A fully parallel multi-frequency EIT system with flexible electrode configuration: KHU Mark2

ACT5 Electrical Impedance Tomography System

OBJECTIVE

This article introduces the Adaptive Current Tomograph 5 (ACT5) Electrical Impedance Tomography (EIT) system. ACT5 is a 32 electrode applied-current multiple-source EIT system that can display real-time images of conductivity and susceptivity at 27 frames per second. The adaptive current sources in ACT5 can apply fully programmable current patterns with frequencies varying from 5 kHz to 500 kHz. The system also displays real-time ECG readings during the EIT imaging process.

METHODS

The hardware and software design and specifications are presented, including the current source design, FPGA hardware, safety features, calibration, and shunt impedance measurement.

RESULTS

Images of conductivity and susceptivity are presented from ACT5 data collected on tank phantoms and a human subject illustrating the system's ability to provide real-time images of pulsatile perfusion and ECG traces.

SIGNIFICANCE

The portability, high signal-to-noise ratio, and flexibility of applied currents over a wide range of frequencies enable this instrument to be used to obtain useful human subject data with relative clinical ease.

Electrospun Rubber Nanofiber Web-Based Dry Electrodes for Biopotential Monitoring

This study aims to find base materials for dry electrode fabrication with high accuracy and without reducing electrode performance for long-term bioelectric potential monitoring after electroless silver plating. Most applications of dry electrodes that have been developed in the past few decades are restricted by low accuracy compared to commercial Ag/AgCl gel electrodes, as in our previous study of PVDF-based dry electrodes. In a recent study, however, nanoweb-based chlorinated polyisoprene (CPI) and poly(styrene-b-butadiene-b-styrene) (SBS) rubber were selected as promising candidates due to their excellent elastic properties, as well as their nanofibril nature, which may improve electrode durability and skin contact. The electroless silver plating technique was employed to coat the nanofiber web with silver, and silver nanoweb(AgNW)-based dry electrodes were fabricated. The key electrode properties (contact impedance, step response, and noise characteristics) for AgNW dry electrodes were investigated thoroughly using agar phantoms. The dry electrodes were subsequently tested on human subjects to establish their realistic performance in terms of ECG, EMG monitoring, and electrical impedance tomography (EIT) measurements. The experimental results demonstrated that the AgNW dry electrodes, particularly the SBS-AgNW dry electrodes, performed similarly to commercial Ag/AgCl gel electrodes and were outperformed in terms of long-term stability.

Robust electrical impedance tomography for biological application: A mini review

Electrical impedance tomography (EIT) has been used by researchers across several areas because of its low-cost and no-radiation properties. Researchers use complex conductivity in bioimpedance experiments to evaluate changes in various indicators within the image target. The diverse volumes and edges of biological tissues and the large impedance range impose dedicated demands on hardware design. The EIT hardware with a high signal-to-noise ratio (SNR), fast scanning and suitable for the impedance range of the image target is a fundamental foundation that EIT research needs to be equipped with. Understanding the characteristics of this technique and state-of-the-art design will accelerate the development of the robust system and provide a guidance for the superior performance of next-generation EIT. This review explores the hardware strategies for EIT proposed in the literature.

Real-Time Measurements of Relative Tidal Volume and Stroke Volume Using Electrical Impedance Tomography with Spatial Filters: A Feasibility Study in a Swine Model Under Normal and Reduced Ventilation

Continuous monitoring of both hemodynamic and respiratory parameters would be beneficial to patients, e.g., those in intensive care unit. The objective of this exploratory animal study was to test the feasibility of simultaneous measurements of relative tidal volume (rTV) and relative stroke volume (rSV) using an electrical impedance tomography (EIT) device equipped with a new real-time source separation algorithm implemented as two spatial filters. Five pigs were anesthetized and mechanically ventilated. The supplied tidal volume from a mechanical ventilator was reduced to 70, 50 and 30% from the 100% normal volume to simulate hypoventilation. The respiratory volume signal and cardiac volume signal were generated by applying the spatial filters to the acquired EIT data, from which values of rTV and rSV were extracted. The measured rTV values were compared with the TV values from the mechanical ventilator using the four-quadrant concordance analysis method. For changes in TV, the concordance rate in each animal ranged from 81.8% to 100%, while it was 92.5% when the data from all five animals were pooled together. When the measured rTV values for each animal were scaled to the absolute TV_EIT values in mL using the TV_Vent data from the mechanical ventilator, the smallest 95% limits of agreement (LoA) were - 6.04 and 7.44 mL for the 70% ventilation level, and the largest 95% LoA were - 18.1 and 19.4 mL for the 50% ventilation level. The percentage error between TV_EIT and TV_Vent was 10.3%. Although similar statistical analyses on rSV data could not be performed due to limited intra-animal variability, changes in rSV values measured by the EIT device were comparable to those measured by an invasive hemodynamic monitor. In this animal study, we were able to demonstrate the feasibility of an EIT device for noninvasive and simultaneous measurements of rTV and rSV in real time. However, the performance of the real-time source separation method needs to be further validated on animals and human subjects, particularly over a wide range of SV values. Future clinical studies are needed to assess the potential usefulness of the new method in dynamic cardiopulmonary monitoring and explore other clinical applications.

Characteristics and topic trends on electrical impedance tomography hardware publications

Objective: Electrical impedance tomography (EIT) is a technique to measure electrical properties of tissue. With the progress of modern integrated circuits and microchips, EIT instrumentation becomes an active research area to improve all aspects of device performance. Plenty of studies on EIT hardware have been presented in prestigious journals. This study explores publications on EIT hardware to identify the developing hotspots and trends. Method: Publications covering EIT hardware on the Web of Science Core Collection (WoSCC) database from 1989 to 2021 were collected for bibliometric analysis. CiteSpace and VOS viewer were used to study the characteristics of the publications. Main results: A total of 592 publications were analyzed, showing that the number of annual publications steadily increased. China, England, and South Korea were the most prolific countries on EIT hardware publications with productive native institutions and authors. Research topics spread out in "bio-electrical impedance imaging", "hardware optimization", "algorithms" and "clinical applications" (e.g., tissue, lung, brain, and oncology). Hardware research in "pulmonary" and "hemodynamic" applications focused on monitoring and were represented by silhouette recognition and dynamic imaging while research in "tumor and tissue" and "brain" applications focused on diagnosis and were represented by optimization of precision. Electrode development was a research focus through the years. Imaging precision and bioavailability of hardware optimization may be the future trend. Conclusion: Overall, system performance, particularly in the areas of system bandwidth and precision in applications may be the future directions of hardware research.

An alternative excitation method for electrical impedance tomography

Electrical impedance tomography (EIT) can be utilized to image the conductivity distribution of material under test. The EIT measurements depend on the quality in the current injection and voltage measuring circuits. The current source plays a vital role in the EIT instruments. In most of the research studies, the push-pull current sources were employed for the source and sink signal generation. It usually requires frequent calibration to achieve proper functioning, especially for the sweeping frequency measurements. In this paper, an alternative excitation method has been proposed for simplifying the design of the current source in EIT instruments, which aims to achieve the performance of the push-pull current source by using a single-ended current source. It could offer the following advantages: (1) hardware simplification and (2) reduced requirements on current source calibration. The corrected measurements could be consistent with that using push-pull excitation, as confirmed by the numerical simulations. In addition, the reconstructed images have also been investigated to illustrate the effectiveness of the proposed method.

Respiration monitoring in PACU using ventilation and gas exchange parameters

The importance of perioperative respiration monitoring is highlighted by high incidences of postoperative respiratory complications unrelated to the original disease. The objectives of this pilot study were to (1) simultaneously acquire respiration rate (RR), tidal volume (TV), minute ventilation (MV), SpO₂ and PetCO₂ from patients in post-anesthesia care unit (PACU) and (2) identify a practical continuous respiration monitoring method by analyzing the acquired data in terms of their ability and reliability in assessing a patient’s respiratory status. Thirteen non-intubated patients completed this observational study. A portable electrical impedance tomography (EIT) device was used to acquire RR_EIT, TV and MV, while PetCO₂, RR_Cap and SpO₂ were measured by a Capnostream35. Hypoventilation and respiratory events, e.g., apnea and hypopnea, could be detected reliably using RR_EIT, TV and MV. PetCO₂ and SpO₂ provided the gas exchange information, but were unable to detect hypoventilation in a timely fashion. Although SpO₂ was stable, the sidestream capnography using the oronasal cannula was often unstable and produced fluctuating PetCO₂ values. The coefficient of determination (R²) value between RR_EIT and RR_Cap was 0.65 with a percentage error of 52.5%. Based on our results, we identified RR, TV, MV and SpO₂ as a set of respiratory parameters for robust continuous respiration monitoring of non-intubated patients. Such a respiration monitor with both ventilation and gas exchange parameters would be reliable and could be useful not only for respiration monitoring, but in making PACU discharge decisions and adjusting opioid dosage on general hospital floor. Future studies are needed to evaluate the potential clinical utility of such an integrated respiration monitor.

Multi-channel Trans-impedance Leadforming for Cardiopulmonary Monitoring: Algorithm Development and Feasibility Assessment using In Vivo Animal Data

OBJECTIVE

The objectives of this study were to (1) develop a multi-channel trans-impedance leadforming method for beat-to-beat stroke volume (SV) and breath-by-breath tidal volume (TV) measurements and (2) assess its feasibility on an existing in vivo animal dataset.

METHODS

A deterministic leadforming algorithm was developed to extract a cardiac volume signal (CVS) and a respiratory volume signal (RVS) from 208-channel trans-impedance data acquired every 20 ms by an electrical impedance tomography (EIT) device. SV_EIT and TV_EIT values were computed as a valley-to-peak value in the CVS and RVS, respectively. The method was applied to the existing dataset from five mechanically-ventilated pigs undergoing ten mini-fluid challenges. An invasive hemodynamic monitor was used in the arterial pressure-based cardiac output (APCO) mode to simultaneously measure SV_APCO values while a mechanical ventilator provided TV_Vent values.

RESULTS

The leadforming method could reliably extract the CVS and RVS from the 208-channel trans-impedance data measured with the EIT device, from which SV_EIT and TV_EIT were computed. The SV_EIT and TV_EIT values were comparable to those from the invasive hemodynamic monitor and mechanical ventilator. Using the data from 5 pigs and a simple calibration method to remove bias, the error in SV<sub>EIT<sub> and TV<sub>EIT<sub> was 9.5% and 5.4%, respectively.

CONCLUSION

We developed a new leadforming method for the EIT device to robustly extract both SV and TV values in a deterministic fashion. Future animal and clinical studies are needed to validate this leadforming method in various subject populations.

SIGNIFICANCE

The leadforming method could be an integral component for a new cardiopulmonary monitor in the future to simultaneously measure SV and TV noninvasively, which would be beneficial to patients.

Noninvasive Beat-To-Beat Stroke Volume Measurements to Determine Preload Responsiveness During Mini-Fluid Challenge in a Swine Model: A Preliminary Study

ABSTRACT

Cardiac output (CO) is an important parameter in fluid management decisions for treating hemodynamically unstable patients in intensive care unit. The gold standard for CO measurements is the thermodilution method, which is an invasive procedure with intermittent results. Recently, electrical impedance tomography (EIT) has emerged as a new method for noninvasive measurements of stroke volume (SV). The objectives of this paper are to compare EIT with an invasive pulse contour analysis (PCA) method in measuring SV during mini-fluid challenge in animals and determine preload responsiveness with EIT. Five pigs were anesthetized and mechanically ventilated. After removing 25% to 30% of the total blood from each animal, multiple fluid injections were conducted. The EIT device successfully tracked changes in SV beat-to-beat during varying volume states, i.e., from hypovolemia and preload responsiveness to target volume and volume overload. From a total of 50 100-mL fluid injections on five pigs (10 injections per pig), the preload responsiveness value was as large as 32.3% in the preload responsiveness state while in the volume overload state it was as low as -4.9%. The bias of the measured SV data using EIT and PCA was 0 mL, and the limits of agreement were ±3.6 mL in the range of 17.6 mL to 51.0 mL. The results of the animal experiments suggested that EIT is capable of measuring beat-to-beat SV changes during mini-fluid challenge and determine preload responsiveness. Further animal and clinical studies will be needed to demonstrate the feasibility of the EIT method as a new tool for fluid management.

Hardware for cell culture electrical impedance tomography: A critical review

Human cell cultures are powerful laboratory tools for biological models of diseases, drug development, and tissue engineering. However, the success of biological experiments often depends on real-time monitoring of the culture state. Conventional culture evaluation methods consist of end-point laborious techniques, not capable of real-time operation and not suitable for three-dimensional cultures. Electrical Impedance Tomography (EIT) is a non-invasive imaging technique with high potential to be used in cell culture monitoring due to its biocompatibility, non-invasiveness, high temporal resolution, compact hardware, automatic operation, and high throughput. This review approaches the different hardware strategies for cell culture EIT that are presented in the literature, discussing the main components of the measurement system: excitation circuit, voltage/current sensing, switching stage, signal specifications, electrode configurations, measurement protocols, and calibration strategies. The different approaches are qualitatively discussed and compared, and design guidelines are proposed.

Simultaneous Imaging of Bio- and Non-Conductive Targets by Combining Frequency and Time Difference Imaging Methods in Electrical Impedance Tomography

As a promising medical imaging modality, electrical impedance tomography (EIT) can image the electrical properties within a region of interest using electrical measurements applied at electrodes on the region boundary. This paper proposes to combine frequency and time difference imaging methods in EIT to simultaneously image bio- and non-conductive targets, where the image fusion is accomplished by applying a wavelet-based technique. To enable image fusion, both time and frequency difference imaging methods are investigated regarding the reconstruction of bio- or non-conductive inclusions in the target region at varied excitation frequencies, indicating that none of those two methods can tackle with the scenarios where both bio- and non-conductive inclusions exist. This dilemma can be resolved by fusing the time difference (td) and appropriate frequency difference (fd) EIT images since they are complementary to each other. Through simulation and in vitro experiment, it is demonstrated that the proposed fusion method can reasonably reconstruct both the bio- and non-conductive inclusions within the lung models established to simulate the ventilation process, which is expected to be beneficial for the diagnosis of lung-tissue related diseases by EIT.

Self-Abrading Servo Electrode Helmet for Electrical Impedance Tomography

Electrical Impedance Tomography (EIT) is a medical imaging technique which has the potential to reduce time to treatment in acute stroke by rapidly differentiating between ischaemic and haemorrhagic stroke. The potential of these methods has been demonstrated in simulation and phantoms, it has not yet successfully translated to clinical studies, due to high sensitivity to errors in scalp electrode mislocation and poor electrode-skin contact. To overcome these limitations, a novel electrode helmet was designed, bearing 32 independently controlled self-abrading electrodes. The contact impedance was reduced through rotation on an abrasive electrode on the scalp using a combined impedance, rotation and position feedback loop. Potentiometers within each unit measure the electrode tip displacement within 0.1 mm from the rigid helmet body. Characterisation experiments on a large-scale test rig demonstrated that approximately 20 kPa applied pressure and 5 rotations was necessary to achieve the target 5 kΩ contact impedance at 20 Hz. This performance was then replicated in a simplified self-contained unit where spring loaded electrodes are rotated by servo motors. Finally, a 32-channel helmet and controller which sequentially minimised contact impedance and simultaneously located each electrode was built which reduced the electrode application and localisation time to less than five minutes. The results demonstrated the potential of this approach to rapidly apply electrodes in an acute setting, removing a significant barrier for imaging acute stroke with EIT.

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.

Noninvasive, simultaneous, and continuous measurements of stroke volume and tidal volume using EIT: feasibility study of animal experiments

Currently, there is no noninvasive method available for simultaneous measurements of tidal volume and stroke volume. Electrical impedance tomography (EIT) has been used for regional lung ventilation imaging. Cardiac EIT imaging, however, has not been successful due to the technical difficulty in extracting weak cardiogenic components. Instead of regional imaging, in this paper, we use the EIT technique to simultaneously measure two global variables of tidal volume and stroke volume. Time-varying patterns of boundary voltage data originating from lung ventilation and cardiac blood flow were extracted from measured boundary voltage data using the principal component analysis (PCA) and independent component analysis (ICA). The source consistency theory was adopted to separately synthesize time-series of boundary voltage data associated with lung ventilation and cardiac blood flow. The respiratory volume signal (RVS) and cardiac volume signal (CVS) were extracted from reconstructed time-difference EIT images of lung ventilation and cardiac blood flow, respectively. After calibrating the volume signals using the mechanical ventilator and the invasive transpulmonary thermodilution (TPTD) method, tidal volume and stroke volume were computed as valley-to-peak values of the RVS and CVS, respectively. The difference in the tidal volume data between EIT and mechanical ventilator was within ± 20 ml from six pigs. The difference in the stroke volume data between EIT and TPTD was within ± 4.7 ml from the same animals. The results show the feasibility of the proposed method as a new noninvasive cardiopulmonary monitoring tool for simultaneous continuous measurements of stroke volume and tidal volume that are two most important vital signs.

Feature Extraction of Upper Airway Dynamics during Sleep Apnea using Electrical Impedance Tomography

Characterizing upper airway occlusion during natural sleep could be instrumental for studying the dynamics of sleep apnea and designing an individualized treatment plan. In recent years, obstructive sleep apnea (OSA) phenotyping has gained attention to classify OSA patients into relevant therapeutic categories. Electrical impedance tomography (EIT) has been lately suggested as a technique for noninvasive continuous monitoring of the upper airway during natural sleep. In this paper, we developed the automatic data processing and feature extract methods to handle acquired EIT data for several hours. Removing ventilation and blood flow artifacts, EIT images were reconstructed to visualize how the upper airway collapsed and reopened during the respiratory event. From the time series of reconstructed EIT images, we extracted the upper airway closure signal providing quantitative information about how much the upper airway was closed during collapse and reopening. Features of the upper airway dynamics were defined from the extracted upper airway closure signal and statistical analyses of ten OSA patients’ data were conducted. The results showed the feasibility of the new method to describe the upper airway dynamics during sleep apnea, which could be a new step towards OSA phenotyping and treatment planning.

Bi-Frequency Symmetry Difference EIT-Feasibility and Limitations of Application to Stroke Diagnosis

OBJECTIVE

Bi-Frequency Symmetry Difference (BFSD)-EIT can detect, localize and identify unilateral perturbations in symmetric scenes. Here, we test the viability and robustness of BFSD-EIT in stroke diagnosis.

METHODS

A realistic 4-layer Finite Element Method (FEM) head model with and without bleed and clot lesions is developed. Performance is assessed with test parameters including: measurement noise, electrode placement errors, contact impedance errors, deviations in assumed tissue conductivity, deviations in assumed anatomy, and a frequency-dependent background. A final test is performed using ischemic patient data. Results are assessed using images and quantitative metrics.

RESULTS

BFSD-EIT may be feasible for stroke diagnosis if a signal-to-noise ratio (SNR) of ≥60 dB is achievable. Sensitivity to errors in electrode positioning is seen with a tolerance of only ±5 mm, but a tolerance of up to ±30 mm is possible if symmetry is maintained between symmetrically opposite partner electrodes. The technique is robust to errors in contact impedance and assumed tissue conductivity up to at least ±50%. Asymmetric internal anatomy affects performance but may be tolerable for tissues with frequency-dependent conductivity. Errors in assumed external geometry marginally affect performance. A frequency-dependent background does not affect performance with carefully chosen frequency points or use of multiple frequency points across a band. The Global Left-Hand Side (LHS) & Right-Hand Side (RHS) Mean Intensity metric is particularly robust to errors.

CONCLUSION

BFSD-EIT is a promising technique for stroke diagnosis, provided parameters are within the tolerated ranges.

SIGNIFICANCE

BFSD-EIT may prove an important step forward in imaging of static scenes such as stroke.

A 13-Channel 1.53-mW 11.28-mm2 Electrical Impedance Tomography SoC Based on Frequency Division Multiplexing for Lung Physiological Imaging

An electrical impedance tomography (EIT) system based on frequency division multiplexing (FDM) is proposed for real-time lung physiological imaging. The FDM technique allows the integration of 13 dedicated voltage sensing channels by combining data on-chip and sharing of ADC to alleviate area penalty caused by multi-channel. The EIT system-on-chip (SoC) is of the following features. 1) Early I/Q demodulation to relax the bandwidth requirement of analog front end and minimize the impact of motion artifacts and dc electrode offset. 2) Eliminates the need of adaptive gain control with constant inverted "U-shape" gain configuration to compensate amplitude variations across all channels. 3) FDM to combine 13 pairs of I/Q signals into two data streams for quantization using only two ΔΣ modulators. 4) Batch data recovery by Blackman window corrected fast Fourier transform without any digital filtering involved. 5) Lowest power consumption and smallest area occupation per channel reported to date. The EIT SoC occupies an area of 11.28 mm² in 130-nm CMOS technology with a total power consumption of 1.53 mW under 1-V power supply. As a result, it generates lung EIT images at up to five frames per second.

Integrated EIT system for functional lung ventilation imaging

Background

Electrical impedance tomography (EIT) has been used for functional lung imaging of regional air distributions during mechanical ventilation in intensive care units (ICU). From numerous clinical and animal studies focusing on specific lung functions, a consensus about how to use the EIT technique has been formed lately. We present an integrated EIT system implementing the functions proposed in the consensus. The integrated EIT system could improve the usefulness when monitoring of mechanical ventilation for lung protection so that it could facilitate the clinical acceptance of this new technique.

Methods

Using a custom-designed 16-channel EIT system with 50 frames/s temporal resolution, the integrated EIT system software was developed to implement five functional images and six EIT measures that can be observed in real-time screen view and analysis screen view mode, respectively. We evaluated the performance of the integrated EIT system with ten mechanically ventilated porcine subjects in normal and disease models.

Results

Quantitative and simultaneous imaging of tidal volume (TV), end-expiratory lung volume change (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\triangle$$\end{document}▵EELV), compliance, ventilation delay, and overdistension/collapse images were performed. Clinically useful parameters were successfully extracted including anterior/posterior ventilation ratio (A/P ratio), center of ventilation (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathrm{CoV}}_{{x}}$$\end{document}CoVx, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathrm{CoV}}_{{y}}$$\end{document}CoVy), global inhomogeneity (GI), coefficient of variation (CV), ventilation delay and percentile of overdistension/collapse. The integrated EIT system was demonstrated to suggest an optimal positive end-expiratory pressure (PEEP) for lung protective ventilation in normal and in the disease model of an acute injury. Optimal PEEP for normal and disease model was 2.3 and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$7.9 \, {\mathrm{cmH}}_{2}\mathrm{O}$$\end{document}7.9cmH2O, respectively.

Conclusions

The proposed integrated approach for functional lung ventilation imaging could facilitate clinical acceptance of the bedside EIT imaging method in ICU. Future clinical studies of applying the proposed methods to human subjects are needed to show the clinical significance of the method for lung protective mechanical ventilation and mechanical ventilator weaning in ICU.

Structured Design Methodology to Achieve a High SNR Electrical Impedance Tomography

In this paper, we present a methodology for designing the main circuit building blocks of an electrical impedance tomography (EIT) system. In particular, we derive equations that map system-level EIT specifications to the performance requirements of each circuit block. We also review the circuit architectures that are best suited for meeting a given set of performance requirements. Our proposed design methodology is focused on maximizing the EIT system's signal-to-noise ratio while minimizing total power consumption.

EIT Imaging of Upper Airway to Estimate Its Size and Shape Changes During Obstructive Sleep Apnea

Noninvasive continuous imaging of the upper airway during natural sleep was conducted for patients with obstructive sleep apnea (OSA) using the electrical impedance tomography (EIT) technique. A safe amount of alternating current (AC) was injected into the lower head through multiple surface electrodes. Since the air is an electrical insulator, upper airway narrowing during OSA altered internal current pathways and changed the induced voltage distribution. Since the measured voltage data from the surface of the lower head were influenced not only by upper airway narrowing but respiratory motions, head motions, and blood flows, we developed a pre-processing algorithm to extract the voltage component originated from upper airway closing and opening. Using an EIT image reconstruction algorithm, time-series of EIT images of the upper airway were produced with a temporal resolution of 50 frames per second. Applying a postprocessing algorithm to the reconstructed EIT images, we could extract quantitative information about changes in the size and shape during upper airway closing and opening. Results of the clinical studies with seven normal subjects and ten OSA patients show the feasibility of the new method for OSA phenotyping and treatment planning.

Portable multi-parameter electrical impedance tomography for sleep apnea and hypoventilation monitoring: feasibility study

OBJECTIVE

Quantitative ventilation monitoring and respiratory event detection are needed for the diagnosis of sleep apnea and hypoventilation. We developed a portable device with a chest belt, nasal cannula and finger sensor to continuously acquire multi-channel signals including tidal volume, nasal pressure, respiratory effort, body position, snoring sound, ECG and SpO₂. The unique feature of the device is the continuous tidal volume signal obtained from real-time lung ventilation images produced by the electrical impedance tomography (EIT) technique.

APPROACH

The chest belt includes 16 electrodes for real-time time-difference EIT imaging and ECG data acquisitions. It also includes a microphone, accelerometer, gyroscope, magnetometer and pressure sensor to acquire, respectively, snoring sound, respiratory effort, body position and nasal pressure signals. A separate finger sensor is used to measure SpO₂. The minute ventilation signal is derived from the tidal volume signal and respiration rate.

MAIN RESULTS

The experimental results from a conductivity phantom, four swine subjects and one human volunteer show that the developed multi-parameter EIT device could supplement existing polysomnography (PSG) and home sleep test (HST) devices to improve the accuracy of sleep apnea diagnosis. The portable device could be also used as a new tool for continuous hypoventilation monitoring of non-intubated patients with respiratory depression.

SIGNIFICANCE

Following the feasibility study in this paper, future validation studies in comparison with in-lab PSG, HST and end-tidal CO₂ devices are suggested to find its clinical efficacy as a sleep apnea diagnosis and hypoventilation monitoring tool.

A Multichannel Real-Time Bioimpedance Measurement Device for Pulse Wave Analysis

Pulse wave analysis is an important method used to gather information about the cardiovascular system. Instead of detecting the pulse wave via pressure sensors, bioimpedance measurements can be performed to acquire minuscule changes in the conductivity of the tissue, caused by the pulse wave. This work presents a microcontroller-based bioimpedance measurement system, which has the capability to acquire impedance measurements from up to four independent channels simultaneously. By combining a problem-specific analog measurement circuit with a 24 bits analog-to-digital converter, the system is capable of acquiring 1000 impedances per second with a signal-to-noise ratio in a range from 92 to 96 dB. For data storage and analysis, the digitized data are sent via universal serial bus to a host PC. A graphical user interface filters and plots the data of all channels in real-time. The performance of the system regarding measuring constant impedances, as well as impedance changes over time is demonstrated. Two different applications for pulse wave analysis via multichannel bioimpedance measurements are presented. Additionally, first measurement results from a human subject are shown to demonstrate the system's applicability of analyzing the pulse wave morphology as well as the aortic pulse wave velocity.

Design of current source for multi-frequency simultaneous electrical impedance tomography

Multi-frequency electrical impedance tomography has been evolving from the frequency-sweep approach to the multi-frequency simultaneous measurement technique which can reduce measuring time and will be increasingly attractive for time-varying biological applications. The accuracy and stability of the current source are the key factors determining the quality of the image reconstruction. This article presents a field programmable gate array-based current source for a multi-frequency simultaneous electrical impedance tomography system. A novel current source circuit was realized by combining the classic current mirror based on the feedback amplifier AD844 with a differential topology. The optimal phase offsets of harmonic sinusoids were obtained through the crest factor analysis. The output characteristics of this current source were evaluated by simulation and actual measurement. The results include the following: (1) the output impedance was compared with one of the Howland pump circuit in simulation, showing comparable performance at low frequencies. However, the proposed current source makes lower demands for resistor tolerance but performs even better at high frequencies. (2) The output impedance in actual measurement below 200 kHz is above 1.3 MΩ and can reach 250 KΩ up to 1 MHz. (3) An experiment based on a biological RC model has been implemented. The mean error for the demodulated impedance amplitude and phase are 0.192% and 0.139°, respectively. Therefore, the proposed current source is wideband, biocompatible, and high precision, which demonstrates great potential to work as a sub-system in the multi-frequency electrical impedance tomography system.

A multi-frequency electrical impedance tomography system for real-time 2D and 3D imaging

This paper presents the design and evaluation of a configurable, fast multi-frequency Electrical Impedance Tomography (mfEIT) system for real-time 2D and 3D imaging, particularly for biomedical imaging. The system integrates 32 electrode interfaces and the current frequency ranges from 10 kHz to 1 MHz. The system incorporates the following novel features. First, a fully adjustable multi-frequency current source with current monitoring function is designed. Second, a flexible switching scheme is developed for arbitrary sensing configuration and a semi-parallel data acquisition architecture is implemented for high-frame-rate data acquisition. Furthermore, multi-frequency digital quadrature demodulation is accomplished in a high-capacity Field Programmable Gate Array. At last, a 3D imaging software, visual tomography, is developed for real-time 2D and 3D image reconstruction, data analysis, and visualization. The mfEIT system is systematically tested and evaluated from the aspects of signal to noise ratio (SNR), frame rate, and 2D and 3D multi-frequency phantom imaging. The highest SNR is 82.82 dB on a 16-electrode sensor. The frame rate is up to 546 fps at serial mode and 1014 fps at semi-parallel mode. The evaluation results indicate that the presented mfEIT system is a powerful tool for real-time 2D and 3D imaging.

A shape-based quality evaluation and reconstruction method for electrical impedance tomography

Linear methods of reconstruction play an important role in medical electrical impedance tomography (EIT) and there is a wide variety of algorithms based on several assumptions. With the Graz consensus reconstruction algorithm for EIT (GREIT), a novel linear reconstruction algorithm as well as a standardized framework for evaluating and comparing methods of reconstruction were introduced that found widespread acceptance in the community. In this paper, we propose a two-sided extension of this concept by first introducing a novel method of evaluation. Instead of being based on point-shaped resistivity distributions, we use 2759 pairs of real lung shapes for evaluation that were automatically segmented from human CT data. Necessarily, the figures of merit defined in GREIT were adjusted. Second, a linear method of reconstruction that uses orthonormal eigenimages as training data and a tunable desired point spread function are proposed. Using our novel method of evaluation, this approach is compared to the classical point-shaped approach. Results show that most figures of merit improve with the use of eigenimages as training data. Moreover, the possibility of tuning the reconstruction by modifying the desired point spread function is shown. Finally, the reconstruction of real EIT data shows that higher contrasts and fewer artifacts can be achieved in ventilation- and perfusion-related images.

FPGA-based voltage and current dual drive system for high frame rate electrical impedance tomography

Electrical impedance tomography (EIT) is used to image the electrical property distribution of a tissue under test. An EIT system comprises complex hardware and software modules, which are typically designed for a specific application. Upgrading these modules is a time-consuming process, and requires rigorous testing to ensure proper functioning of new modules with the existing ones. To this end, we developed a modular and reconfigurable data acquisition (DAQ) system using National Instruments' (NI) hardware and software modules, which offer inherent compatibility over generations of hardware and software revisions. The system can be configured to use up to 32-channels. This EIT system can be used to interchangeably apply current or voltage signal, and measure the tissue response in a semi-parallel fashion. A novel signal averaging algorithm, and 512-point fast Fourier transform (FFT) computation block was implemented on the FPGA. FFT output bins were classified as signal or noise. Signal bins constitute a tissue's response to a pure or mixed tone signal. Signal bins' data can be used for traditional applications, as well as synchronous frequency-difference imaging. Noise bins were used to compute noise power on the FPGA. Noise power represents a metric of signal quality, and can be used to ensure proper tissue-electrode contact. Allocation of these computationally expensive tasks to the FPGA reduced the required bandwidth between PC, and the FPGA for high frame rate EIT. In 16-channel configuration, with a signal-averaging factor of 8, the DAQ frame rate at 100 kHz exceeded 110 frames s (-1), and signal-to-noise ratio exceeded 90 dB across the spectrum. Reciprocity error was found to be for frequencies up to 1 MHz. Static imaging experiments were performed on a high-conductivity inclusion placed in a saline filled tank; the inclusion was clearly localized in the reconstructions obtained for both absolute current and voltage mode data.

Design of a microscopic electrical impedance tomography system for 3D continuous non-destructive monitoring of tissue culture

BACKGROUND

Non-destructive continuous monitoring of regenerative tissue is required throughout the entire period of in vitro tissue culture. Microscopic electrical impedance tomography (micro-EIT) has the potential to monitor the physiological state of tissues by forming three-dimensional images of impedance changes in a non-destructive and label-free manner. We developed a new micro-EIT system and report on simulation and experimental results of its macroscopic model.

METHODS

We propose a new micro-EIT system design using a cuboid sample container with separate current-driving and voltage sensing electrodes. The top is open for sample manipulations. We used nine gold-coated solid electrodes on each of two opposing sides of the container to produce multiple linearly independent internal current density distributions. The 360 voltage sensing electrodes were placed on the other sides and base to measure induced voltages. Instead of using an inverse solver with the least squares method, we used a projected image reconstruction algorithm based on a logarithm formulation to produce projected images. We intended to improve the quality and spatial resolution of the images by increasing the number of voltage measurements subject to a few injected current patterns. We evaluated the performance of the micro-EIT system with a macroscopic physical phantom.

RESULTS

The signal-to-noise ratio of the developed micro-EIT system was 66 dB. Crosstalk was in the range of -110.8 to -90.04 dB. Three-dimensional images with consistent quality were reconstructed from physical phantom data over the entire domain. From numerical and experimental results, we estimate that at least 20 × 40 electrodes with 120 μm spacing are required to monitor the complex shape of ingrowth neotissue inside a scaffold with 300 μm pore.

CONCLUSION

The experimental results showed that the new micro-EIT system with a reduced set of injection current patterns and a large number of voltage sensing electrodes can be potentially used for tissue culture monitoring. Numerical simulations demonstrated that the spatial resolution could be improved to the scale required for tissue culture monitoring. Future challenges include manufacturing a bioreactor-compatible container with a dense array of electrodes and a larger number of measurement channels that are sensitive to the reduced voltage gradients expected at a smaller scale.

An instrumental electrode model for solving EIT forward problems

An instrumental electrode model (IEM) capable of describing the performance of electrical impedance tomography (EIT) systems in the MHz frequency range has been proposed. Compared with the commonly used Complete Electrode Model (CEM), which assumes ideal front-end interfaces, the proposed model considers the effects of non-ideal components in the front-end circuits. This introduces an extra boundary condition in the forward model and offers a more accurate modelling for EIT systems. We have demonstrated its performance using simple geometry structures and compared the results with the CEM and full Maxwell methods. The IEM can provide a significantly more accurate approximation than the CEM in the MHz frequency range, where the full Maxwell methods are favoured over the quasi-static approximation. The improved electrode model will facilitate the future characterization and front-end design of real-world EIT systems.

Electrical impedance imaging system using FPGAs for flexibility and interoperability

BACKGROUND

Modern EIT systems require simultaneously operating multiple functions for flexibility, interoperability, and clinical applicability. To implement versatile functions, expandable design and implementation tools are needed. On the other hand, it is necessary to develop an ASIC-based EIT system to maximize its performance. Since the ASIC design is expensive and unchangeable, we can use FPGAs as a prior step to the digital ASIC design and carefully classify which functions should be included in the ASIC. In this paper, we describe the details of the FPGA design adopted in the KHU Mark2.5 EIT system.

METHODS

We classified all functions of the KHU Mark2.5 EIT system into two categories. One is the control and processing of current injection and voltage measurement. The other includes the collection and management of the multi-channel data with timing controls for internal and external interconnections. We describe the implementation of these functions in two kinds of FPGAs called the impedance measurement module (IMM) FPGA and the intra-network controller FPGA.

RESULTS

We present functional and timing simulations of the key functions in the FPGAs. From phantom and animal imaging experiments, we show that multiple functions of the system are successfully implemented in the FPGAs. As examples, we demonstrate fast multi-frequency imaging and ECG-gated imaging.

CONCLUSION

Given an analog design of a parallel EIT system, it is important to optimize its digital design to minimize systematic artifacts and maximize performance. This paper described technical details of the FPGA-based fully parallel EIT system called the KHU Mark2.5 with numerous functions needed for clinical applications. Two kinds of FPGAs described in this paper can be used as a basis for future EIT digital ASIC designs for better application-specific human interface as well as hardware performance.

Bioelectrical Impedance Methods for Noninvasive Health Monitoring: A Review

Under the alternating electrical excitation, biological tissues produce a complex electrical impedance which depends on tissue composition, structures, health status, and applied signal frequency, and hence the bioelectrical impedance methods can be utilized for noninvasive tissue characterization. As the impedance responses of these tissue parameters vary with frequencies of the applied signal, the impedance analysis conducted over a wide frequency band provides more information about the tissue interiors which help us to better understand the biological tissues anatomy, physiology, and pathology. Over past few decades, a number of impedance based noninvasive tissue characterization techniques such as bioelectrical impedance analysis (BIA), electrical impedance spectroscopy (EIS), electrical impedance plethysmography (IPG), impedance cardiography (ICG), and electrical impedance tomography (EIT) have been proposed and a lot of research works have been conducted on these methods for noninvasive tissue characterization and disease diagnosis. In this paper BIA, EIS, IPG, ICG, and EIT techniques and their applications in different fields have been reviewed and technical perspective of these impedance methods has been presented. The working principles, applications, merits, and demerits of these methods has been discussed in detail along with their other technical issues followed by present status and future trends.

The differential Howland current source with high signal to noise ratio for bioimpedance measurement system

The stability and signal to noise ratio (SNR) of the current source circuit are the important factors contributing to enhance the accuracy and sensitivity in bioimpedance measurement system. In this paper we propose a new differential Howland topology current source and evaluate its output characters by simulation and actual measurement. The results include (1) the output current and impedance in high frequencies are stabilized after compensation methods. And the stability of output current in the differential current source circuit (DCSC) is 0.2%. (2) The output impedance of two current circuits below the frequency of 200 KHz is above 1 MΩ, and below 1 MHz the output impedance can arrive to 200 KΩ. Then in total the output impedance of the DCSC is higher than that of the Howland current source circuit (HCSC). (3) The SNR of the DCSC are 85.64 dB and 65 dB in the simulation and actual measurement with 10 KHz, which illustrates that the DCSC effectively eliminates the common mode interference. (4) The maximum load in the DCSC is twice as much as that of the HCSC. Lastly a two-dimensional phantom electrical impedance tomography is well reconstructed with the proposed HCSC. Therefore, the measured performance shows that the DCSC can significantly improve the output impedance, the stability, the maximum load, and the SNR of the measurement system.

Multi-frequency electrical impedance tomography system with automatic self-calibration for long-term monitoring

Electrical Impedance Tomography (EIT) is a safe medical imaging technology, requiring no ionizing or heating radiation, as opposed to most other imaging modalities. This has led to a clinical interest in its use for long-term monitoring, possibly at the bedside, for ventilation monitoring, bleeding detection, gastric emptying and epilepsy foci diagnosis. These long-term applications demand auto-calibration and high stability over long time periods. To address this need we have developed a new multi-frequency EIT system called the KHU Mark2.5 with automatic self-calibration and cooperation with other devices via a timing signal for synchronization with other medical instruments. The impedance measurement module (IMM) for flexible configuration as a key component includes an independent constant current source, an independent differential voltmeter, and a current source calibrator, which allows automatic self-calibration of the current source within each IMM. We installed a resistor phantom inside the KHU Mark2.5 EIT system for intra-channel and inter-channel calibrations of all voltmeters in multiple IMMs. We show the deterioration of performance of an EIT system over time and the improvement due to automatic self-calibration. The system is able to maintain SNR of 80 dB for frequencies up to 250 kHz and below 0.5% reciprocity error over continuous operation for 24 hours. Automatic calibration at least every 3 days is shown to maintain SNR above 75 dB and reciprocity error below 0.7% over 7 days at 1 kHz. A clear degradation in performance results with increasing time between automatic calibrations allowing the tailoring of calibration to suit the performance requirements of each application.

FPGA Based High Speed Data Acquisition System for Electrical Impedance Tomography

Electrical Impedance Tomography (EIT) systems are used to image tissue bio-impedance. EIT provides a number of features making it attractive for use as a medical imaging device including the ability to image fast physiological processes (>60 Hz), to meet a range of clinical imaging needs through varying electrode geometries and configurations, to impart only non-ionizing radiation to a patient, and to map the significant electrical property contrasts present between numerous benign and pathological tissues. To leverage these potential advantages for medical imaging, we developed a modular 32 channel data acquisition (DAQ) system using National Instruments' PXI chassis, along with FPGA, ADC, Signal Generator and Timing and Synchronization modules. To achieve high frame rates, signal demodulation and spectral characteristics of higher order harmonics were computed using dedicated FFT-hardware built into the FPGA module. By offloading the computing onto FPGA, we were able to achieve a reduction in throughput required between the FPGA and PC by a factor of 32:1. A custom designed analog front end (AFE) was used to interface electrodes with our system. Our system is wideband, and capable of acquiring data for input signal frequencies ranging from 100 Hz to 12 MHz. The modular design of both the hardware and software will allow this system to be flexibly configured for the particular clinical application.

Breast EIT using a new projected image reconstruction method with multi-frequency measurements

We propose a new method to produce admittivity images of the breast for the diagnosis of breast cancer using electrical impedance tomography(EIT). Considering the anatomical structure of the breast, we designed an electrode configuration where current-injection and voltage-sensing electrodes are separated in such a way that internal current pathways are approximately along the tangential direction of an array of voltage-sensing electrodes. Unlike conventional EIT imaging methods where the number of injected currents is maximized to increase the total amount of measured data, current is injected only twice between two pairs of current-injection electrodes attached along the circumferential side of the breast. For each current injection, the induced voltages are measured from the front surface of the breast using as many voltage-sensing electrodes as possible. Although this electrode configurational lows us to measure induced voltages only on the front surface of the breast,they are more sensitive to an anomaly inside the breast since such an injected current tends to produce a more uniform internal current density distribution. Furthermore, the sensitivity of a measured boundary voltage between two equipotential lines on the front surface of the breast is improved since those equipotential lines are perpendicular to the primary direction of internal current streamlines. One should note that this novel data collection method is different from those of other frontal plane techniques such as the x-ray projection and T-scan imaging methods because we do not get any data on the plane that is perpendicular to the current flow. To reconstruct admittivity images using two measured voltage data sets, a new projected image reconstruction algorithm is developed. Numerical simulations demonstrate the frequency-difference EIT imaging of the breast. The results show that the new method is promising to accurately detect and localize small anomalies inside the breast.

Comparison of frequency difference reconstruction algorithms for the detection of acute stroke using EIT in a realistic head-shaped tank

Imaging of acute stroke might be possible using multi-frequency electrical impedance tomography (MFEIT) but requires absolute or frequency difference imaging. Simple linear frequency difference reconstruction has been shown to be ineffective in imaging with a frequency-dependant background conductivity; this has been overcome with a weighted frequency difference approach with correction for the background but this has only been validated for a cylindrical and hemispherical tank. The feasibility of MFEIT for imaging of acute stroke in a realistic head geometry was examined by imaging a potato perturbation against a saline background and a carrot-saline frequency-dependant background conductivity, in a head-shaped tank with the UCLH Mk2.5 MFEIT system. Reconstruction was performed with time difference (TD), frequency difference (FD), FD adjacent (FDA), weighted FD (WFD) and weighted FDA (WFDA) linear algorithms. The perturbation in reconstructed images corresponded to the true position to <9.5% of image diameter with an image SNR of >5.4 for all algorithms in saline but only for TD, WFDA and WFD in the carrot-saline background. No reliable imaging was possible with FD and FDA. This indicates that the WFD approach is also effective for a realistic head geometry and supports its use for human imaging in the future.

Modelling of an oesophageal electrode for cardiac function tomography

There is a need in critical care units for continuous cardiopulmonary monitoring techniques. ECG gated electrical impedance tomography is able to localize the impedance variations occurring during the cardiac cycle. This method is a safe, inexpensive and potentially fast technique for cardiac output imaging but the spatial resolution is presently low, particularly for central locations such as the heart. Many parameters including noise deteriorate the reconstruction result. One of the main obstacles in cardiac imaging at the heart location is the high impedance of lungs and muscles on the dorsal and posterior side of body. In this study we are investigating improvements of the measurement and initial conductivity estimation of the internal electrode by modelling an internal electrode inside the esophagus. We consider 16 electrodes connected around a cylindrical mesh. With the random noise level set near 0.05% of the signal we evaluated the Graz consensus reconstruction algorithm for electrical impedance tomography. The modelling and simulation results showed that the quality of the target in reconstructed images was improved by up to 5 times for amplitude response, position error, resolution, shape deformation and ringing effects with perturbations located in cardiac related positions when using an internal electrode.

Design of a microscopic electrical impedance tomography system using two current injections

We describe a novel design of a microscopic electrical impedance tomography (micro-EIT) system for long-term noninvasive monitoring of cell or tissue cultures. The core of the micro-EIT system is a sample container including two pairs of current-injection electrodes and 360 voltage-sensing electrodes. In designing the container, we took advantage of a hexagonal structure with fixed dimensions and electrode configuration. This eliminated technical difficulties related to the unknown irregular boundary geometry of an imaging object in conventional medical EIT. Attaching a pair of large current-injection electrodes fully covering the left and right sides of the hexagonal container, we generated uniform parallel current density inside the container filled with saline. The 360 voltage-sensing electrodes were placed on the front, bottom and back sides of the hexagonal container in three sets of 8 × 15 arrays with equal gaps between them. We measured voltage differences between all neighboring pairs along the direction of the parallel current pathway. For the homogeneous container, all measured voltages must be the same since the voltage changes linearly along that direction. Any anomaly in the container perturbed the current pathways and therefore equipotential lines to produce different differential voltage data. For conductivity image reconstructions, we adopted a lately developed image reconstruction algorithm for this electrode configuration to first produce projected conductivity images on the front, bottom and back sides. Using a backprojection method, we reconstructed three-dimensional conductivity images from those projection images. To improve the image quality and also to meet the mathematical requirement on the uniqueness of a reconstructed image, we used a second pair of thin and long current-injection electrodes located at the middle of the front and back sides. This paper describes the design and construction of such a micro-EIT system with experimental results. Proposing the novel micro-EIT system design, we suggest future studies of miniaturizing the sample container for true microscopic conductivity imaging of cell or tissue cultures.