The effect of serial data collection on the accuracy of electrical impedance tomography images

Generation of Anatomically Inspired Human Airway Tree Using Electrical Impedance Tomography: A Method to Estimate Regional Lung Filling Characteristics

The purpose of lung recruitment is to improve and optimize the air exchange flow in the lungs by adjusting the respiratory settings during mechanical ventilation. Electrical impedance tomography (EIT) is a monitoring tool that permits measurement of regional pulmonary filling characteristics or filling index (FI) during ventilation. The conventional EIT system has limitations which compromise the accuracy of the FI. This paper proposes a novel and automated methodology for accurate FI estimation based on EIT images of recruitable regional collapse and hyperdistension during incremental positive end-expiratory pressure. It identifies details of the airway tree (AT) to generate a correction factor to the FIs providing an accurate measurement. Multi-scale image enhancement followed by identification of the AT skeleton with a robust and self-exploratory tracing algorithm is used to automatically estimate the FI. AT tracing was validated using phantom data on a ground-truth lung. Based on generated phantom EIT images, including an established reference, the proposed method results in more accurate FI estimation of 65% in all quadrants compared with the current state-of-the-art. Measured regional filling characteristics were also examined by comparing regional and global impedance variations in clinically recorded data from ten different subjects. Clinical tests on filling characteristics based on extraction of the AT from the resolution enhanced EIT images indicated a more accurate result compared with the standard EIT images.

Beneficial techniques for spatio-temporal imaging in electrical impedance tomography

OBJECTIVE

Electrical impedance tomography (EIT) typically reconstructs individual images from electrical voltage measurements at pairs of electrodes due to current driven through other electrode pairs on a body. EIT images have low spatial resolution, but excellent temporal resolution. There are four methods for integrating temporal data into an EIT reconstruction: filtering over measurements, filtering over images, combined spatial and temporal (spatio-temporal) regularization, and Kalman filtering. These spatio-temporal methods have not been directly compared, making it difficult to evaluate relative performance and choose an appropriate method for particular use cases.

APPROACH

We (i) develop a common framework, (ii) develop comparison metrics, (iii) perform simulation and tank studies which directly compare algorithms, and (iv) report on relative advantages of the different algorithms.

MAIN RESULTS

Temporal filtering is well understood, but often not considered as part of the imaging process despite a direct impact on image reconstruction quality. Spatio-temporal regularized techniques are not yet efficient but offer tantalizing advantages. Kalman filtering enables adaptive filtering for time-varying measurement/image noise at the cost of often over-regularized (sub-optimal) images which can now be understood in the same framework as the other techniques. Further research into efficient implementations of Gauss-Newton spatio-temporal regularization will allow temporal and spatial covariance to be explicitly defined for longer time series (n > 10 frames) where temporal regularization can be more effective. For the immediate analysis of temporally varying images, we recommend the use of adaptive (time-varying) temporal filtering of measurements followed by adaptive spatial regularization (hyperparameter selection) as the most computationally efficient and effective approach currently available.

SIGNIFICANCE

The analysis of variation within regions of an EIT image to extract physiological measures (functional imaging), has become an important EIT technique where temporal and spatial aspects of analysis are tightly integrated. This work gives guidance on available methods and suggests directions for future research.

Extended Joint Sparsity Reconstruction for Spatial and Temporal ERT Imaging

Electrical resistance tomography (ERT) is an imaging technique to recover the conductivity distribution with boundary measurements via attached electrodes. There are a wide range of applications using ERT for image reconstruction or parameter calculation due to high speed data collection, low cost, and the advantages of being non-invasive and portable. Although ERT is considered a high temporal resolution method, a temporally regularized method can greatly enhance such a temporal resolution compared to frame-by-frame reconstruction. In some of the cases, especially in the industrial applications, dynamic movement of an object is critical. In practice, it is desirable for monitoring and controlling the dynamic process. ERT can determine the spatial conductivity distribution based on previous work, and ERT potentially shows good performance in exploiting temporal information as well. Many ERT algorithms reconstruct images frame by frame, which is not optimal and would assume that the target is static during collection of each data frame, which is inconsistent with the real case. Although spatiotemporal-based algorithms can account for the temporal effect of dynamic movement and can generate better results, there is not that much work aimed at analyzing the performance in the time domain. In this paper, we discuss the performance of a novel spatiotemporal total variation (STTV) algorithm in both the spatial and temporal domain, and Temporal One-Step Tikhonov-based algorithms were also employed for comparison. The experimental results show that the STTV has a faster response time for temporal variation of the moving object. This robust time response can contribute to a much better control process which is the main aim of the new generation of process tomography systems.

Detection of thoracic vascular structures by electrical impedance tomography: a systematic assessment of prominence peak analysis of impedance changes

OBJECTIVE

Electrical impedance tomography (EIT) is a non-invasive and radiation-free bedside monitoring technology, primarily used to monitor lung function. First experimental data shows that the descending aorta can be detected at different thoracic heights and might allow the assessment of central hemodynamics, i.e. stroke volume and pulse transit time.

APPROACH

First, the feasibility of localizing small non-conductive objects within a saline phantom model was evaluated. Second, this result was utilized for the detection of the aorta by EIT in ten anesthetized pigs with comparison to thoracic computer tomography (CT). Two EIT belts were placed at different thoracic positions and a bolus of hypertonic saline (10 ml, 20%) was administered into the ascending aorta while EIT data were recorded. EIT images were reconstructed using the GREIT model, based on the individual's thoracic contours. The resulting EIT images were analyzed pixel by pixel to identify the aortic pixel, in which the bolus caused the highest transient impedance peak in time.

MAIN RESULTS

In the phantom, small objects could be located at each position with a maximal deviation of 0.71 cm. In vivo, no significant differences between the aorta position measured by EIT and the anatomical aorta location were obtained for both measurement planes if the search was restricted to the dorsal thoracic region of interest (ROIs).

SIGNIFICANCE

It is possible to detect the descending aorta at different thoracic levels by EIT using an intra-aortic bolus of hypertonic saline. No significant differences in the position of the descending aorta on EIT images compared to CT images were obtained for both EIT belts.

Analysis and compensation for errors in electrical impedance tomography images and ventilation-related measures due to serial data collection

Electrical impedance tomography (EIT) is increasingly being used as a bedside tool for monitoring regional lung ventilation. However, most clinical systems use serial data collection which, if uncorrected, results in image distortion, particularly at high breathing rates. The objective of this study was to determine the extent to which this affects derived parameters. Raw EIT data were acquired with the GOE-MF II EIT device (CareFusion, Höchberg, Germany) at a scan rate of 13 images/s during both spontaneous breathing and mechanical ventilation. Boundary data for periods of undisturbed tidal breathing were corrected for serial data collection errors using a Fourier based algorithm. Images were reconstructed for both the corrected and original data using the GREIT algorithm, and parameters describing the filling characteristics of the right and left lung derived on a breath by breath basis. Values from the original and corrected data were compared using paired t-tests. Of the 33 data sets, 23 showed significant differences in filling index for at least one region, 11 had significant differences in calculated tidal impedance change and 12 had significantly different filling fractions (p = 0.05). We conclude that serial collection errors should be corrected before image reconstruction to avoid clinically misleading results.

A comparison framework for temporal image reconstructions in electrical impedance tomography

Electrical impedance tomography (EIT) provides low-resolution images of internal conductivity distributions, but is able to achieve relatively high temporal resolutions. Most EIT image reconstruction algorithms do not explicitly account for the temporal constraints on the measurements or physiological processes under investigation. Instead, algorithms typically assume both that the conductivity distribution does not change during the acquisition of each EIT data frame, and that frames can be reconstructed independently, without consideration of the correlation between images. A failure to account for these temporal effects will result in aliasing-related artefacts in images. Several methods have been proposed to compensate for these effects, including interpolation of raw data, and reconstruction algorithms using Kalman and temporal filtering. However, no systematic work has been performed to understand the severity of the temporal artefacts nor the extent to which algorithms can account for them. We seek to address this need by developing a temporal comparison framework and figures of merit to assess the ability of reconstruction algorithms to account for temporal effects. Using this approach, we compare combinations of three reconstruction algorithms using three EIT data frame types: perfect, realistic and interpolated. The results show that, without accounting for temporal effects, artefacts are present in images for dynamic conductivity contrasts at frequencies 10-20 times slower than the frame rate. The proposed methods show some improvements in reducing these artefacts.

Electrical impedance tomography imaging of the cardiopulmonary system

PURPOSE OF REVIEW

This review article summarizes the recent advances in electrical impedance tomography (EIT) related to cardiopulmonary imaging and monitoring on the background of the 30-year development of this technology.

RECENT FINDINGS

EIT is expected to become a bedside tool for monitoring and guiding ventilator therapy. In this context, several studies applied EIT to determine spatial ventilation distribution during different ventilation modes and settings. EIT was increasingly combined with other signals, such as airway pressure, enabling the assessment of regional respiratory system mechanics. EIT was for the first time used prospectively to define ventilator settings in an experimental and a clinical study. Increased neonatal and paediatric use of EIT was noted. Only few studies focused on cardiac function and lung perfusion. Advanced radiological imaging techniques were applied to assess EIT performance in detecting regional lung ventilation. New approaches to improve the quality of thoracic EIT images were proposed.

SUMMARY

EIT is not routinely used in a clinical setting, but the interest in EIT is evident. The major task for EIT research is to provide the clinicians with guidelines how to conduct, analyse and interpret EIT examinations and combine them with other medical techniques so as to meaningfully impact the clinical decision-making.

Variability in EIT Images of Lung Ventilation as a Function of Electrode Planes and Body Positions

This study is aimed at investigating the variability in resistivity changes in the lung region as a function of air volume, electrode plane and body position. Six normal subjects (33.8 ± 4.7 years, range from 26 to 37 years) were studied using the Sheffield Electrical Impedance Tomography (EIT) portable system. Three transverse planes at the level of second intercostal space, the level of the xiphisternal joint, and midway between upper and lower locations were chosen for measurements. For each plane, sixteen electrodes were uniformly positioned around the thorax. Data were collected with the breath held at end expiration and after inspiring 0.5, 1.0, or 1.5 liters of air from end expiration, with the subject in both the supine and sitting position. The average resistivity change in five regions, two 8x8 pixel local regions in the right lung, entire right, entire left and total lung regions, were calculated. The results show the resistivity change averaged over electrode positions and subject positions was 7-9% per liter of air, with a slightly larger resistivity change of 10 % per liter air in the lower electrode plane. There was no significant difference (p>0.05) between supine and sitting. The two 8x8 regions show a larger inter individual variability (coefficient of variation, CV, is from 30% to 382%) compared to the entire left, entire right and total lung (CV is from 11% to 51%). The results for the global regions are more consistent. The large inter individual variability appears to be a problem for clinical applications of EIT, such as regional ventilation. The variability may be mitigated by choosing appropriate electrode plane, body position and region of interest for the analysis.