capacitances of the source with respect to surrounding equipment. To minimise these effects, it is required that the source is electrically isolated from the surrounding equipment and the subject under study. In this manner stray capacitances with respect to elements of the current source are reduced. In such a configuration common mode voltages to the input amplifier of the measuring system are also reduced. The paper describes design considerations and the implementation of a wideband current source capable of injecting alternating current in the order of 300 microARMS into biological tissue having impedances up to 1 k omega. Current stabilisation is obtained by means of a control circuit which measures the actual current passing through the tissue under study. Leakage currents arising from shielding and stray capacitances are compensated for. The usable frequency range is between 4 kHz and 1024 kHz and current stability is better than 0.2%. Through the use of a symmetrical, floating circuit a configuration is obtained which substantially reduces stray effects. The current source is connected to other circuits by means of two isolation ports: (1) a transformer coupling for the carrier frequency; and (2) an opto-coupler to transfer a phase reference signal obtained from current measurement. The current amplitude can be modulated by controlling the reference input to the control loop by means of a third auxiliary isolation port for transfer of the modulating signal.

Influences of lung parenchyma density and thoracic fluid on ventilatory EIT measurements

Ventilatory impedance changes can be measured by electrical impedance tomography (EIT). Several studies have pointed out that the ventilatory-induced impedance change measured over the lungs shows a linear relationship with tidal volume. However, EIT measures the ventilatory impedance changes relative to a reference. Therefore, changes in the reference due to lung parenchyma destruction (increase of thoracic impedance) or lung water (decrease of thoracic impedance) might influence ventilatory EIT measurements. A study was designed to evaluate the influence of the density of lung parenchyma and the thoracic fluid content on ventilatory EIT measurements. Eleven emphysema patients with a variable degree of lung parenchyma destruction, nine haemodialysis patients with general fluid overload and ten healthy subjects were measured. The impedance changes were measured with the subject in the supine position breathing a constant tidal volume of 1 litre starting at the maximum end-expiratory level. In the emphysema group a significantly lower impedance change between ins- and expiration was found in comparison with the healthy subjects (11.6 +/- 6.4 AU l-1 versus 18.6 +/- 4.2 AU l-1, p < 0.05), whereas the haemodialysis group showed a significantly larger impedance change between ins- and expiration before haemodialysis (30.5 +/- 13.1 AU l-1, p < 0.05). A significant decrease in ventilation-induced impedance change during dialysis was found (30.5 +/- 13.1 AU l-1 versus 21.4 +/- 8.6 AU l-1, p < 0.01). Furthermore, a significant correlation between lung function parameters, which indicate the severity of lung parenchyma destruction, and the measured impedance change was found in emphysema patients. From these results it can be concluded that the density of lung parenchyma and the thoracic fluid content have a serious impact on the ventilation-induced impedance change.

Model for the dielectric properties of human lung tissue against frequency and air content

Electrical impedance tomographic spectroscopy measurements of the lungs are taken from nine normal subjects, in the frequency range 9.6 kHz-1.2 MHz. The results show that resistivity rho'FRC relative to functional residual capacity increases almost linearly with inspiration volume V, with the slope of the curve increasing with frequency f. Resistivity rho'9.6 kHz relative to 9.6 kHz decreases with f. rho'9.6 kHz increases with V, at any given frequency. Curves for rho'9.6 kHz show a roughly linear trend with log10(f). Based on a discussion of the measurement results, a mathematical lung tissue model is designed that involves extra-capillary blood vessels and alveoli, the walls of which consist of blood-filled capillaries, epithelial cells and intercellular liquid. Using this model, the increase in rho'FRC with V is explained by the thinning of alveolar walls with increasing air content. The almost linear shape of curves for rho'9.6 kHz is attributed to four partly overlapping main dispersions caused by extra-capillary blood vessels, epithelial cells, blood and the capillary network.

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.

Extraction of electrical characteristics from pixels of multifrequency EIT images

Computer modelling has shown that electrical characteristics of individual pixels may be extracted from within multiple-frequency electrical impedance tomography (MFEIT) images formed using a reference data set obtained from a purely resistive, homogeneous medium. In some applications it is desirable to extract the electrical characteristics of individual pixels from images where a purely resistive, homogeneous reference data set is not available. One such application of the technique of MFEIT is to allow the acquisition of in vivo images using reference data sets obtained from a non-homogeneous medium with a reactive component. However, the reactive component of the reference data set introduces difficulties with the extraction of the true electrical characteristics from the image pixels. This study was a preliminary investigation of a technique to extract electrical parameters from multifrequency images when the reference data set has a reactive component. Unlike the situation in which a homogeneous, resistive data set is available, it is not possible to obtain the impedance and phase information directly from the image pixel values of the MFEIT images data set, as the phase of the reactive reference is not known. The method reported here to extract the electrical characteristics (the Cole-Cole plot) initially assumes that this phase angle is zero. With this assumption, an impedance spectrum can be directly extracted from the image set. To obtain the true Cole-Cole plot a correction must be applied to account for the inherent rotation of the extracted impedance spectrum about the origin, which is a result of the assumption. This work shows that the angle of rotation associated with the reactive component of the reference data set may be determined using a priori knowledge of the distribution of frequencies of the Cole-Cole plot. Using this angle of rotation, the true Cole-Cole plot can be obtained from the impedance spectrum extracted from the MFEIT image data set. The method was investigated using simulated data, both with and without noise, and also for image data obtained in vitro. The in vitro studies involved 32 logarithmically spaced frequencies from 4 kHz up to 1 MHz and demonstrated that differences between the true characteristics and those of the impedance spectrum were reduced significantly after application of the correction technique. The differences between the extracted parameters and the true values prior to correction were in the range from 16% to 70%. Following application of the correction technique the differences were reduced to less than 5%. The parameters obtained from the Cole-Cole plot may be useful as a characterization of the nature and health of the imaged tissues.

Non-invasive, in-vivo electrical impedance of EMT-6 tumours during hyperthermia: correlation with morphology and tumour-growth-delay

The electrical impedance at frequencies from 100 Hz to 40 MHz of EMT-6 tumours was measured non-invasively, in vivo, during hyperthermia using an apparatus constructed for this purpose. Histology and morphometry were performed on tumours harvested periodically during the heating. A ratio of conductivities at two frequencies (sigma (10MHz)/sigma (10kHz)), which minimizes the tissues temperature-coefficient effects, was used to correlate impedance changes with the histopathological changes. The bulk of the cell population followed a necrotic cell death sequence during heating. Initial increase of the sigma-ratio correlated with cell swelling, and a reversal of the rate of this increase correlated with the appearance of small membrane breaks and evidence of mitochondrial damage. A continued, slowing sigma-ratio increase to a maximum correlated with continued cell swelling accompanied by increasing membrane disruption. The subsequent decrease in sigma-ratio correlated with continued general cell lysing. Between the appearance of the first membrane breaks (sigma-ratio peak) and the evidence of general lysing (sigma-ratio peak), the tumour-growth-delay increased non-linearly. Because the sigma-ratio consistently discerned these events, these measurements were able to predict the fate of this cell population when subjected to hyperthermia. Knowledge of temperature or time of heating was not required.

In vitro multifrequency electrical impedance measurements and modelling of the cervix in late pregnancy

Idiopathic preterm labour is the greatest single perinatal problem occurring in an unpredictable 6-8% of all pregnancies and accounting for 75% of all perinatal deaths. Preterm cervical softening is used clinically as an important indicator of cervical dysfunction but the subjective nature of present clinical assessment methods prevents reliable prediction of preterm labour. This paper reports the finding of a pilot investigation concerned with obtaining quantitative measurements of the in vitro electrical impedance of the cervix using a four-electrode multifrequency impedance measurement system. Impedance measurement obtained from six samples of cervical tissue taken from different subjects of caesarean section were fitted to the Cole equation and parameters derived to describe the ratio of extra- versus intracellular impedance and the characteristic frequency. Subjects at term display a lower extra- versus intracellular impedance ratio than the preterm subjects. This appears consistent with the expected increase in the hydration of the cervix approaching term and the resulting decrease in the extracellular impedance. Further studies are required to determine if multifrequency electrical impedance tomography could be used as a non-invasive screening test for preterm labour.

EITS changes following oleic acid induced lung water

We present the results of using electrical impedance tomographic spectroscopy (EITS) to follow the changes in lung water induced by oleic acid. Measurements were made on three goats before and after the injection of oleic acid. In addition to the EITs measurements, lung water was also measured using a double-indicator technique. Large falls in lung electrical impedance were seen as a result of the increase in lung water but the size of the fall was a function of the frequency at which the measurements were made. These changes have been modelled using the Cole equation. Four-electrode measurements were also made on two extracted porcine lungs and Cole equation modelling carried out following the introduction of saline into the lungs. Results were similar in the two sets of animal experiments.

Factors affecting electrode-gel-skin interface impedance in electrical impedance tomography

The magnitude, mismatch and temporal variations of the electrode-gel-skin interface impedance can cause problems in electrical impedance tomography (EIT) measurement. It is shown that at the high frequencies generally encountered in EIT the capacitive properties of the electrode interface, and especially those of the skin, are of primary importance. A wide range of techniques are reviewed that could possibly be used to minimise these problems. These techniques include the use of skin preparation, penetration enhancers, temperature and electrical impulses. Although several of these techniques appear very attractive, they are not without serious potential drawbacks. A combination of some of these techniques may well hold the key to success.

Reproducibility of electrical impedance tomographic spectroscopy (EITS) parametric images of neonatal lungs

The reproducibility of electrical impedance tomographic spectroscopy (EITS) images of neonatal lungs have been investigated in 11 clinically stable babies. We have used the Sheffield Mark IIIa EITS system. An average inspiration frame was generated from the data frames associated with maximum inspiration. Frequency images were reconstructed from these frames. The frequency images were analysed to locate the pixel with the maximum change in the right lung field. The change was defined as the 614 kHz measurement relative to 9.6 kHz. A 3 x 3 pixel region of interest was centred at this point. The changes in impedance with frequency for this region of interest show good overall reproducibility between electrode applications for eight frequencies (95% limits of agreement +/- 28%). This reproducibility is improved (95% limits of agreement +/- 13%) by omitting the highest frequency (1.2 MHz) which is most subject to system noise. The parameters for the Cole model derived from data with the highest frequency omitted are less reproducible between electrode applications (95% limits of agreement, R/S +/- 0.83, fc +/- 81.6, RC +/- 0.52, SC +/- 0.39). We suspect that the parametric model used may have an effect on this. The signals recorded at the highest frequency (1.2 MHz) are a major source of variability. The reproducibility results are improved by omitting this frequency from the analysis.

Modelling of cardiac-related changes in lung resistivity measured with EITS

Resistivity data from 9.6 kHZ to 1.2 MHz were recorded from eight normal subjects using an electrical impedance tomographic spectroscopy (EITS) system and then averaged to a mean cardiac cycle using the ECG gating technique. The Cole-Cole model, that is, extracellular resistance R connected in parallel with intracellular resistance S and membrane capacitance C in series, with a distribution parameter a, was applied to model the frequency characteristics and to produce parametric images. During systole, SC and RC were found to decrease and FR increase. The changes in R/S were not consistent among the subjects. We estimated the peak changes in R, S and C to be -2.5%, -3.3% and -7.6% respectively. The results can be explained by considering the blood vessels as spheres of different sizes with blood inside them. The decrease in R during systole might be caused by the increased blood content in relatively large vessels, whereas that in S by the increased blood volume in relatively small vessels. The capacitance of blood is normally smaller than that of lung tissue, whereas FR blood is higher than that of lung tissue. Hence, as blood content increases, C should decrease and FR increase.

Parametric modelling for electrical impedance spectroscopy system

Three parametric modelling approaches based on the Cole-Cole model are introduced. Comparison between modelling only the real part and modelling both the real and imaginary parts is carried out by simulations, in which random and systematic noise are considered, respectively. The results of modelling the in vitro data collected from sheep are given to reach the conclusions.

Feasibility of neonatal lung imaging using electrical impedance tomography

The feasibility of detecting the lungs in preterm babies using electrical impedance tomography (EIT) was investigated. A single frequency instrument using 16 electrodes to apply current and detect peripheral voltages was constructed. The instrument applied AC current of 1.5 mA peak-peak at a carrier frequency of 20 kHz. Images were reconstructed using a sensitivity-regions backprojection method. A 9-day-old preterm baby was tested and data were collected at a speed of 10 frames/s. A dynamic image showing the lungs at full inspiration referenced to expiration is illustrated in this paper. Impedance measurements taken across the chest during the first 2 s did not show a clear pattern thus demonstrating irregular breathing. Region of interest analysis were carried out on the reconstructed images and tracked with time. Fourier transforms were then performed on these signals and a fundamental frequency at 1 Hz, corresponding to normal breathing rate of 60 breaths/min, was detected. Harmonics of the signal caused distortion especially on the left lung where the effects of cardiac events were more dominant.

Tissue spectroscopy with electrical impedance tomography: computer simulations

A method is proposed by which bioelectrical spectroscopy could be combined with electrical impedance tomography (EIT) to provide noninvasive characterization of tissue. Multifrequency (2-200 kHz) EIT measurements were simulated with a numerical model for a volume of porcine liver immersed in an electrolytic tank. From the reconstructed EIT images the tissue characterization method was then applied enabling a plot of complex resistivity to be drawn for any selected pixel in the image. Simulations were performed for a small volume of degraded tissue embedded in the normal tissue to examine its effect on the derived spectroscopic parameters. The method could have an application in transplant surgery for screening organs for tissue degradation.

Multifrequency and parametric EIT images of neonatal lungs

The aims of the study were to investigate the problems involved in making multifrequency EIT measurements on neonates and to compare the images obtained with the results from a group of normal adults. The Sheffield electrical impedance tomographic spectroscopy (EITS) system acquires multifrequency data using a set of eight drive and eight receive electrodes. EITS measurements were made on an inhomogeneous group of 10 neonates admitted to the special care baby unit for observation and feeding. R/S, characteristic frequency, RC and SC parameters were generated using the Cole equation. Comparisons of the parameters were made with data collected from normal adults in another study. We have shown that it is possible to obtain EITS parametric images of neonatal lungs and that there are some differences in Cole parameters between the adult and neonatal groups.

A Cole phantom for EIT

A phantom was designed for testing and comparing multifrequency EIT data collection systems. The phantom simulates a cylinder of homogeneous conductor with 16 drive and 16 receive electrodes interleaved. Combinations of resistors and capacitors were used to simulate the complex impedance, Z*, of a typical tissue in the frequency range 8-2048 kHz obeying the Cole equation Z* = Z infinity + (Z0 - Z infinity)/[1 + (if/fc)(1- alpha )] where Z* is the complex impedance at frequency f, Z0 and Z infinity are the limiting values of impedance at low and high frequencies, fc is the characteristic frequency and alpha is a constant. A practical phantom was then constructed on which four different sets of spectroscopic parameters could be selected: (i) alpha = 0.20, fc = 150 kHz, Z0/Z infinity = 3.31; (ii) alpha = 0, fc = 273 kHz, Z0/Z infinity = 2.64; (iii) alpha = 0, fc = 71.1 kHz, Z0/Z infinity = 1.36; and (iv) Z0/Z infinity = 1.00 with no dispersion.

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 fast parametric modelling algorithm with the Powell method

This paper presents a model that comprises only two parameters (R/S, fr) and the application of three function minimization algorithms (simplex, Powell and modified Powell) to this model to obtain parametric images. Comparisons among the three algorithms in terms of efficiency and reliability were carried out. It was found that, with proper initialization by taking the shape of the modelled data into consideration, the minimization function can be approximated by a quadratic function near the minimum point, therefore the iteration times can be minimized in the modified Powell method. The results show that with the modified Powell method a substantial reduction of computation time can be achieved in the parametric imaging. This makes it possible to obtain a 16 x 16 parametric image in 1 s.

Measured and expected Cole parameters from electrical impedance tomographic spectroscopy images of the human thorax

Electrical impedance tomographic spectroscopy (EITS) images have been recorded from a group of 12 normal subjects using frequencies from 9.6 kHz to 1.2 MHz. The impedance changes with frequency have been modelled on a pixel by pixel basis to produce parametric images as a means of characterizing tissue. The modelling was based on the Cole equation. The lungs are seen as areas of high characteristic frequency and low time constants SC and RS. The R/S images are much less uniform over the region of the lungs. Values characterizing the lung and cardiac regions are given. The results appear to be consistent with a model for the lungs whereby the model parameters can be related to alveolar structure and composition.

In vitro tissue characterization and modelling using electrical impedance measurements in the 100 Hz-10 MHz frequency range

In vitro electrical impedance spectrometry was performed on tissue samples excised from sheep. Measured data have been processed to reduce dispersion in measurements and to provide criteria useful for tissue comparison. Two electrical models are proposed for tissues exhibiting a one-circle impedance locus and a two-circle impedance locus. Measurement results and electrical parameters of tissues and models fitted to experimental data are presented. Model sensitivity to parameter variations is discussed.