Bioimpedance tomography (electrical impedance tomography)

Research Trends and Hotspots of Medical Electrical Impedance Tomography Algorithms: A Bibliometric Analysis From 1987 to 2021

Electrical impedance tomography (EIT) is a gradually maturing medical imaging technique that relies on computational algorithms for reconstructing and visualizing internal conductivity distributions within the human body. To provide a comprehensive and objective understanding of the current state and trends in the EIT algorithm research, we conducted bibliometric analysis on a 25-year EIT algorithm research dataset sourced from Web of Science Core Collections. We visualized publication characteristics, collaboration patterns, keywords, and co-cited references. The results indicate a steady increase in annual publications over recent decades. The United States, United Kingdom, China, and South Korea contributed 60% of the articles collaboratively. Keyword analysis unveiled three distinct stages in the evolution of EIT algorithm research: the establishment of fundamental algorithm frameworks, optimization for improved imaging performance, and the development of algorithms for clinical applications. Additionally, there has been a shift in research focus from traditional theories to the incorporation of new methods, such as artificial intelligence. Co-cited references suggest that integrating EIT with other established imaging techniques may emerge as a new trend in EIT algorithm research. In summary, EIT algorithms have been a consistent research focus, with current efforts centered on optimizing algorithms to enhance imaging performance. The emerging research trend involves utilizing more diverse and intersecting algorithms.

Fundamentals of Skin Bioimpedances

The bioimpedances of tissues beyond the stratum corneum, which is the outermost layer of skin, contain crucial clinical information. Nevertheless, bioimpedance measurements of both the viable skin and the adipose tissue are not widely used, mainly because of the complex multilayered skin structure and the electrically insulating nature of the stratum corneum. Here, a theoretical framework is established for analyzing the impedances of multilayered tissues and, in particular, of skin. Then, strategies are determined for the system-level design of electrodes and electronics, which minimize 4-wire (or tetrapolar) measurement errors even in the presence of a top insulating tissue, thus enabling non-invasive characterizations of tissues beyond the stratum corneum. As an example, non-invasive measurements of bioimpedances of living tissues are demonstrated in the presence of parasitic impedances which are much (e.g., up to 350 times) higher than the bioimpedances of the living tissues beyond the stratum corneum, independently on extreme variations of the barrier (tape stripping) or of the skin-electrode contact impedances (sweat). The results can advance the development of bioimpedance systems for the characterization of viable skin and adipose tissues in several applications, including transdermal drug delivery and the assessment of skin cancer, obesity, dehydration, type 2 diabetes mellitus, cardiovascular risk, and multipotent adult stem cells.

Implicit Solutions of the Electrical Impedance Tomography Inverse Problem in the Continuous Domain with Deep Neural Networks

Electrical impedance tomography (EIT) is a non-invasive imaging modality used for estimating the conductivity of an object Ω from boundary electrode measurements. In recent years, researchers achieved substantial progress in analytical and numerical methods for the EIT inverse problem. Despite the success, numerical instability is still a major hurdle due to many factors, including the discretization error of the problem. Furthermore, most algorithms with good performance are relatively time consuming and do not allow real-time applications. In our approach, the goal is to separate the unknown conductivity into two regions, namely the region of homogeneous background conductivity and the region of non-homogeneous conductivity. Therefore, we pose and solve the problem of shape reconstruction using machine learning. We propose a novel and simple jet intriguing neural network architecture capable of solving the EIT inverse problem. It addresses previous difficulties, including instability, and is easily adaptable to other ill-posed coefficient inverse problems. That is, the proposed model estimates the probability for a point of whether the conductivity belongs to the background region or to the non-homogeneous region on the continuous space Rd∩Ω with d∈{2,3}. The proposed model does not make assumptions about the forward model and allows for solving the inverse problem in real time. The proposed machine learning approach for shape reconstruction is also used to improve gradient-based methods for estimating the unknown conductivity. In this paper, we propose a piece-wise constant reconstruction method that is novel in the inverse problem setting but inspired by recent approaches from the 3D vision community. We also extend this method into a novel constrained reconstruction method. We present extensive numerical experiments to show the performance of the architecture and compare the proposed method with previous analytic algorithms, mainly the monotonicity-based shape reconstruction algorithm and iteratively regularized Gauss-Newton method.

Deep feature-domain matching for cardiac-related component separation from a chest electrical impedance tomography image series: proof-of-concept study

Objectives.The cardiac-related component in chest electrical impedance tomography (EIT) measurement is of potential value to pulmonary perfusion monitoring and cardiac function measurement. In a spontaneous breathing case, cardiac-related signals experience serious interference from ventilation-related signals. Traditional cardiac-related signal-separation methods are usually based on certain features of signals. To further improve the separation accuracy, more comprehensive features of the signals should be exploited.Approach.We propose an unsupervised deep-learning method called deep feature-domain matching (DFDM), which exploits the feature-domain similarity of the desired signals and the breath-holding signals. This method is characterized by two sub-steps. In the first step, a novel Siamese network is designed and trained to learn common features of breath-holding signals; in the second step, the Siamese network is used as a feature-matching constraint between the separated signals and the breath-holding signals.Main results.The method is first tested using synthetic data, and the results show satisfactory separation accuracy. The method is then tested using the data of three patients with pulmonary embolism, and the consistency between the separated images and the radionuclide perfusion scanning images is checked qualitatively.Significance.The method uses a lightweight convolutional neural network for fast network training and inference. It is a potential method for dynamic cardiac-related signal separation in clinical settings.

Emerging trends and hot spots on electrical impedance tomography extrapulmonary applications

Objective

Electrical impedance tomography (EIT) develops rapidly in technology and applications. Nowadays EIT is used in multiple clinical and experimental scenarios including pulmonary, brain, and tissue monitoring, etc. The present study explores the research trends and hotspots on EIT extrapulmonary application research by bibliometrics analysis.

Approach

Publications on EIT extrapulmonary applications between 1987 and 2021 were retrieved from the Web of Science Core Collection database. For precise screening, search strategy "electrical impedance tomography" plus "hemodynamic" or "brain" or "nerve" or "cancer" or "venous" or "vessel" or "tumor" or "veterinary" or "tissue" or "cell" or "wearable" or "application" and excluding "lung", "ventilation" "respiratory", "pulmonary", "algorithm", "current", "voltage" or "electrode" were used. CiteSpace and VOSviewer were used to analyze the publication features, collaboration, keywords co-occurrence, and co-cited reference.

Main results

A total of 506 articles were finally identified. The global publication numbers on extrapulmonary applications gradually increased yearly in the past 30 years. The US, UK, and China contributed most three publications concerning EIT extrapulmonary applications. "tissues", "conductivity", "model" were research hotspots, and "cutaneous melanoma", "microstructure", "diagnosis" were recent topics (Portions of this research have previously been presented in poster form).

Significance

Overall, EIT extrapulmonary applications bibliometrics analysis provides a unique insight into research focus, current trends, and future directions.

Affordable, portable and self-administrable electrical impedance tomography enables global and regional lung function assessment

Accessibility of diagnostic screening and treatment monitoring devices for respiratory diseases is critical in promoting healthcare and reducing sudden complications and mortality. Spirometry is the standard for diagnosing and monitoring several lung diseases. However, it lacks regional assessment capabilities necessary for detecting subtle regional changes in certain diseases. It also requires challenging breathing maneuvers difficult for elderlies, children, and diseased patients. Here, we actualized an affordable, portable, and self-administrable electrical impedance tomography (EIT) system for home-based lung function assessment and telemedicine. Through simultaneous EIT-spirometry trials on healthy subjects, we demonstrated that our device can predict spirometry indicators over a wide range and can provide regional mapping of these indicators. We further developed a close-to-effortless breathing paradigm and tested it by longitudinally monitoring a COVID-19 discharged subject and two healthy controls with results suggesting the paradigm can detect initial deterioration followed by recovery. Overall, the EIT system can be widely applicable for lung function screening and monitoring both at homes and clinics.

Estimation method for the anisotropic electrical conductivity of in vivo human muscles and fat between 10 kHz and 1 MHz

Objective. In low frequency dosimetry the variability in the electrical conductivity values assigned to body model tissues represents a major source of uncertainty. The aim of this study is to propose a method for estimating the conductivity of human anisotropic skeletal muscle and fat in vivo in the frequency range from 10 kHz to 1 MHz. Approach. A method based on bounded electrical impedance tomography was used. Bioimpedance measurements were performed on the legs of ten subjects. Anatomically realistic models of the legs were then created using magnetic resonance images. The inverse problem of the tissue conductivities was solved using the finite element method. The results were validated using resampling techniques. These findings were also used to study the effects of muscle anisotropy on magnetic field exposure. Main results. The estimated conductivities for anisotropic muscle were found to be in good agreement with values found in existing literature and the anisotropy was shown to decrease with increasing frequency, with the ratio of lateral to longitudinal conductivity increasing from 37% to 64%. The conductivity of fat was found to be almost a constant 0.07 S m−1 in the frequency range considered. Significance. The proposed method was shown to be a viable option when estimating in vivo conductivity of human tissue. The results can be used in numerical dosimetry calculations or as limits in future investigations studying conductivity with bioimpedance measurements.

Study and comparison of different Machine Learning-based approaches to solve the inverse problem in Electrical Impedance Tomographies

Electrical Impedance Tomography (EIT) is a non-invasive technique used to obtain the electrical internal conductivity distribution from the interior of bodies. This is a promising method from the manufacturing viewpoint, since it could be used to estimate different physical inner body properties during the production of goods. Nevertheless, this technique requires dealing with an inverse problem that makes its usage in real-time processes challenging. Recently, Machine Learning techniques have been proposed to solve the inverse problem accurately. However, the majority of prior research is focused on qualitative results, and they typically lack a systematic methodology to determine the optimal hyperparameters appropriately. This work presents a systematic comparison of six popular Machine Learning algorithms: Artificial Neural Network, Random Forest, K-Nearest Neighbors, Elastic Net, Ada Boost, and Gradient Boosting. Particularly, the last two algorithms were based on decision tree learners. Furthermore, we studied the relationship between model performance and different EIT configurations. Specifically, we analyzed whether the measurement pattern and the number of used electrodes could increase the model performance. Experiments revealed that tree-based models present high performance, even better than Neural Networks, the most widely-used Machine Learning model to deal with EIT. Experiments also showed a model performance improvement when the EIT configuration was optimized. Most favorable metrics were attained using the tree-based Gradient Boosting model with a combination of both adjacent and mono measurement patterns as well as with 32 electrodes deployed during the tomographic process. With this particular setting, we achieved an accuracy of 99.14% detecting internal artifacts and a Root Mean Square Error of 4.75 predicting internal conductivity distributions.

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.

Bio-conductivity characteristics of chronic kidney disease stages examined by portable frequency-difference electrical impedance tomography

Chronic kidney disease (CKD) is an escalating global health concern, and non-invasive means for early CKD detection is eagerly awaited. Here, we explore the potential of using home-based frequency-difference electrical impedance tomography (fdEIT) to evaluate CKD based on bio-conductivity characteristics. We first verified the feasibility of using portable EIT capturing bio-conductivity in fresh pig kidneys ex vivo. We further performed bio-conductivity measurement in vivo paired with standard eGFR measurements on CKD patients by EIT and traditional blood test, respectively. Our results showed a significant correlation between renal bio-conductivity changes captured by fdEIT and standard eGFR scores. These results hold promise to be developed into a non-invasive and portable device for early CKD detection and longitudinal CKD treatment monitoring in clinical, community and home-based settings. Clinical Relevance - A novel non-invasive bio-conductivity approach was developed for CKD classification. The renal assessment with portable EIT device demonstrated the potential to ameliorate the detection and classification of CKD into a portable, accessible, self-administrable home-based process.

Majorization–Minimization Total Variation Solution Methods for Electrical Impedance Tomography

Inverse problems arise in many areas of science and engineering, such as geophysics, biology, and medical imaging. One of the main imaging modalities that have seen a huge increase in recent years is the noninvasive, nonionizing, and radiation-free imaging technique of electrical impedance tomography (EIT). Other advantages of such a technique are the low cost and ubiquitousness. An imaging technique is used to recover the internal conductivity of a body using measurements from electrodes from the body’s surface. The standard procedure is to obtain measurements by placing electrodes in the body and measuring conductivity inside the object. A current with low frequency is applied on the electrodes below a threshold, rendering the technique harmless for the body, especially when applied to living organisms. As with many inverse problems, EIT suffers from ill-posedness, i.e., the reconstruction of internal conductivity is a severely ill-posed inverse problem and typically yields a poor-quality solution. Moreover, the desired solution has step changes in the electrical properties that are typically challenging to be reconstructed by traditional smoothing regularization methods. To counter this difficulty, one solves a regularized problem that is better conditioned than the original problem by imposing constraints on the regularization term. The main contribution of this work is to develop a general ℓp regularized method with total variation to solve the nonlinear EIT problem through a iteratively reweighted majorization–minimization strategy combined with the Gauss–Newton approach. The main idea is to majorize the linearized EIT problem at each iteration and minimize through a quadratic tangent majorant. Simulated numerical examples from complete electrode model illustrate the effectiveness of our approach.

Impedance-Optical Dual-Modal Cell Culture Imaging With Learning-Based Information Fusion

While Electrical Impedance Tomography (EIT) has found many biomedicine applications, better image quality is needed to provide quantitative analysis for tissue engineering and regenerative medicine. This paper reports an impedance-optical dual-modal imaging framework that primarily targets at high-quality 3D cell culture imaging and can be extended to other tissue engineering applications. The framework comprises three components, i.e., an impedance-optical dual-modal sensor, the guidance image processing algorithm, and a deep learning model named multi-scale feature cross fusion network (MSFCF-Net) for information fusion. The MSFCF-Net has two inputs, i.e., the EIT measurement and a binary mask image generated by the guidance image processing algorithm, whose input is an RGB microscopic image. The network then effectively fuses the information from the two different imaging modalities and generates the final conductivity image. We assess the performance of the proposed dual-modal framework by numerical simulation and MCF-7 cell imaging experiments. The results show that the proposed method could improve the image quality notably, indicating that impedance-optical joint imaging has the potential to reveal the structural and functional information of tissue-level targets simultaneously.

Electrical Impedance Tomography Technical Contributions for Detection and 3D Geometric Localization of Breast Tumors: A Systematic Review

Impedance measuring acquisition systems focused on breast tumor detection, as well as image processing techniques for 3D imaging, are reviewed in this paper in order to define potential opportunity areas for future research. The description of reported works using electrical impedance tomography (EIT)-based techniques and methodologies for 3D bioimpedance imaging of breast tissues with tumors is presented. The review is based on searching and analyzing related works reported in the most important research databases and is structured according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) parameters and statements. Nineteen papers reporting breast tumor detection and location using EIT were systematically selected and analyzed in this review. Clinical trials in the experimental stage did not produce results in most of analyzed proposals (about 80%), wherein statistical criteria comparison was not possible, such as specificity, sensitivity and predictive values. A 3D representation of bioimpedance is a potential tool for medical applications in malignant breast tumors detection being capable to estimate an ap-proximate the tumor volume and geometric location, in contrast with a tumor area computing capacity, but not the tumor extension depth, in a 2D representation.

Experimental Characterization Techniques for Solid-Liquid Slurry Flows in Pipelines: A Review

In industrial environments, having instrumentation able to attain fast, accurate, and autonomous measurements is pivotal to understanding the dynamics of liquid and particles during transport. Ideally, these instruments, consisting of either probes or sensors, should be robust, fast, and unintrusive, i.e., not cause interference on the very flows being monitored, and require minimal maintenance. Beyond monitoring, the process knowledge gained through real time inspection allows teams to make informed technical decisions based on particle behavior, i.e., settling of particles causing pipe wear and clustering or blockages that can damage the unit or cause shutdowns, both of which with economical drawbacks. The purpose of this review is to examine experimental measurement techniques used to characterize physical properties and operational parameters of solid-liquid slurry flows, focusing on non-ionizing radiation methods. With this text the intent is not to provide an exhaustive examination of each individual technique but rather an overview on the most pertinent types of instrumentation, which will be presented, in addition to application examples from the literature, while directing the reader for pertinent seminal and review papers for a more in-depth analysis.

Electrical impedance tomography for non-invasive identification of fatty liver infiltrate in overweight individuals

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of cardiometabolic diseases in overweight individuals. While liver biopsy is the current gold standard to diagnose NAFLD and magnetic resonance imaging (MRI) is a non-invasive alternative still under clinical trials, the former is invasive and the latter costly. We demonstrate electrical impedance tomography (EIT) as a portable method for detecting fatty infiltrate. We enrolled 19 overweight subjects to undergo liver MRI scans, followed by EIT measurements. The MRI images provided the a priori knowledge of the liver boundary conditions for EIT reconstruction, and the multi-echo MRI data quantified liver proton-density fat fraction (PDFF%) to validate fat infiltrate. Using the EIT electrode belts, we circumferentially injected pairwise current to the upper abdomen, followed by acquiring the resulting surface-voltage to reconstruct the liver conductivity. Pearson's correlation analyses compared EIT conductivity or MRI PDFF with body mass index, age, waist circumference, height, and weight variables. We reveal that the correlation between liver EIT conductivity or MRI PDFF with demographics is statistically insignificant, whereas liver EIT conductivity is inversely correlated with MRI PDFF (R = -0.69, p = 0.003, n = 16). As a pilot study, EIT conductivity provides a portable method for operator-independent and cost-effective detection of hepatic steatosis.

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.

The Research Progress of Electrical Impedance Tomography for Lung Monitoring

Medical imaging can intuitively show people the internal structure, morphological information, and organ functions of the organism, which is one of the most important inspection methods in clinical medical diagnosis. Currently used medical imaging methods can only be applied to some diagnostic occasions after qualitative lesions have been generated, and the general imaging technology is usually accompanied by radiation and other conditions. However, electrical impedance tomography has the advantages of being noninvasive and non-radiative. EIT (Electrical Impedance Tomography) is also widely used in the early diagnosis and treatment of some diseases because of these advantages. At present, EIT is relatively mature and more and more image reconstruction algorithms are used to improve imaging resolution. Hardware technology is also developing rapidly, and the accuracy of data collection and processing is continuously improving. In terms of clinical application, EIT has also been used for pathological treatment of lungs, the brain, and the bladder. In the future, EIT has a good application prospect in the medical field, which can meet the needs of real-time, long-term monitoring and early diagnosis. Aiming at the application of EIT in the treatment of lung pathology, this article reviews the research progress of EIT, image reconstruction algorithms, hardware system design, and clinical applications used in the treatment of lung diseases. Through the research and introduction of several core components of EIT technology, it clarifies the characteristics of EIT system complexity and its solutions, provides research ideas for subsequent research, and once again verifies the broad development prospects of EIT technology in the future.

Wearable Electrical Impedance Tomography Belt With Dry Electrodes

Electrical impedance tomography (EIT) is a noninvasive imaging technology used to reconstruct the conductivity distribution in objects and the human body. In recent years, numerous EIT systems and image reconstruction algorithms have been developed. However, most of these EIT systems require conventional electrodes with conductive gels (wet electrodes) and cannot be adapted to different body types, resulting in limited applicability. In this study, a wearable wireless EIT belt with dry electrodes was designed to enable EIT imaging of the human body without using wet electrodes. The specific design of the belt mechanism and dry electrodes provide the advantages of easy wear and adaptation to different body sizes. Additionally, the GaussNewton method was used to optimize the EIT image. Finally, experiments were performed on the phantom and human body to validate the performance of the proposed EIT belt. The results demonstrate that the proposed system can provide accurate location information of the objects in the EIT image and the system can be successfully applied for noninvasive measurement of the human body.

Urinary Bladder Volume Monitoring Using Magnetic Induction Tomography: A Rotational Simulation Model for Anatomical Slices within the Pelvic Region

Urinary bladder volume monitoring can benefit from contactless measurements, as alternative to the traditional medical methods of transurethral catheterization or ultrasound examination. The emerging modality of Magnetic Induction Tomography (MIT) offers the possibility for estimation of the intravesical volume in the physiological and pathological states using conductivity map reconstructions of the tissues present in the pelvic region. Within MIT, eddy currents originating from the conductive urine can produce their own magnetic field in response to an external magnetic source that is susceptible of being detected outside the body by means of a static ring of sensing coils. However, the ill-conditioned and ill-posed nature of the MIT Inverse Problem make the numerical implementation and conductivity estimation highly laborious. In this paper, we present a rotational frame model based on the MIT principles with application in urodynamic studies, which allows to extend the number of contactless measurements without increasing the overall dimension of the simulation domain, at the expense of solving multiple MIT Forward Problems. On the inversion process, the single-step Gauss-Newton method with Laplacian regularizer is recruited to estimate the bladder volume non-invasively and remotely (estimation error of 19%), paving the way for this technique to surpass the current limitations found in intravesical volume monitoring in quasi-real time.

Noninvasive visualization of electrical conductivity in tissues at the micrometer scale

Despite its importance in regulating cellular or tissue function, electrical conductivity can only be visualized in tissue indirectly as voltage potentials using fluorescent techniques, or directly with radio waves. These either requires invasive procedures like genetic modification or suffers from limited resolution. Here, we introduce radio-frequency thermoacoustic mesoscopy (RThAM) for the noninvasive imaging of conductivity by exploiting the direct absorption of near-field ultrashort radio-frequency pulses to stimulate the emission of broadband ultrasound waves. Detection of ultrasound rather than radio waves enables micrometer-scale resolutions, over several millimeters of tissue depth. We confirm an imaging resolution of <30 μm in phantoms and demonstrate microscopic imaging of conductivity correlating to physical structures in 1- and 512-cell zebrafish embryos, as well as larvae. These results support RThAM as a promising method for high-resolution, label-free assessment of conductivity in tissues.

Bedside noninvasive monitoring of mechanically ventilated patients

PURPOSE OF REVIEW

Among noninvasive lung imaging techniques that can be employed at the bedside electrical impedance tomography (EIT) and lung ultrasound (LUS) can provide dynamic, repeatable data on the distribution regional lung ventilation and response to therapeutic manoeuvres.In this review, we will provide an overview on the rationale, basic functioning and most common applications of EIT and Point of Care Ultrasound (PoCUS, mainly but not limited to LUS) in the management of mechanically ventilated patients.

RECENT FINDINGS

The use of EIT in clinical practice is supported by several studies demonstrating good correlation between impedance tomography data and other validated methods of assessing lung aeration during mechanical ventilation. Similarly, LUS also correlates with chest computed tomography in assessing lung aeration, its changes and several pathological conditions, with superiority over other techniques. Other PoCUS applications have shown to effectively complement the LUS ultrasound assessment of the mechanically ventilated patient.

SUMMARY

Bedside techniques - such as EIT and PoCUS - are becoming standards of the care for mechanically ventilated patients to monitor the changes in lung aeration, ventilation and perfusion in response to treatment and to assess weaning from mechanical ventilation.

Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges

Recent advances in hemodynamic monitoring have seen the advent of non-invasive methods which offer ease of application and improve patient comfort. Bioimpedance Analysis or BIA is one of the currently employed non-invasive techniques for hemodynamic monitoring. Impedance Cardiography (ICG), one of the implementations of BIA, is widely used as a non-invasive procedure for estimating hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Even though BIA is not a new diagnostic technique, it has failed to gain consensus as a reliable measure of hemodynamic parameters. Several devices have emerged for estimating CO using ICG which are based on evolving methodologies and techniques to calculate SV. However, the calculations are generally dependent on the electrode configurations (whole body, segmental or localised) as well as the accuracy of different techniques in tracking blood flow changes. Blood volume changes, concentration of red blood cells, pulsatile velocity profile and ambient temperature contribute to the overall conductivity of blood and hence its impedance response during flow. There is a growing interest in investigating limbs for localised BIA to estimate hemodynamic parameters such as pulse wave velocity. As such, this paper summarises the current state of hemodynamic monitoring through BIA in terms of different configurations and devices in the market. The conductivity of blood flow has been emphasized with contributions from both volume and velocity changes during flow. Recommendations for using BIA in hemodynamic monitoring have been mentioned highlighting the suitable range of frequencies (1 kHz-1 MHz) as well as safety considerations for a BIA setup. Finally, current challenges in using BIA such as geometry assumption and inaccuracies have been discussed while mentioning potential advantages of a multi-frequency analysis to cover all the major contributors to blood's impedance response during flow.

Bioimpedance Spectroscopy: Basics and Applications

In this review, we aim to introduce the reader to the technique of electrical impedance spectroscopy (EIS) with a focus on its biological, biomaterials, and medical applications. We explain the theoretical and experimental aspects of the EIS with the details essential for biological studies, i.e., interaction of metal electrodes with biological matter and liquids, strategies of measurement rate increasing, noise reduction in bio-EIS experiments, etc. We also give various examples of successful bio-EIS practical implementations in science and technology, from whole-body health monitoring and sensors for vision prosthetic care to single living cell examination platforms, virus disease research, biomolecules detection, and implementation of novel biomaterials. The present review can be used as a bio-EIS tutorial for students as well as a handbook for scientists and engineers because of the extensive references covering the contemporary research papers in the field.

Using electrical impedance tomography for rapid determination of starch and soluble sugar contents in Rosa hybrida

Soluble sugars and starches are important metabolites of plant life and physiological markers of plant stress response. There is an urgent need to develop a non-destructive and rapid method for determining plant starch and soluble sugar contents. Electrical impedance tomography (EIT) technology has been used to determine the physiological state and cold resistance of select plant tissues. However, so far there have been no reports on the use of EIT for the rapid estimation of soluble sugar and starch contents. In this study, EIT was used to obtain reconstructed voltage values and estimate starch and soluble sugar contents in the stems of three Rosa hybrida cultivars during February to May, which were grown in the Specimen Park (38° 50′ N, 115° 26′ E) of Hebei Agricultural University, Baoding City, Hebei Province, China. Stems from two of the cultivars were used for establishing regression models for starch and soluble sugar contents as functions of reconstructed voltage values. The third cultivar was used to test the accuracy of the regression models. The quadratic regression model was best for determining soluble sugar content and the logarithmic regression model was best for determining starch content. Thus, this research provided technical support for using EIT to analyze changes in physiological parameters and to rapidly estimate physiological indexes of plants. More studies were now needed to validate the results in this paper.

Research on the measurement of intracranial hemorrhage in rabbits by a parallel-plate capacitor

Intracranial hemorrhage (ICH) carrying extremely high morbidity and mortality can only be detected by CT, MRI and other large equipment, which do not meet the requirements for bedside continuous monitoring and pre-hospital first aid. Since the biological tissues have different dielectric properties except the pure resistances, and the permittivity of blood is far larger than that of other brain tissues, here a new method was used to detect events of change at the blood/tissue volume ratio by measuring of the head permittivity. In this paper, we use a self-made parallel plate capacitor to detect the intracranial hemorrhage in rabbits by contactless capacitance measurement. The sensitivity of the parallel-plate capacitor was also evaluated by the physical solution measurement. The results of physical experiments show that the capacitor can distinguish between three solutions with different permittivity, and the capacitance increased with the increase of one solution between two plates. At the next step in the animal experiment, the capacitance changes caused by 2 ml blood injection into the rabbit brain were measured. The results of animal experiments show that the capacitance was almost unchanged before and after the blood injection, but increased with the increase of the blood injection volume. The increase of capacitance caused by blood injection was much larger than that before and after blood injection (P < 0.01). The experiments show that this method is feasible for the detection of intracranial hemorrhage in a non-invasive and contactless manner.

A novel bounded EIT protocol to generate inhomogeneous skull conductivity maps non-invasively

Electrical Impedance Tomography (EIT) can be used to estimate the electrical properties of the head tissues in a parametric approach. This modality is called parametric EIT or bounded EIT (bEIT). Typical bEIT protocols alternate between several current injection patterns with two current injection electrodes each: one source and one sink ("1-to-1"), while the rest of the electrodes measure the resulting electric potential. Then, one value of conductivity per tissue (e.g. scalp and/or skull) is estimated independently for each current injection pair. With these protocols, it is difficult to obtain local estimates of the skull tissue. Thus, the grand average of the estimates obtained from each pair is assigned to each tissue modeling them as homogeneous. However, it is known that these tissues are inhomogeneous within the same subject. We propose the use of current injection patterns with one source and many sinks ("1to-N") located at the opposite side of the head to build individual and inhomogeneous skull conductivity maps. We validate the method with simulations and compare its performance with equivalent maps generated by using the classical "1-to-1" patterns. The map generated by the novel method shows better spatial correlation with the more conductive spongy bone presence.Clinical Relevance- The novel bEIT protocol allows to map individual head models with spatially resolved skull conductivities in vivo and non-invasively for use in electroencephalography (EEG) source localization, transcranial electrical stimulation (TES) dose calculations and TES pattern optimization, without the risk of ionizing radiation associated with computed tomography (CT) scans.

Investigating Electrical Impedance Spectroscopy for Estimating Blood Flow-Induced Variations in Human Forearm

This work aims to investigate the feasibility of employing multi-frequency bioimpedance analysis for hemodynamic assessment. Towards this, we aim to explore one of its implementations, electrical impedance spectroscopy (EIS), for estimating changes in radial artery diameter due to blood flow. Following from our previous investigations, here, we use a commercial device-the Quadra^® Impedance Spectroscopy device-for impedance measurements of the forearm of three subjects under normal conditions and occluding the artery with a cuff. This was performed simultaneously with ultrasound measurements as a reference. The impedance spectra were measured over time, yielding waveforms reflecting changes due to blood flow. Contributions from the fat/muscle domains were accounted for using the occluded impedance response, resulting in arterial impedance. A modified relationship was approximated to calculate the diameter from the arterial impedance, which showed a similarity with ultrasound measurements. Comparison with the ultrasound measurements revealed differences in phase and amplitude, primarily due to the approximated relationship between impedance and diameter and neglecting the impedance phase analysis. This work shows the potential of EIS, with improvements, towards estimating blood flow-induced variation in arteries. Further analysis and improvements could help place this technology in mainstream clinical practice for hemodynamic monitoring.

Cole-impedance parameters representing biceps tissue bioimpedance in healthy adults and their alterations following eccentric exercise

The purpose of this study is to identify if participation in an eccentric exercise protocol altered the Cole-impedance model parameters that represent localized bicep tissue bioimpedance. This supports continued efforts to identify which features of tissue bioimpedance may be effective markers to non-invasively identify skeletal muscle damage. Here, the Cole-impedance model parameters that best fit the localized electrical impedance of exercised (using an eccentric stimulus) and unexercised biceps of 6 participants (collected before, immediately after and at 24 h, 48 h, 72 h and 96 h) are determined using a numerical optimization technique. Statistical tests comparing the pre-exercise and post-exercise model parameters report significant decreases in R ∞ and R 1 with significant increases in C at 72 h and 96 h post-exercise for exercised biceps (aligning with noted periods of peak swelling). These changes in R ∞ , R 1 , and C were not observed in the unexercised biceps. These results support that the C parameter of the Cole-impedance model fit to bioimpedance data may be a suitable marker for identifying skeletal muscle damage.

Simple Wireless Impedance Pneumography System for Unobtrusive Sensing of Respiration

This extended paper presents the development and implementation at a prototype level of a wireless, low-cost system for the measurement of the electrical bioimpedance of the chest with two channels using the AD5933 in a bipolar electrode configuration to measure impedance pneumography. The measurement device works for impedance measurements ranging from 1 Ω to 1800 Ω. Fifteen volunteers were measured with the prototype. We found that the left hemithorax has higher impedance compared to the right hemithorax, and the acquired signal presents the phases of the respiratory cycle with variations between 1 Ω, in normal breathing, to 6 Ω in maximum inhalation events. The system can measure the respiratory cycle variations simultaneously in both hemithorax with a mean error of -0.18 ± 1.42 BPM (breaths per minute) in the right hemithorax and -0.52 ± 1.31 BPM for the left hemithorax, constituting a useful device for the breathing rate calculation and possible screening applications.

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.

Design of Bio-Impedance Electrode Topologies for Specific Depth Sensing in Skin Layer

Bio-impedance analysis provides non-invasive estimation of body composition. Recently, applications based on bio-impedance measurement in skin tissue such as skin cancer diagnosis and skin composition monitoring have been studied. For scanning the electrical properties along the skin depth, the relationship between the electrode topologies and the depth sensitivity should be clarified. This work reports a systematic analysis on designing line electrode topologies to measure the bio-impedance of the skin layer at specific depth using a finite element method (FEM). Four electrodes consisting of two outer current electrodes and two inner voltage electrodes in the form of Wenner-Schlumberger array were employed on the top of a collagen layer as a skin model. The numerical results demonstrate a change in the effective depth of measurement depending on the electrode topologies, which also have a good agreement with an analytic solution. This study suggests a decision guideline for designing the electrode topologies to achieve target depth sensitivity in bio-impedance measurement of skin tissue.Clinical Relevance-This establishes the effect of electrode topologies on depth sensitivity in bio-impedance measurements in skin layer.

An Optimal Electrical Impedance Tomography Drive Pattern for Human-Computer Interaction Applications

In this article, we presented an optimal Electrical Impedance Tomography (EIT) drive pattern based on feature selection and model explanation, and proposed a portable EIT system for applications in human-computer interaction for gesture recognition and contact detection, which can reduce the measurement time and realize a performance trade-off between the accuracy and the time response. In our experiment, eleven hand gestures were designed to verify the proposed approach and EIT system. Compared to the traditional eight-electrode method, the optimal electrode drive pattern achieved a recognition accuracy of 97.5% with seven electrodes and the measurement time was reduced by 60%. To illustrate the universality of this method, we performed a contact detection experiment. By setting seven labels on the conductive panel and using optimal electrode drive pattern, the detection accuracy reached 100% with seven electrodes and the measurement time was reduced by 85%.

Measurement in opaque flows: a review of measurement techniques for dispersed multiphase flows

A review is presented of measurement techniques to characterise dispersed multiphase flows, which are not accessible by means of conventional optical techniques. The main issues that limit the accuracy and effectiveness of optical techniques are briefly discussed: cross-talk, a reduced signal-to-noise ratio, and (biased) data drop-out. Extensions to the standard optical techniques include the use of fluorescent tracers, refractive index matching, ballistic imaging, structured illumination, and optical coherence tomography. As the first non-optical technique, a brief discussion of electrical capacitance tomography is given. While truly non-invasive, it suffers from a low resolving power. Ultrasound-based techniques have rapidly evolved from Doppler-based profiling to recent 2D approaches using feature tracking. The latter is also suitable for time-resolved flow studies. Magnetic resonance velocimetry can provide time-averaged velocity fields in 3D for the continuous phase. Finally, X-ray imaging is demonstrated to be an important tool to quantify local gas fractions. While potentially very powerful, the impact of the techniques will depend on the development of acquisition and measurement protocols for fluid mechanics, rather than for clinical imaging. This requires systematic development, aided by careful validation experiments. As theoretical predictions for multiphase flows are sparse, it is important to formulate standardised 'benchmark' flows to enable this validation.

Sandblasting improves the performance of electrodes of miniature electrical impedance tomography via double layer capacitance

Effect of sandblasting of the copper electrode structures before deposition of gold thin film for micro electrical impedance tomography (EIT) system has been studied experimentally. The comparison has been performed on the unmodified copper electrodes and the sandblasted electrodes before deposition of gold layer, using structural analysis while their performance in EIT system has been measured and analyzed. The results of scanning electron microscopy and atomic force microscopy show that the sandblasting of the electrodes results in the deposition of gold film with smaller grain size and uniformly, comparing to the unmodified structure. The measurement of impedance shows that the sandblasting will increase the double layer capacitance of electrode structure which improves the impedance measurement accordingly.

Wireless Low-Cost Bioimpedance Measurement Device for Lung Capacity Screening

This paper presents the development and implementation at a prototype level of a wireless, low-cost system for the measurement of the electrical bio-impedance of the chest with two channels using the AD5933 in a bipolar electrode configuration to measure lung volume variation. 15 volunteers were measured with the prototype, and the acquired signal presents the phases of the respiratory cycle, useful for the breathing rate calculation and for possible screening applications.

Towards a thoracic conductive phantom for EIT

Phantom experiments are a crucial step for testing new hardware or imaging algorithms for electrical impedance tomography (EIT) studies. However, constructing an accurate phantom for EIT research remains critical; some studies have attempted to model the skull and breasts, and even fewer, as yet, have considered the thorax. In this study, a critical comparison between the electrical properties (impedance) of three materials is undertaken: a polyurethane foam, a silicone mixture and a thermoplastic polyurethane filament. The latter was identified as the most promising material and adopted for the development of a flexible neonatal torso. The validation is performed by the EIT image reconstruction of the air filled cavities, which mimic the lung regions. The methodology is reproducible for the creation of any phantom that requires a slight flexibility.

Assessment of Work of Breathing in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

The assessment of the work of breathing (WOB) of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) is difficult, particularly when the patient first presents with acute hypercapnia and respiratory acidosis. Acute exacerbations of COPD patients are in significant respiratory distress and noninvasive measurements of WOB are easier for the patient to tolerate. Given the interest in using alternative therapies to noninvasive ventilation, such as high flow nasal oxygen therapy or extracorporeal carbon dioxide removal, understanding the physiological changes are key and this includes assessment of WOB. This narrative review considers the role of three different methods of assessing WOB in patients with acute exacerbations of COPD. Esophageal pressure is a very well validated measure of WOB, however the ability of patients with acute exacerbations of COPD to tolerate esophageal tubes is poor. Noninvasive alternative measurements include parasternal electromyography (EMG) and electrical impedance tomography (EIT). EMG is easily applied and is a well validated measure of neural drive but is more likely to be degraded by the electrical environment in intensive care or high dependency. EIT is less well validated as a tool for WOB in COPD but extremely well tolerated by patients. Each of the different methods assess WOB in a different way and have different advantages and disadvantages. For research into therapies treating acute exacerbations of COPD, combinations of EIT, EMG and esophageal pressure are likely to be better than only one of these.

A Power Adaptive, 1.22-pW/Hz, 10-MHz Read-Out Front-End for Bio-Impedance Measurement

This paper presents a read-out front-end application-specific integrated circuit (ASIC) for the measurement of tissue impedances. The 10 mm² 2-channel front-end ASIC is fabricated in a 0.18 μm CMOS technology. The measurement results show that the proposed ASIC operates over a frequency range of 100 Hz up to 10 MHz. The ASIC has 1.22 pW/Hz power performance, with an SNR over 72 dB for frequencies ≤ 1 MHz, and over 65 dB SNR for frequencies ≥ 1 MHz. The total measured power consumption of the read-out front-end is shown to range from 2.1 to 21.7 mW depending on the input frequency. To achieve a wide dynamic range, the instrumentation amplifier has an adaptive gain control feature, and it employs programmable bias currents and reconfigurable structure to save power while processing low-frequency signals. A dual digital-to-analog converter (DAC) hybrid SAR analog-to-digital converter (ADC) is presented that reduces the power consumption of the ADC driver by sevenfold for frequencies between 4 kHz and 1 MHz.

Extracorporeal carbon dioxide removal for acute hypercapnic exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial

Background

Chronic obstructive pulmonary disease (COPD) is a common cause of chronic respiratory failure and its course is punctuated by a series of acute exacerbations which commonly lead to hospital admission. Exacerbations are managed through the application of non-invasive ventilation and, when this fails, tracheal intubation and mechanical ventilation. The need for mechanical ventilation significantly increases the risk of death. An alternative therapy, extracorporeal carbon dioxide removal (ECCO₂R), has been shown to be efficacious in removing carbon dioxide from the blood; however, its impact on respiratory physiology and patient outcomes has not been explored.

Methods/design

A randomised controlled open label trial of patients (12 in each arm) with acute exacerbations of COPD at risk of failing conventional therapy (NIV) randomised to either remaining on NIV or having ECCO₂R added to NIV with a primary endpoint of time to cessation of NIV. The change in respiratory physiology following the application of ECCO₂R and/or NIV will be measured using electrical impedance tomography, oesophageal pressure and parasternal electromyography. Additional outcomes, including patient tolerance, outcomes, need for readmission, changes in blood gases and biochemistry and procedural complications, will be measured. Physiological changes will be compared within one patient over time and between the two groups. Healthcare costs in the UK system will also be compared between the two groups.

Discussion

COPD is a common disease and exacerbations are a leading cause of hospital admission in the UK and worldwide, with a sizeable mortality. The management of patients with COPD consumes significant hospital and financial resources. This study seeks to understand the feasibility of a novel approach to the management of patients with acute exacerbations of COPD as well as to understand the underlying physiological changes to explain why the approach does or does not assist this patient cohort. Detailed respiratory physiology has not been previously undertaken using this technique and there are no other randomised controlled trials currently in the literature.

Trial registration

ClinicalTrials.gov, NCT02086084.

Electronic supplementary material

The online version of this article (10.1186/s13063-019-3548-4) contains supplementary material, which is available to authorized users.

Microelectrode array electrical impedance tomography for fast functional imaging in the thalamus

Electrical Impedance Tomography (EIT) has the potential to be able to observe functional tomographic images of neural activity in the brain at millisecond time-scales. Prior modelling and experimental work has shown that EIT is capable of imaging impedance changes from neural depolarisation in rat somatosensory cortex. Here, we investigate the feasibility of EIT for imaging impedance changes using a stereotaxically implanted microelectrode array in the thalamus. Microelectrode array EIT was simulated using an anatomically accurate marmoset brain model. Impedance imaging was validated and detectability estimated using physiological noise recorded from the marmoset visual thalamus. The results suggest that visual-input-driven impedance changes in visual subcortical bodies within 300 μm of the implanted array could be reliably reconstructed and localised, comparable to local field potential measurements. Furthermore, we demonstrated that microelectrode array EIT could reconstruct concurrent activity in multiple subcortical bodies simultaneously.

Real-Time Identification of Upper Airway Occlusion Using Electrical Impedance Tomography

STUDY OBJECTIVES

Real-time monitoring of upper airway collapse during sleep could be instrumental for studies in biomechanics of obstructive sleep apnea (OSA) and selecting individualized treatment modalities. Although some imaging techniques are used under sedated sleep, none are available during the entire natural sleep process. We hypothesized that electrical impedance tomography (EIT) can be used for noninvasive continuous imaging of the upper airway during natural sleep and quantifying upper airway collapse in terms of its size.

METHODS

After determining surface landmarks to attach the electrodes for monitoring the retroglossal airway, EIT was conducted in 10 healthy participants. As a feasibility test of EIT in detecting upper airway collapse, transient airway closure was induced by the swallowing maneuver. These EIT images were confirmed by simultaneous magnetic resonance imaging (MRI) scans. Subsequently, EIT scans were conducted in 7 healthy participants and 10 patients with OSA under nonsedated sleep to determine whether it could identify upper airway narrowing or collapse. Respiratory events were identified by concurrent polysomnography (PSG).

RESULTS

Swallowing-induced airway closure was identified successfully in all 10 participants on simultaneous EIT and MRI scans. Sizes and positions of the upper airway closures in reconstructed EIT images were well correlated with those in magnetic resonance images. Obstructive hypopnea and apnea were detected successfully by EIT in 10 patients with OSA, and no significant changes in EIT data were observed in 7 healthy participants during concurrent EIT and PSG tests. Additionally, conductivity changes in the airway were greater during obstructive apnea than during hypopnea (64.3% versus 26.3%, respectively; P < .001) compared with those during baseline respiration.

CONCLUSIONS

EIT could be a useful real-time monitoring device for detecting upper airway narrowing or collapse during natural sleep in patients with OSA. Currently, changes in the upper airway size can be estimated with good accuracy, but shape estimation needs future improvements in the EIT image quality.

A Smart Wireless Ear-Worn Device for Cardiovascular and Sweat Parameter Monitoring During Physical Exercise: Design and Performance Results

Wearable biomedical technology has gained much support lately as devices have become more affordable to the general public and they can easily interact with mobile phones and other platforms. The feasibility and accuracy of the data generated by these devices so as to replace the standard medical methods in use today is still under scrutiny. In this paper, we present an ear-worn device to measure cardiovascular and sweat parameters during physical exercise. ECG bipolar recordings capture the electric potential around both ears, whereas sweat rate is estimated by the impedance method over one segment of tissue closer to the left ear, complemented by the measurement of the lactate and pH levels using amperiometric and potentiometric sensors, respectively. Together with head acceleration, the acquired data is sent to a mobile phone via BLE, enabling extended periods of signal recording. Results obtained by the device have shown a SNR level of 18 dB for the ECG signal recorded around the ears, a THD value of −20.46 dB for the excitation signal involved in impedance measurements, sweat conductivity of 0.08 S/m at 1 kHz and sensitivities of 50 mV/pH and 0.8 μA/mM for the pH and lactate acquisition channels, respectively. Testing of the device was performed in human subjects during indoors cycling with characteristic level changes.

Monitoring of regional lung ventilation using electrical impedance tomography

Among recent lung imaging techniques and devices, electrical impedance tomography (EIT) can provide dynamic information on the distribution regional lung ventilation. EIT images possess a high temporal and functional resolution allowing the visualization of dynamic physiological and pathological changes on a breath-by-breath basis. EIT detects changes in electric impedance (i.e., changes in gas/fluid ratio) and describes them in real time, both visually through images and waveforms, and numerically, allowing the clinician to monitor disease evolution and response to treatment. The use of EIT in clinical practice is supported by several studies demonstrating a good correlation between impedance tomography data and other validated methods of measuring lung volume. In this review, we will provide an overview on the rationale, basic functioning and most common applications of EIT in the management of mechanically ventilated patients.

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.

Magnetic Manipulation of Blood Conductivity with Superparamagnetic Iron Oxide-Loaded Erythrocytes

The active and passive electrophysiological properties of blood and tissue have been utilized in a vast array of clinical techniques to noninvasively characterize anatomy and physiology and to diagnose a wide variety of pathologies. However, the accuracy and spatial resolution of such techniques are limited by several factors, including an ill-posed inverse problem, which determines biological parameters and signal sources from surface potentials. Here, we propose a method to noninvasively modulate tissue conductivity by aligning superparamagnetic iron oxide-loaded erythrocytes with an oscillating magnetic field. A prototype device is presented, which incorporates a three-dimensional set of Helmholtz coil pairs and fluid-channel-embedded electrode arrays. Alignment of loaded cells (∼11 mM iron) within a field of 12 mT is demonstrated, and this directed reorientation is shown to alter the conductivity of blood by ∼5 and ∼0.5% for stationary and flowing blood, respectively, within fields as weak as 6-12 mT. Focal modulation of conductivity could drastically improve numerous bioimpedance-based detection modalities.