Mk3.5: a modular, multi-frequency successor to the Mk3a EIS/EIT system

Compensation for Electrode Detachment in Electrical Impedance Tomography with Wearable Textile Electrodes

Electrical impedance tomography (EIT) is a radiation-free and noninvasive medical image reconstruction technique in which a current is injected and the reflected voltage is received through electrodes. EIT electrodes require good connection with the skin for data acquisition and image reconstruction. However, detached electrodes are a common occurrence and cause measurement errors in EIT clinical applications. To address these issues, in this study, we proposed a method for detecting faulty electrodes using the differential voltage value of the detached electrode in an EIT system. Additionally, we proposed the voltage-replace and voltage-shift methods to compensate for invalid data from the faulty electrodes. In this study, we present the simulation, experimental, and in vivo chest results of our proposed methods to verify and evaluate the feasibility of this approach.

Evaluation of Pulmonary Structure and Function in Patients with Cystic Fibrosis from Electrical Impedance Tomography Data

Electrical impedance tomography (EIT) is a medical imaging technique in which low frequency, low amplitude electromagnetic fields applied through electrodes on the skin are used to compute the conductivity and/or permittivity inside the body and form functional images from the reconstructed values. This work describes methods of computing EIT-derived surrogate measures of pulmonary function and identifying regions of air trapping and consolidation from functional EIT images. These methods were developed for pediatric patients with cystic fibrosis, for whom a real-time non-ionizing imaging modality can be of great benefit for monitoring disease progression or a pulmonary exacerbation.

A Multi-Frequency Focused Impedance Measurement System Based on Analogue Synchronous Peak Detection

Monitoring of anatomical structures and physiological processes by electrical impedance has attracted scientists as it is noninvasive, nonionizing and the instrumentation is relatively simple. Focused Impedance Method (FIM) is attractive in this context, as it has enhanced sensitivity at the central region directly beneath the electrode configuration minimizing contribution from neighboring regions. FIM essentially adds or averages two concentric and orthogonal combinations of conventional Tetrapolar Impedance Measurements (TPIM) and has three versions with 4, 6, and 8 electrodes. This paper describes the design and testing of a multi-frequency FIM (MFFIM) system capable of measuring all three versions of FIM at 8 frequencies in the range 10 kHz—1 MHz. A microcontroller based multi-frequency signal generator and a balanced Howland current source with high output impedance (476 kΩ at 10 kHz and 58.3 kΩ at 1 MHz) were implemented for driving currents into biological tissues with an error <1%. The measurements were carried out at each frequency sequentially. The peak values of the amplified voltage signals were measured using a novel analogue synchronous peak detection technique from which the transfer impedances were obtained. The developed system was tested using TPIM measurements on a passive RC Cole network placed between two RC networks, the latter representing skin-electrode contact impedances. Overall accuracy of the measurement was very good (error <4% at all frequencies except 1 MHz, with error 6%) and the resolution was 0.1 Ω. The designed MFFIM system had a sampling rate of >45 frames per second which was deemed adequate for noninvasive real-time impedance measurements on biological tissues.

Dry Wearable Textile Electrodes for Portable Electrical Impedance Tomography

Electrical impedance tomography (EIT), a noninvasive and radiation-free medical imaging technique, has been used for continuous real-time regional lung aeration. However, adhesive electrodes could cause discomfort and increase the risk of skin injury during prolonged measurement. Additionally, the conductive gel between the electrodes and skin could evaporate in long-term usage and deteriorate the signal quality. To address these issues, in this work, textile electrodes integrated with a clothing belt are proposed to achieve EIT lung imaging along with a custom portable EIT system. The simulation and experimental results have verified the validity of the proposed portable EIT system. Furthermore, the imaging results of using the proposed textile electrodes were compared with commercial electrocardiogram electrodes to evaluate their performance.

Evaluation of Thoracic Equivalent Multiport Circuits Using an Electrical Impedance Tomography Hardware Simulation Interface

Electrical impedance tomography is a low-cost, safe, and high temporal resolution medical imaging modality which finds extensive application in real-time thoracic impedance imaging. Thoracic impedance changes can reveal important information about the physiological condition of patients’ lungs. In this way, electrical impedance tomography can be a valuable tool for monitoring patients. However, this technique is very sensitive to measurement noise or possible minor signal errors, coming from either the hardware, the electrodes, or even particular biological signals. Thus, the design of a good performance electrical impedance tomography hardware setup which properly interacts with the tissue examined is both an essential and a challenging concept. In this paper, we adopt an extensive simulation approach, which combines the system’s analogue and digital hardware, along with equivalent circuits of 3D finite element models that represent thoracic cavities. Each thoracic finite element model is created in MATLAB based on existing CT images, while the tissues’ conductivity and permittivity values for a selected frequency are acquired from a database using Python. The model is transferred to a multiport RLC network, embedded in the system’s hardware which is simulated at LT SPICE. The voltage output data are transferred to MATLAB where the electrical impedance tomography signal sampling and digital processing is also simulated. Finally, image reconstructions are performed in MATLAB, using the EIDORS library tool and considering the signal noise levels and different electrode and signal sampling configurations (ADC bits, sampling frequency, number of taps).

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

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

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.

A Parametric EIT System Spice Simulation with Phantom Equivalent Circuits

In this paper a number of LT Spice simulations have been carried out on an Electrical Impedance Tomography (EIT) system, which includes the whole analog and digital circuitry as well as the subject to be examined (phantom model). The aim of this study is to show how the analog and digital parts, the electrodes and the subject’s physical properties may impact the measurements and the quality of the reconstructed image. This could provide a useful tool for designing an EIT system. Special attention has been given to the current source’s output impedance and swing, to the noise produced by the circuits and to the Analog to Digital Converters (ADCs) resolution and sampling rate. Furthermore, some 3D phantom subjects have been modeled and simulated as equivalent circuits, merged with the EIT simulated hardware, in order to observe how changes on their properties interact with the whole circuitry and affect the final result. Observations show that mirrored current sources with z o u t > 350 k Ω and sufficiently high ADC acquisition sampling rate ( f s a m p l e ≥ 16 f i n ) can result to accurate impedance measurements and therefore quality image reconstruction within a frequency span of at least 10 to 100 kHz. Moreover, possible hardware failures (electrode disconnections and imbalanced contact impedances) can be detected with a simple examination of the first extracted image and measurement set, so that by direct modification of the reconstruction process, a corrected result can be obtained.

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

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

The ACE1 Electrical Impedance Tomography System for Thoracic Imaging

The design and performance of the ACE1 (Active Complex Electrode) electrical impedance tomography system for single-ended phasic voltage measurements is presented. The design of the hardware and calibration procedures allow for reconstruction of conductivity and permittivity images. Phase measurement is achieved with the ACE1 active electrode circuit which measures the amplitude and phase of the voltage and the applied current at the location at which current is injected into the body. An evaluation of the system performance under typical operating conditions includes details of demodulation and calibration and an in-depth look at insightful metrics, such as signal-to-noise ratio variations during a single current pattern. Static and dynamic images of conductivity and permittivity are presented from ACE1 data collected on tank phantoms and human subjects to illustrate the system's utility.

A floating wide-band current source for electrical impedance tomography

The quality of reconstructed images in Electrical Impedance Tomography (EIT) depends on two essential factors: first, precision of the EIT hardware in current injection and voltage measurement and second, efficiency of its image reconstruction algorithm. Therefore the current source plays an important and a vital role in EIT instruments. Floating-load current sources constructed using sink and source drivers have better performance and higher output impedance than grounded-load (single-ended) current sources. In addition, a main feature of this kind is that the current source is not connected to the ground potential directly but via a large impedance. In this paper, we first focus on recent studies on designed EIT current sources, and after that, a practical design of a floating-load high output impedance current source-operating over a wide frequency band-will be proposed in detail. Simulation results of the proposed voltage-controlled current source (VCCS), along with some other models, will be shown and compared. At the end, the results of practical tests on the VCCS and a few EIT images, taken using our prototype EIT system coupled with the mentioned VCCS, will be illustrated which proves the quality of the proposed current source.

Continuous bladder volume monitoring system for wearable applications

In this research, we propose a bladder volume monitoring system that can be effectively applied for various voiding dysfunctions. Whereas conventional systems lack consecutive measurements, the proposed system can continuously monitor a user's status even during unconscious sleep. For the convenience, we design a simple and comfortable waist-belt-type device by using the body impedance analysis (BIA) technique. To support various measurement scenarios, we develop applications by connecting the device to a smartphone. To minimize motion noises, which are inevitable when monitoring over an extended period, we propose a motion artifact reduction algorithm that exploits multiple frequency sources. The experimental results show a strong relationship between the impedance variation and the bladder volume; this confirms the feasibility of our system.

A 10 MHz Read-Out Chain for Electrical Impedance Tomography

This paper presents the design and implementation of a read-out chain for electrical impedance tomography (EIT) imaging. The EIT imaging approach can be incorporated to take spectral images of the tissue under study, offering an affordable, portable device for home health monitoring. A fast read-out channel covering a wide range of frequencies is a must for such applications. The proposed read-out channel comprising a programmable gain instrumentation amplifier, an analog-to-digital converter (ADC), and an ADC driver is designed and fabricated in a 0.18  m CMOS technology. The proposed read-out chain operates over the wide frequency range of 100 Hz to 10 MHz, with an average signal-to-noise ratio of more than 60 dB. The entire read-out channel consumes between 6.9 and 21.8 mW, depending on its frequency of operation.

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

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

System Description and First Application of an FPGA-Based Simultaneous Multi-Frequency Electrical Impedance Tomography

A new prototype of a multi-frequency electrical impedance tomography system is presented. The system uses a field-programmable gate array as a main controller and is configured to measure at different frequencies simultaneously through a composite waveform. Both real and imaginary components of the data are computed for each frequency and sent to the personal computer over an ethernet connection, where both time-difference imaging and frequency-difference imaging are reconstructed and visualized. The system has been tested for both time-difference and frequency-difference imaging for diverse sets of frequency pairs in a resistive/capacitive test unit and in self-experiments. To our knowledge, this is the first work that shows preliminary frequency-difference images of in-vivo experiments. Results of time-difference imaging were compared with simulation results and shown that the new prototype performs well at all frequencies in the tested range of 60 kHz-960 kHz. For frequency-difference images, further development of algorithms and an improved normalization process is required to correctly reconstruct and interpreted the resulting images.

Wearable lung-health monitoring system with electrical impedance tomography

The wearable lung-health monitoring system is proposed with an electrical impedance tomography (EIT). The proposed system has light belt-type form factor which is implemented with the EIT integrated circuit (IC) on the planar-fashionable circuit board (P-FCB) technology. The EIT IC provides programmable current stimulation which is optimally controlled by the results of contact impedance monitoring. The measured data is transmitted to the mobile device and the lung EIT images are reconstructed and displayed with up to 20 frames/s real-time. From the lung EIT image, the measured lung air volume ratio can be used as an indicator of the lung-health, and other various parameters can be extracted to monitor lung status. The proposed wearable system achieves the user convenience for lung-health monitoring which can be used personally at home. The proposed system is fully implemented and verified on both in-vitro and in-vivo tests.

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

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

Electrical impedance imaging system using FPGAs for flexibility and interoperability

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

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.

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

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

Electrical tissue impedance spectroscopy: a novel device to measure esophageal mucosal integrity changes during endoscopy

BACKGROUND

Patients with gastroesophageal reflux disease (GERD) have impaired esophageal mucosal integrity. Measurement of the mucosal integrity is complex and time-consuming. Electrical tissue impedance spectroscopy (ETIS) is a device that measures impedance of tissue in vivo during endoscopy. In this study, we aimed to validate ETIS as a measure of esophageal mucosal integrity.

METHODS

Electrical tissue impedance spectroscopy measurements were performed during upper endoscopy in 12 GERD patients and 11 healthy controls after cessation of proton pump inhibition. During endoscopy biopsies of the distal esophagus were obtained for transmission electron microscopy to determine dilation of intercellular spaces (DIS) and for Ussing chamber experiments to determine transepithelial permeability and transepithelial electrical resistance.

KEY RESULTS

Extracellular impedance measured in vivo by ETIS was significantly lower in GERD patients compared to controls [mean (SD) 5621 (3299) Ω.m and 8834 (2542) Ω.m, respectively, P < 0.05]. We found a strong inverse relation between extracellular impedance determined by ETIS and DIS (r = -0.76, P < 0.05), and between extracellular resistance in vivo and transepithelial permeability of esophageal biopsies (r = -0.65, P < 0.01).

CONCLUSIONS & INFERENCES

Electrical tissue impedance spectroscopy is a new tool that can be used to evaluate esophageal mucosal integrity changes during endoscopy.

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

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

Bioimpedance spectroscopy: a new tool to assess early esophageal changes linked to gastroesophageal reflux disease?

Bioimpedance spectroscopy can identify pathological changes related to precancerous lesions of the cervix uteri and esophagus. It therefore has the potential to detect early reflux-related changes in the esophageal mucosa, such as dilated intercellular spaces. The reliable detection of dilated intercellular spaces at the time of endoscopy would yield a significant diagnostic advantage for separating patients with functional heartburn from the large proportion of patients with gastroesophageal reflux symptoms but no macroscopic esophagitis or pathological acid exposure. The bioimpedance of the esophageal mucosa, measured with a small caliber probe, was evaluated in a series of preclinical experiments. First, sections of rabbit esophageal epithelium were mounted in Ussing chambers and exposed to solutions at pH 7.4 or pH 1.5 for 45 minutes. Impedance measurements were taken at varying probe pressures. Second, rabbit esophageal epithelia were perfused for 45 minutes in situ with pH 1.1 or control solutions and impedance measurements taken. Samples from both in vitro and in situ experiments were taken for morphological examination by light microscopy. Finally, esophageal bioimpedance was measured in awake dogs with permanent esophagocutaneous stoma. The in situ experiments demonstrated that morphological changes in the esophageal mucosa could be discerned by the use of bioimpedance spectroscopy. The variability in resistivity was species-independent but was affected by the pressure applied to the probe. The results suggest that evaluation of bioimpedance spectroscopy for use in a clinical setting is warranted. Small morphological differences in the esophageal mucosa may be detected by the use of bioimpedance spectroscopy.

Frequency-division multiplexing for electrical impedance tomography in biomedical applications

Electrical impedance tomography (EIT) produces an image of the electrical impedance distribution of tissues in the body, using electrodes that are placed on the periphery of the imaged area. These electrodes inject currents and measure voltages and from these data, the impedance can be computed. Traditional EIT systems usually inject current patterns in a serial manner which means that the impedance is computed from data collected at slightly different times. It is usually also a time-consuming process. In this paper, we propose a method for collecting data concurrently from all of the current patterns in biomedical applications of EIT. This is achieved by injecting current through all of the current injecting electrodes simultaneously, and measuring all of the resulting voltages at once. The signals from various current injecting electrodes are separated by injecting different frequencies through each electrode. This is called frequency-division multiplexing (FDM). At the voltage measurement electrodes, the voltage related to each current injecting electrode is isolated by using Fourier decomposition. In biomedical applications, using different frequencies has important implications due to dispersions as the tissue's electrical properties change with frequency. Another significant issue arises when we are recording data in a dynamic environment where the properties change very fast. This method allows simultaneous measurements of all the current patterns, which may be important in applications where the tissue changes occur in the same time scale as the measurement. We discuss the FDM EIT method from the biomedical point of view and show results obtained with a simple experimental system.

A portable system for the assessment of neuromuscular diseases with electrical impedance myography

PRIMARY OBJECTIVE

To create a system for the acquisition of multi-angle, multifrequency muscle impedance data.

RESEARCH DESIGN

Device development and preliminary testing.

METHODS AND PROCEDURES

The system presented here employs an interrogating signal composed of multiple tones with frequencies between 10 kHz and 300 kHz. The use of a composite signal makes possible measurement of impedance at multiple frequencies simultaneously. In addition, this system takes impedance measurements at multiple orientations with respect to the muscle fibres by means of an electronically reconfigurable electrode array. The required measurement time is reduced by taking advantage of muscle's linearity with respect to the flow of electrical current.

MAIN OUTCOMES AND RESULTS

The system was tested in normal subjects, a patient with amyotrophic lateral sclerosis, and one with inclusion body myositis; unique impedance signatures were identified the two patients.

CONCLUSIONS

Early data suggest that this system is capable of high-quality data collection and may detect changes in neuromuscular disease; study of additional normal subjects and patients with a variety of neuromuscular diseases is warranted.

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 Geselowitz's 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.

Absolute electrical impedance tomography (aEIT) guided ventilation therapy in critical care patients: simulations and future trends

Thoracic electrical impedance tomography (EIT) is a noninvasive, radiation-free monitoring technique whose aim is to reconstruct a cross-sectional image of the internal spatial distribution of conductivity from electrical measurements made by injecting small alternating currents via an electrode array placed on the surface of the thorax. The purpose of this paper is to discuss the fundamentals of EIT and demonstrate the principles of mechanical ventilation, lung recruitment, and EIT imaging on a comprehensive physiological model, which combines a model of respiratory mechanics, a model of the human lung absolute resistivity as a function of air content, and a 2-D finite-element mesh of the thorax to simulate EIT image reconstruction during mechanical ventilation. The overall model gives a good understanding of respiratory physiology and EIT monitoring techniques in mechanically ventilated patients. The model proposed here was able to reproduce consistent images of ventilation distribution in simulated acutely injured and collapsed lung conditions. A new advisory system architecture integrating a previously developed data-driven physiological model for continuous and noninvasive predictions of blood gas parameters with the regional lung function data/information generated from absolute EIT (aEIT) is proposed for monitoring and ventilator therapy management of critical care patients.

Code-division-multiplexed electrical impedance tomography spectroscopy

Electrical impedance tomography uses multiple impedance measurements to image the internal conductivity of an object, such as the human body. Code-division multiplexing is proposed as a new method that can provide simultaneous impedance measurements of the multiple channels. Code division provides clear advantages of a wide frequency range at reduced cost and reduced complexity of sources. A potential drawback is the lack of perfectly orthogonal code sets. This caused an increase of 0.62% in root-mean-square spectral error when two codes were used to record two impedance channels simultaneously on a low-pass filter network. The method described provides images and spectra which are equivalent to the conventional time-multiplexed method, with increases in frequency resolution and measurement speed which may be of benefit in some applications of electrical impedance tomography spectroscopy.

A Handheld Electrical Impedance Myography probe for the assessment of neuromuscular disease

Electrical Impedance Myography (EIM) is a non-invasive, painless clinical technique for the diagnosis and monitoring of a variety of neuromuscular diseases including amyotrophic lateral sclerosis and focal nerve injuries. It involves the application of a low-intensity alternating current to a muscle group and the measurement of the consequent surface voltage patterns. This paper presents a system for the rapid and accurate acquisition of data employing an interrogating signal composed of multiple tones with frequencies between 10 kHz and 4 MHz. The use of this composite signal makes possible measurement of impedance at multiple frequencies simultaneously. In addition, this system takes impedance measurements at multiple orientations with respect to the muscle fibers by means of an electronically reconfigurable electrode array and utilizes the linearity of muscle tissue to reduce the required measurement time. Testing of the EIM system on beef has established the capability of this system to rapidly detect the anisotropic conductive properties of muscle tissue at multiple frequencies.

Design and construction of small sized pencil probe to measure bio-impedance

Currently, bio-impedance measurements are performed with relatively large probes which are not suitable for all in vivo studies. These are typically designed and constructed for different uses, such as for cervical and oesophagus tissues and are too large for many investigations, including those involving the bladder. Therefore, it was decided to design and construct a small sized pencil probe, using a microscope to solder very small wires to a tiny tip (about 2mm in diameter). In addition, different approaches were used to construct, treat, and perform the safety tests and calibration procedure on the probe before taking impedance measurements of the urinary bladder.

Calibration methods for a multi-channel multi-frequency EIT system

Multi-channel multi-frequency electrical impedance tomography (EIT) systems require a careful calibration to minimize systematic errors. We describe novel calibration methods for the recently developed KHU Mark1 EIT system. Current source calibration includes maximization of output resistance and minimization of output capacitance using multiple generalized impedance converters. Phase and gain calibrations are used for voltmeters. Phase calibration nulls out the total system phase shift in measured voltage data. Gain calibrations are performed in two steps of intra- and inter-channel calibrations. Intra-channel calibration for each voltmeter compensates frequency dependence of its voltage gain and also discrepancy between design and actual gains. Inter-channel calibration compensates channel-dependent voltage gains of all voltmeters. Using the calibration methods described in this paper, we obtained 1 MOmega minimal output impedance of the current source in the frequency range 10 Hz-500 kHz. The reciprocity error was as small as 0.05% after intra- and inter-channel voltmeter calibrations. To demonstrate effects of calibration in reconstructed images, we used a homogenous phantom from which uniform images should be produced. Reconstructed time- and frequency-difference images using uncalibrated data showed spurious anomalies. By using calibrated data, standard deviations of time- and frequency-difference images of the homogenous phantom were reduced by about 40% and 90%, respectively.

Surface fluids effects on the bladder tissue characterisation using electrical impedance spectroscopy

The electrical impedance of the human urinary bladder in both benign and malignant areas can be measured using an electrical impedance spectroscopy system (EIS). Glycine is usually used in the bladder surgery in the theatre to make an insulation medium for electro-surgery and the extension of the mucosa. In addition, a saline solution is usually used to wash the inside of the bladder after bladder surgery and it is used to extend the bladder tissue mucosa. Therefore, the effect of glycine and the saline solution that fills the bladder is important, because it was expected that the application of common surface fluids (air, saline solution and glycine solution) in the bladder epithelium would affect the measured electrical impedance of the urothelium, to differentiate the malignant area from the normal bladder tissue. In this study, bladders were removed from the patients' bodies and then were moved from theatre to the histopathology department immediately after excision. These bladder samples were then opened and pinned to a corkboard to take the impedance readings, using the impedance spectroscopy system. Following this, the bladder and corkboard were completely submerged in a saline solution and readings were taken at about 1cm from the sutures. Subsequently, this procedure was repeated with the bladder submerged in glycine and then air, respectively. According to the statistical work, these fluids were found to have a significant effect on the measured impedance of the bladder tissue in benign and malignant areas. Furthermore, the best fluid between air, glycine and saline, to measure the impedance of the urinary bladder, is air (P<0.0001).

A review of errors in multi-frequency EIT instrumentation

Multi-frequency electrical impedance tomography (MFEIT) was proposed over 10 years ago as a potential spectroscopic impedance imaging method. At least seven systems have been developed for imaging the lung, heart, breast and brain, yet none has yet achieved clinical acceptance. While the absolute impedance varies considerably between different tissues, the changes in the spectrum due to physiological changes are expected to be quite small, especially when measured through a volume. This places substantial requirements on the MFEIT instrumentation to maintain a flat system frequency response over a broad frequency range (dc-MHz). In this work, the EIT measurement problem is described from a multi-frequency perspective. Solutions to the common problems are considered from recent MFEIT systems, and the debate over four-terminal or two-terminal (multiple source) architecture is revisited. An analysis of the sources of MFEIT errors identifies the major sources of error as stray capacitance and common-mode voltages which lead to a load dependence in the frequency response of MFEIT systems. A system that employs active electrodes appears to be the most able to cope with these errors (Li et al 1996). A distributed system with digitization at the electrode is suggested as a next step in MFEIT system development.

The contribution of the lungs to thoracic impedance measurements: a simulation study based on a high resolution finite difference model

A high resolution electrical finite difference model of the human thorax based on a 43 slice MRI data set along with lead field theory was used to examine the contribution of the lungs to the total impedance for a typical mid-thoracic 2D EIT eight and sixteen electrode configuration. Regional analysis of the thoracic sources of impedance revealed that the maximum contribution of lungs to the total impedance was approximately 22% for the eight electrode array and 25% for the sixteen electrode array. Analysis of impedance distribution of the lungs using a mid-thoracic application showed that the contribution of impedance of each slice followed closely the volume of the lungs in the given slice. This suggests that the mid-thoracic application gives results reflecting the entire lung. The contributions of the lung impedance for the various electrode positions showed that the eight electrode configuration had a more smooth change between adjacent electrodes compared to the 16 electrode arrangement.

Analysis of resting noise characteristics of three EIT systems in order to compare suitability for time difference imaging with scalp electrodes during epileptic seizures

Electrical impedance tomography measurements in clinical applications are limited by an undesired noise component. We have investigated the noise in three systems suitable for imaging epileptic seizures, the UCH Mark1b, UCH Mark2.5 and KHU Mark1 16 channel, at applied frequencies in three steps from 1 to 100 kHz, by varying load impedance, single terminal or multiplexed measurements, and in test objects of increasing complexity from a resistor to a saline filled tank and human volunteer. The noise was white, and increased from about 0.03% rms on the resistor to 0.08% on the human; it increased with load but was independent of use of the multiplexer. The KHU Mark1 delivered the best performance with noise spectra of about 0.02%, which could be further reduced by averaging to a level where reliable imaging of changes of about 0.1% estimated during epileptic seizures appears plausible.

Multi-frequency EIT system with radially symmetric architecture: KHU Mark1

We describe the development of a multi-frequency electrical impedance tomography (EIT) system (KHU Mark1) with a single balanced current source and multiple voltmeters. It was primarily designed for imaging brain function with a flexible strategy for addressing electrodes and a frequency range from 10 Hz-500 kHz. The maximal number of voltmeters is 64, and all of them can simultaneously acquire and demodulate voltage signals. Each voltmeter measures a differential voltage between a pair of electrodes. All voltmeters are configured in a radially symmetric architecture in order to optimize the routing of wires and minimize cross-talk. We adopted several techniques from existing EIT systems including digital waveform generation, a Howland current generator with a generalized impedance converter (GIC), digital phase-sensitive demodulation and tri-axial cables. New features of the KHU Mark1 system include multiple GIC circuits to maximize the output impedance of the current source at multiple frequencies. The voltmeter employs contact impedance measurements, data overflow detection, spike noise rejection, automatic gain control and programmable data averaging. The KHU Mark1 system measures both in-phase and quadrature components of trans-impedances. By using a script file describing an operating mode, the system setup can be easily changed. The performance of the developed multi-frequency EIT system was evaluated in terms of a common-mode rejection ratio, signal-to-noise ratio, linearity error and reciprocity error. Time-difference and frequency-difference images of a saline phantom with a banana object are presented showing a frequency-dependent complex conductivity of the banana. Future design of a more innovative system is suggested including miniaturization and wireless techniques.

Visualization and Post-processing of 5D Brain Images

Visualization plays a central role in the presentation and interpretation of medical image data. Radiologists and surgeons must be able to accurately interpret the data for diagnosis and surgical planning. The data obtained from many imaging systems can contain functional as well as structural information producing 4D datasets. In some cases this can extend to 5D when the image provides spectral information. Generally speaking, more information can be revealed in 5D than 4D imaging. Although several approaches are available to visualize 4D medical data, there is limited research on the visualization of 5D medical data. To present 5D medical datasets efficiently on a 2D screen provides considerable challenges to visualization. In this paper, a 5D brain EIT (Electrical Impedance Tomography) dataset is used as a case study. The relationship and differences between multiple dimensional dataset visualization in different areas are analysed. A statistical post-processing method is then adopted to concentrate information included in the fifth dimension. A scheme to visualize 5D medical dataset is proposed and results are shown based on a simulated dataset.

Bioimpedance tomography (electrical impedance tomography)

Electrical impedance tomography (EIT) is a relatively new imaging method that has evolved over the past 20 years. It has the potential to be of great value in clinical diagnosis; however, EIT is a technically difficult problem to solve in terms of developing hardware for data capture and the algorithms to reconstruct the images. This review looks at the development of EIT and how it has evolved. It focuses on its clinical applications, examining hardware for the collection of data and reconstruction algorithms to generate images. Finally, this review looks at future developments that are evolving from EIT. These new variations use mixed modalities that may produce interesting new clinical imaging tools.