Pascal Olivier Gaggero

Adjacent stimulation and measurement patterns considered harmful

We characterize the ability of electrical impedance tomography (EIT) to distinguish changes in internal conductivity distributions, and analyze it as a function of stimulation and measurement patterns. A distinguishability measure, z, is proposed which is related to the signal-to-noise ratio of a medium and to the probability of detection of conductivity changes in a region of interest. z is a function of the number of electrodes, the EIT stimulation and measurement protocol, the stimulation amplitude, the measurement noise, and the size and location of the contrasts. Using this measure we analyze various choices of stimulation and measurement patterns under the constraint of medical electrical safety limits (maximum current into the body). Analysis is performed for a planar placement of 16 electrodes for simulated 3D tank and chest shapes, and measurements in a saline tank. Results show that the traditional (and still most common) adjacent stimulation and measurement patterns have by far the poorest performance (by 6.9 ×). Good results are obtained for trigonometric patterns and for pair drive and measurement patterns separated by over 90°. Since the possible improvement over adjacent patterns is so large, we present this result as a call to action: adjacent patterns are harmful, and should be abandoned. We recommend using pair drive and measurement patterns separated by one electrode less than 180°. We describe an approach to modify an adjacent pattern EIT system by adjusting electrode placement.

Electrical impedance tomography system based on active electrodes

Electrical impedance tomography (EIT) can image the distribution of ventilated lung tissue, and is thus a promising technology to help monitor patient breathing to help selection of mechanical ventilation parameters. Two key difficulties in EIT instrumentation make such monitoring difficult: (1) EIT data quality depends on good electrode contact and is sensitive to changes in contact quality, and (2) EIT electrodes are difficult and time consuming to place on patients. This paper presents the design and initial tests of an active electrode-based system to address these difficulties. Our active electrode EIT system incorporates an active electrode belt, a central voltage-driven current source, central analog to digital converters and digital to analog converters, a central FPGA-based demodulator and controller. The electrode belt is designed incorporating 32 active electrodes, each of which contains the electronic amplifiers, switches and associated logic. Tests show stable device performance with a convenient ease of use and good imaging ability in volunteer tests.

Evaluation of EIT system performance

An electrical impedance tomography (EIT) system images internal conductivity from surface electrical stimulation and measurement. Such systems necessarily comprise multiple design choices from cables and hardware design to calibration and image reconstruction. In order to compare EIT systems and study the consequences of changes in system performance, this paper describes a systematic approach to evaluate the performance of the EIT systems. The system to be tested is connected to a saline phantom in which calibrated contrasting test objects are systematically positioned using a position controller. A set of evaluation parameters are proposed which characterize (i) data and image noise, (ii) data accuracy, (iii) detectability of single contrasts and distinguishability of multiple contrasts, and (iv) accuracy of reconstructed image (amplitude, resolution, position and ringing). Using this approach, we evaluate three different EIT systems and illustrate the use of these tools to evaluate and compare performance. In order to facilitate the use of this approach, all details of the phantom, test objects and position controller design are made publicly available including the source code of the evaluation and reporting software.

Evaluation and Real-Time Monitoring of Data Quality in Electrical Impedance Tomography

Electrical impedance tomography (EIT) is a noninvasive method to image conductivity distributions within a body. One promising application of EIT is to monitor ventilation in patients as a real-time bedside tool. Thus, it is essential that an EIT system reliably provide meaningful information, or alert clinicians when this is impossible. Because the reconstructed images are very sensitive to system instabilities (primarily from electrode connection variability and movement), EIT systems should continuously monitor and, if possible, correct for such errors. Motivated by this requirement, we describe a novel approach to quantitatively measure EIT data quality. Our goals are to define the requirements of a data quality metric, develop a metric q which meets these requirements, and an efficient way to calculate it. The developed metric q was validated using data from saline tank experiments and a retrospective clinical study. Additionally, we show that q may be used to compare the performance of EIT systems using phantom measurements. Results suggest that the calculated metric reflects well the quality of reconstructed EIT images for both phantom and clinical data. The proposed measure can thus be used for real-time assessment of EIT data quality and, hence, to indicate the reliability of any derived physiological information.

Distinguishability in EIT using a hypothesis-testing model

In this paper we propose a novel formulation for the distinguishability of conductivity targets in electrical impedance tomography (EIT). It is formulated in terms of a classic hypothesis test to make it directly applicable to experimental configurations. We test to distinguish conductivity distributions σ2 from σ1, from which EIT measurements are obtained with added white Gaussian noise with covariance Σn. In order to distinguish the distributions, we must reject the null hypothesis , which has a probability based on the z-score: . This result shows that distinguishability is a product of the impedance change amplitude, the measurement strategy and the inverse of the noise amplitude. This approach is used to explore different current stimulation strategies.

A Novel Method for Monitoring Data Quality in Electrical Impedance Tomography

Electrical impedance tomography (EIT) has the promise to help improve care for patients undergoing ventilation therapy by providing real-time bed-side information on the distribution of ventilation in their lungs. To realise this potential, it is important for an EIT system to provide a reliable and meaningful signal at all times, or alert clinicians when this is not possible. Because the reconstructed images in EIT are sensitive to system instabilities (including electrode connection problems) and artifacts caused by e.g. movement or sweat, there is a need for EIT systems to continuously monitor, recognize and, if possible, correct for such errors. Motivated by this requirement, our paper describes a novel approach to quantitatively measure EIT data quality suitable for online and offline applications. We used a publicly available data set of ventilation data from two pediatric patients with lung disease to evaluate the data quality on clinical data. Results suggest that the developed data quality could be a useful tool for real-time assessment of the quality of EIT data and, hence, to indicate the reliability of any derived physiological information.