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A cross section of a human thorax from an X-ray CT showing current stream lines from drive electrodes and equi-potentials from a different pair of measurement electrodes. Note how lines are bent by the change in conductivity between different organs.
Electrical impedance tomography (EIT) is a medical imaging technique in
which an image of the conductivity or permittivity of part of the body is inferred from surface electrical measurements. Typically, conducting electrodes are attached to the skin of the subject and small alternating currents are applied to some or all of the electrodes. The resulting electrical potentials are measured, and the process may be repeated for numerous different configurations of applied current.
Proposed applications include monitoring of lung function, detection of cancer in the skin and breast and location of epileptic foci Until recently, all applications have been considered experimental. However in 2011 the first commercial EIT device for lung function monitoring in intensive care patients was introduced. The invention of EIT as a medical imaging technique is usually attributed to John G. Webster and a publication in 1978, although the first practical realisation of a medical EIT system was detailed in 1984 due to the work of David C. Barber and Brian H. Brown. Mathematically, the problem of recovering conductivity from surface measurements of current and potential is a non-linear inverse problem and is severely ill-posed. The mathematical formulation of the problem is due to Alberto Calderón, and in the mathematical literature of
The measurements again may be taken either by a single voltage measurement circuit multiplexed over the electrodes or a separate circuit for each electrode. This is repeated for numerous "stimulation patterns". Earlier systems typically used an analog demodulation circuit to . and in industrial process monitoring the arrays of electrodes are used for example to monitor mixtures of conductive fluids in vessels or pipes. For example lungs are less conductive when the alveoli is filled with air. In that context the technique is usually called electrical resistance tomography (note the slight contrast to the name used in geophysics). and certainly below the threshold at which they would cause stimulation of nerves. is applied across two or more electrodes. such as successive pairs of adjacent electrodes. The method is used in industrial process imaging for imaging conductive fluids. each controlled by a digital to analog converter. The currents used are relatively small. either a single current source switched between electrodes using a multiplexor or a system of Voltage-to-current converters. the idea dates from the 1930s. one for each electrode. typically a few milli-Amperes of alternating current at a frequency of 10– 100 kHz. Contents 1 Theory 2 Lung imaging 3 Breast imaging 4 Brain imaging 5 Commercial systems 6 See also 7 References 8 External links Theory In biological tissue the electrical conductivity and permittivity varies between tissue types likewise depending on temperature and physiological factors. In geophysics a similar technique (called electrical resistivity tomography) is used using electrodes on the surface of the earth or in bore holes to locate resistivity anomalies. Other electrodes are used to measure the resulting voltage.inverse problems it is often referred to as "Calderón's Inverse Problem" or the "Calderón Problem". The frequency of the alternating current is sufficiently high not to give rise to electrolytic effects in the body and the Ohmic power dissipated is sufficiently small and diffused over the body to be easily handled by the body's thermoregulatory system. The current is applied using current sources. Metal electrodes are generally in direct contact with the fluid but electronics and reconstruction techniques are broadly similar to the medical case. In geophysics. There is extensive mathematical research on the problem of uniqueness of solution and numerical algorithms for this problem. In EIT adhesive electrodes applied to the skin and an electric current.
The voltages measured are then passed to a computer to perform the reconstruction and display of the image. The open source project EIDORS  provides a suite of programs (written in Matlab / Octave) for data reconstruction and display under the GNU GPL license. That is. Another approach is to construct a finite element model of the body and adjust the conductivities (for example using a variant of Levenburg–Marquart method) to fit the measured data. Although an accurate chest shape was used only a 2D reconstruction algorithm was used resulting in a distorted image. Many EIT systems are capable of working at several frequencies and can measure both the magnitude and phase of the voltage. This is more challenging as it requires an accurate body shape and the exact position of the electrodes. Many recent systems convert the alternating signal directly. Electrodes on chest Wires attached Resulting image The above images are from the EIT group at Oxford Brookes University and depict an early attempt at three dimensional EIT imaging of the chest using the OXBACT3 EIT system.convert the alternating voltage to a direct current level then an analog to digital converter. the differences in voltage between two time points is left-multiplied by the regularized inverse to produce an approximate difference between the permittivity and conductivity images. the demodulation then being performed digitally. Thus. EIT can resolve the changes in the distribution of lung volumes between dependent and non-dependent lung regions as ventilator parameters are changed. Such ventilation can often result in Ventilator-associated lung injury. In most practical systems used in a medical setting a 'difference image' is formed. The results of a similar chest study have been published. The reconstructed image is a time average and shows lungs as low conductivity regions. Lung imaging EIT is useful for monitoring patient lungs because the air has a large conductivity contrast to the other tissues in the thorax. . The most promising clinical application of lung EIT measurements is for Lung function monitoring of patients being treated with Mechanical ventilation. If images are required in real time a typical approach is the application of some form of regularized inverse of a linearization of the forward problem. EIT measurements may be used to control the specific ventilator settings to maintain lung protective ventilation for each patient.
the contrast agent used in breast MRI. which is typically defined by the intra-thoracic impedance distribution at the end of expiration. functional EIT determines relative impedance changes that may be caused by either ventilation or changes of end-expiratory lung volume. EIT measurements may be used to control the specific ventilator settings to maintain lung protective ventilation for each patient. and 51% for the two combined. directly at the bedside. . The speciﬁcity was 39% for mammography. These relative changes are referred to a baseline level.g. and with the nephrotoxicity of Gadolinium. Literature shows that the electrical properties differ between normal and malignant breast tissues. In contrast. 62% for the T-Scan alone. These shortcomings and concerns related to the use of ionizing radiation. Breast imaging EIT is being investigated in the field of breast imaging as an alternative/complementary technique to mammography and magnetic resonance imaging (MRI) for breast cancer detection. with high distress for the patient and cost for the healthcare structure. A report to the United States Food and Drug Administration (FDA) describes a study involving 504 subjects where the sensitivity of mammography was 82%. pneumothorax.g. However absolute EIT (a-EIT) also has the potential to become a clinically useful tool for Lung imaging. atelectasis and lung edema) and those with higher resistivity (e. the shape of the body and the precise location of the electrodes. pleural effusion. The low specificity of mammography  and of MRI  result in a relatively high rate of false positive screenings. While initial studies assessing aspects of a-EIT have already been published. 47% for the T-Scan alone. emphysema). for mammography. These attributes make regional lung function monitoring particularly useful whenever there is a need to improve oxygenation or CO2 elimination and when therapy changes are intended to achieve a more homogenous gas distribution in mechanically ventilated patients. Thus. and 88% for the two combined. Several research groups are across the world are actively developing the technique. A successful commercial development of non-tomographic electrical impedance imaging is the T-Scan device  which has been demonstrated to improve sensitivity and speciﬁcity when used as an adjunct to screening mammography. as simplified assumptions would lead to major reconstruction artifacts. The reconstruction of absolute impedance images requires that the exact dimensions. EIT lung function imaging can resolve the changes in the regional distribution of lung volumes between e. hemothorax. as of today this area of research has not yet reached the level of maturity which would make it suitable for clinical use. as this approach would allow one to directly distinguish between lung conditions which result from regions with lower resistivity (e. setting the stage for cancer detection through determination of electrical properties. be taken into account. Functional EIT images can be generated continuously.Most EIT studies have focused on regional lung function monitoring using the information determined by functional EIT (f-EIT). dependent and non-dependent lung regions as ventilator parameters are changed. make the development of alternative techniques highly desirable.g.
a respiratory monitoring company who distribute Goe MF II system that was developed at the University of Göttingen. CareFusion. The first such system is produced by Maltron International  who distribute a Sheffield Mark 3. An EIT device for lung function monitoring that is designed for everyday clinical use in the critical care environment has been made available by Dräger Medical in 2011  See also Bioimpedance Electrical resistivity tomography Electrical capacitance tomography Respiratory monitoring References .Brain imaging EIT has been suggested as a basis for brain imaging to enable the detection and monitoring of cerebral ischemia and haemorrhage. epileptic foci localization. Other manufactures include Dräger Medical.7%. the resistance of its membrane preventing this reduces by a factor of 80. together with research into normal brain function and neuronal activity.5 system. In this use EIT depends upon applying low frequency currents above the skull that are around <100 Hz since during neuronal rest at this frequency these currents remain in the extracellular space unable enter into the intracellular space within neurons. Impedance Medical Technologies  who manufacture systems based on designs by the Research Institute of Radioengineering and Electronics of the Russian Academy of Science  in Moscow. notably in intensive care for monitoring ventilation. Unfortunately while such changes are detectable "they are just too small to support reliable production of images. aimed especially at breast cancer detection. Such systems typically comply with medical safety legislation and are being used by research groups in hospitals." The prospects of using this technique for imaging will depend upon improved signal processing or recording. This resistivity change provides a means of detecting coherent neuronal activity across large numbers of neurons and so the tomographic imaging of neural activity in the brain. Commercial systems Although medical EIT systems are not widely used several medical equipment manufactures now supply commercial versions of systems developed by university research groups.06–1. However when a neuron makes an action potential or depolarization. When this happens across large numbers of neurons a resistivity change is made of about 0.
E. M. D. Jarolimek. N.S. ISBN 0-7503-0952-0.1109/TBME. "Contrast-enhanced breast MRI: factors affecting sensitivity and specificity". A. Physiol Meas 27 (5): S25–S42. 2002. (1984). Techniques and Applications. Instrum 17 (9): 723–733. DS (2009). Food and Drug Administration. (1998). ^ Adler. B. Scanned copy of paper. Daye. Abu-Alfa. Radiology 242 (3): 647. (2007). Kanal. "The false-negative mammogram". PMID 16636416.. Yearbook of Intensive Care and Emergency Medicine. doi:10. McLeod.S. ^ M. T. IEEE Trans. Laver-Moskovitz. ^ Assenheimer. ^ a b c Holder D. Apl. E. "Gadolinium-based MR contrast agents and nephrogenic systemic fibrosis".1088/0967-3334/19/1/006. Abraham (2001).1007/3-540-33396-7_40. 25 (3): 250–254. "On an inverse boundary value problem". Williams.1088/0022-3735/17/9/002. Electrical Impedance Tomography: Methods. ^ Barber. Cowper. Process Tomography: Principles.. P. 1995). ^ Frerichs.. ^ Piccoli. 25 (2–3): 133–138. 15. E:Sci. PMID 11236875. "Applied Potential Tomography". pp. Phys. Berlin: Springer. ^ a b Gilad. Michel. 17. (2006). PMID 9370560. Eng. 16. Meas. doi:10. (2006). Ron. Yearbook of Intensive Care and Emergency Medicine. O. 22 (1): 147–157. Institute of Physics. K. 6. EIDORS documentation.. Nitzan.P. Dov. doi:10. PMID 9747612. "The impedivity of freshly excised human breast tissue". ^ Huynh. Manor. ISBN 978-3-540-30155-4. PMID 11236870.1088/0967-3334/27/5/S03.. (1998).. doi:10. RadioGraphics 18 (5): 1137–1154. Udi. Calderón. Lionheart. in Seminar on Numerical Analysis and its Applications to Continuum Physics. April 24. Webster. "Impedance changes recorded with scalp electrodes during visual evoked responses: implications for Electrical Impedance Tomography of . Holder. Alberto P. J. P. (1999) "Developments in inverse problems since Calderón's foundational paper". 9. "An Impedance Camera for Spatially Specific Measurements of the Thorax". ^ Kerrouche. ISBN 0750607440 8. "Electrical Impedance Tomography and its Perspectives in Intensive Care Medicine". Scholz. J.. "Uses and abuses of EIDORS: An extensible software base for EIT". 14. 5.. ^ Jossinet. Weiler. R. Physiological Measurement 19 (1): 61–76. S. 13. Beck and R. C. Brown. Biomed. PMID 680754.. Butterworth-Heinemann (July 19. ^ Uhlmann G. A.. Andy. ^ Adler A. Nahaliel. Modeling EIT current flow in a human thorax model. 11. Lionheart. David.1088/0967-3334/22/1/301. doi:10. "Time series of EIT chest images using singular value decomposition and Fourier transform".C. Comput. Saad. Physiological Measurement 22 (1): 1–8.P. University of Chicago Press. Malonek. (1997).1. I. (1978). 4.1148/radiol.H. 12. 437–447. ^ Henderson. doi:10. "The T-SCAN technology: electrical impedance as a diagnostic tool for breast cancer detection". doi:10.G.P970033. Harmonic Analysis and Partial Differential Equations: Essays in Honor of Alberto P. 2006. (editors ME Christ and CE Kenig). WRB (2001). (1980) "On an inverse boundary value problem". ^ TransScan T-Scan 2000 .326329.2423061640.1978. doi:10. 10. ISBN 0-226-10455-9 7. Rio de Janeiro. Physiol. 2004. European Radiology 7: 281–288. CN. The paper has been reprinted as Calderon. ^ Calderón A. Orah. ^ Kuo. 2010-11-03 2. 3. S. W.1088/0967-3334/22/1/318. Mat. J.. William (2006). N. J. H. History and Applications.
Electrical Impedance Tomography and Diffuse Optical Tomography Reconstruction Software at Sourceforge View page ratings Rate this page What's this? Trustworthy Objective Complete Well-written I am highly knowledgeable about this topic (optional) Categories: Electrodiagnosis Log in / create account Article Talk Read Edit View history Main page Contents Featured content Current events Random article Donate to Wikipedia Interaction . Retrieved 17 June 2011. The Pioneer of Electrical Impedance Tomography". 20. NeuroImage 47 (2): 514–22. "The Maltron Sheffield MK 3.5. doi:10. 19. ^ Maltron International.085.04. "Technical Data for PulmoVista 500". 18. Retrieved 17 June 2011. "Impedance Medical Technologies".neuroimage. PMID 19426819. ^ IMT.2009. ^ Draeger medical. External links EIT website University College London EIDORS .1016/j. Retrieved 17 June 2011.fast neural activity".
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