Adrian J. Wilson

The sensitivity of focused electrical impedance measurements.

One of the problems with tetrapolar impedance measurements is the lack of spatial sensitivity within the measured volume. In this paper we compare the sensitivity of tetrapolar measurements and the focused impedance measurements (FIM) proposed by Rabbani et al (1999 Ann. New York Acad. Sci. 873 408-20), which give an improved sensitivity profile. Using a previously validated model of sensitivity based on Geselowitzs lead theory, the sensitivity of FIM using eight, six and four electrodes was investigated. All electrode configurations showed a maximum in the average sensitivity of a plane at a depth of one-third of the drive-receive electrode spacing. No difference was found in the sensitivity value of this maximum between electrode configurations having the same drive-receive electrode spacing. The six- and eight-electrode configurations showed negative sensitivity regions down to half of the drive-receive electrode spacing, whilst the four-electrode measurement showed negative sensitivity regions down to one-third of the drive-receive electrode spacing. The single peak in sensitivity beneath the centre of the electrode configuration became dominant at 0.56, 1.4 and 0.14 of the receive electrode spacing for the eight-, six- and four-electrode configurations respectively. Thus, the four-electrode FIM configuration gives a single peak closest to the surface.

The possible use of combined electrical impedance and ultrasound velocity measurements for the non-invasive measurement of temperature during mild hyperthermia

This paper explores the possibility of using combined measurements of electrical impedance and changes in ultrasound time of flight for determining deep body temperature during mild hyperthermia. Simultaneous electrical impedance spectra (1 kHz-1024 kHz) and ultrasound time-of-flight measurements were made on layered sheep liver and fat tissue samples as the temperature was increased from 30-50 °C. The change in propagation velocity for 100% fat and 100% liver samples was found to vary linearly with temperature and the temperature coefficient of the time-of-flight was shown to vary linearly with the % fat in the sample (0.009% °C-1%-1). Tetrapolar impedance measurements normalized to 8 kHz were shown to have a small sensitivity to temperature for both liver (0.001% °C-1 ≤ 45 °C) and fat (0.002% °C-1 ≤ 512 kHz) and the best linear correlation between the normalized impedance and the % fat in the sample was found at 256 kHz (gradient 0.026%-1, r2 = 0.65). A bootstrap analysis on 15 layered tissue samples evaluated using the normalized impedance at 256 kHz to determine the % fat in the sample and the temperature coefficient of the time of flight to determine the temperature. The results showed differences (including some large differences) between the predicted and measured temperatures and an error evaluation identified the possible origins of these.

A computer model of the artificially ventilated human respiratory system in adult intensive care

A multi-technique approach to modelling artificially ventilated patients on the adult general intensive care unit (ICU) is proposed. Compartmental modelling techniques were used to describe the mechanical ventilator and the flexible hoses that connect it to the patient. 3D CFD techniques were used to model flow in the major airways and a Windkessel style balloon model was used to model the mechanical properties of the lungs. A multi-compartment model of the lung based on bifurcating tree structures representing the conducting airways and pulmonary circulation allowed lung disease to be modelled in terms of altered V/Q ratios within a lognormal distribution of values and it is from these that gas exchange was determined. A compartmental modelling tool, Bathfp, was used to integrate the different modelling techniques into a single model. The values of key parameters in the model could be obtained from measurements on patients in an ICU whilst a sensitivity analysis showed that the model was insensitive to the value of other parameters within it. Measured and modelled values for arterial blood gases and airflow parameters are compared for 46 ventilator settings obtained from 6 ventilator dependent patients. The results show correlation coefficients of 0.88 and 0.85 for the arterial partial pressures of the O(2) and CO(2), respectively (p<0.01) and of 0.99 and 0.96 for upper airway pressure and tidal volume, respectively (p<0.01). The difference between measured and modelled values was large in physiological terms, suggesting that some optimisation of the model is required.

Quantification of lung injury using ventilation and perfusion distributions obtained from gamma scintigraphy

This paper explores the potential of isotope V/Q lung scans to quantify lung disease. Areas of restricted perfusion in subjects with a pulmonary embolus (PE) were identified in 3D reconstructions of V/Q images achieved using anatomical data from the Visible Human Project. From these, the extent of lung damage was quantified. Significant differences in the values of both LogSD V and LogSD Q (p > 0.05) obtained from plots of V and Q against Log(V/Q) were found between normal subjects and subjects with a PE, but no correlation was found between either of these parameters and the degree of lung damage in subjects with a PE (p > 0.05). Whilst V/Q values were log normally distributed, the V/Q distributions from the subjects with a PE failed to show the bimodal distribution predicted from theoretical considerations and MIGET measurements previously reported. There was a statistically significant difference in the mean and standard deviation values of the V/Q distributions between normal subject and subjects with a PE (p < 0.05) but not in the median values (p > 0.05). There was no correlation between the mean, median and standard deviation of the distributions from the subjects with a PE and the percentage of damage present (p > 0.05).

A Novel Passive Movement Method for Parameter Estimation of a Musculoskeletal Arm Model Incorporating a Modified Hill Muscle Model

Abstract In this paper we present a method of parameterising a two muscle arm model incorporating a structurally identifiable modified Hill muscle model. Length and moment of inertia values were obtained by direct measurement and calculation. Spring and damping parameters in the model were determined by parameter estimation from experiments using passive flexion and extension movements. The results showed good agreement between measured and simulated data with consistent parameter values across subjects. Adding a hand load improved the agreement by reducing errors resulting from body segment geometry assumptions.

Theoretical models for the quantification of lung injury using ventilation and perfusion distributions

This paper describes two approaches to modelling lung disease: one based on a multi-compartment statistical model with a log normal distribution of ventilation perfusion ratio ([image omitted]) values; and the other on a bifurcating tree which emulates the anatomical structure of the lung. In the statistical model, the distribution becomes bimodal, when the [image omitted] values of a randomly selected number of compartments are reduced by 85% to simulate lung disease. For the bifurcating tree model a difference in flow to the left and right branches coupled with a small random variation in flow ratio between generations results in a log normal distribution of flows in the terminal branches. Restricting flow through branches within the tree to simulate lung disease transforms this log normal distribution to a bi-modal one. These results are compatible with those obtained from experiments using the multiple inert gas elimination technique, where log normal distributions of [image omitted] ratio become bimodal in the presence of lung disease.

Quantification of 18FDG in the Normal Colon-A First Step in Investigating Whether Its Presence Is a Marker of a Physiological Process.

The visibility of the colon in positron emission tomography (PET) scans of patients without gastrointestinal disease indicating the presence of 18F Fluorodeoxyglucose (18FDG) is well recognised, but unquantified and unexplained. In this paper a qualitative scoring system was applied to PET scans from 30 randomly selected patients without gastrointestinal disease to detect the presence of 18FDG in 4 different sections of the colon and then both the total pixel value and the pixel value per unit length of each section of the colon were determined to quantify the amount of 18FDG from a randomly selected subset of 10 of these patients. Analysis of the qualitative scores using a non-parametric ANOVA showed that all sections of the colon contained 18FDG but there were differences in the amount of 18FDG present between sections (p<0.05). Wilcoxon matched-pair signed-rank tests between pairs of segments showed statistically significant differences between all pairs (p<0.05) with the exception of the caecum and ascending colon and the descending colon. The same non-parametric statistical analysis of the quantitative measures showed no difference in the total amount of 18FDG between sections (p>0.05), but a difference in the amount/unit length between sections (p<0.01) with only the caecum and ascending colon and the descending colon having a statistically significant difference (p<0.05). These results are consistent since the eye is drawn to focal localisation of the 18FDG when qualitatively scoring the scans. The presence of 18FDG in the colon is counterintuitive since it must be passing from the blood to the lumen through the colonic wall. There is no active mechanism to achieve this and therefore we hypothesise that the transport is a passive process driven by the concentration gradient of 18FDG across the colonic wall. This hypothesis is consistent with the results obtained from the qualitative and quantitative measures analysed.

Measurement and modelling the sensitivity of tetrapolar transfer impedance measurements.

Finite element method (FEM) modelling of a small disk in a homogeneous saline medium showed that the sensitivity distribution for tetrapolar transfer impedance measurements was dependant on the ratio, σdisk/σsaline, and not absolute conductivity values. In addition, the amplitude of the negative sensitivity regions between the drive and receive electrodes decreased non-linearly with σdisk/σsaline for σdisk/σsaline < 1, eventually becoming zero. This non-linear behaviour determined the limit of the assumption of a small change in conductivity in Geselowitzs lead theorem with 0.5 <σdisk/σsaline <1.5 for the measurements reported. The modelling supported the design of a sensitivity measurement system using an insulating support and a metal disk in a saline filled tank. Measurements were shown to give good agreement with sensitivity predictions from Geselowitzs lead theorem. Replacing the homogeneous medium in the FEM model with layers of different conductivity parallel to the plane of the electrodes changed the sensitivity distribution when the thickness of the layers adjacent to the electrodes were less than ½ the electrode spacing. A layer of greater conductivity over a layer of lesser conductivity next to the electrodes gave a peak in the sensitivity distribution and extended regions of negative sensitivity further into the tissue.

18F-Fluorodeoxyglucose: the Trojan horse of PET/CT.

In our paper [1], we present the results of two Friedman tests. Neither was applied to assess reproducibility. Using the test, statistically significant differences were found among the methods for (a) measurement of differential renal function and (b) their reproducibility measured as the maximum – minimum difference of five estimates. In our study we did not use the other methods specified in their letter.