A portable EIT system for emergency medical care

Electrical Impedance Tomography (EIT) is a medical imaging technique in which images of tissue conductivity within a body can be inferred from surface electrode measurements. The main goal of this study is to develop a portable EIT system incorporating an optimized electrode layout to detect intracranial haematomas for use in emergency care. A growing haematoma can cause severe and even permanent damage to the delicate tissue of the brain, morbidity, and eventual death of the patient. No capability is at present available for the diagnosis of haematomas pre-hospitalisation or by first-responders. The lack of this crucial information can lead to bad decisions on patient management, and in particular, where to send the patient. Blood has a high electrical conductivity contrast relative to other cranial tissue and can be detected and monitored using electrical impedance methods. EIT is a non-invasive, low-cost monitoring alternative to other imaging modalities, and has the potential to detect bleeding and to localize the approximate bleeding site. A device of this nature would reduce treatment delays, save on costs and waste, and most significantly, positively impact patient outcomes. The first step was a numerical simulation study on FE models. The full array and the hemi-array electrode layouts were modelled and the anomalies were simulated in different positions with different sizes. The results were obtained using TSVD and WMNM reconstruction methods by COMSOL linked with MATLAB. The simulated anomalies were detected for all the positions using both layouts; however those from the full array were in general superior to the hemi-array. In order to perform realistic experiments, a prototype EIT system was constructed in the laboratory. The constructed EIT has 16 channels and operates in the frequency range of 10 kHz to 100 kHz with a temporal resolution of 100 frames per second and high level of accuracy of 93.5 %. The minimum number of 8 electrodes was chosen in this study for emergency care. Minimizing the number of electrodes speeds up the electrode setup process and avoids the need to move the patient s head in emergency care. In the second part of this study, phantom experiments were performed to find an optimised electrode layout for emergency care. The full array and the hemi-array were investigated using phantom experiments. As expected, the full array layout had the best performance in general; however, the performance of the hemi-array layout was very poor. Thus a novel optimised electrode layout (semi-array) for emergency care was proposed and evaluated in phantom experiments. For the hemi-array and the semi-array layouts, measurement sensitivity depends strongly on the anomaly location since the electrodes are not placed all over the head. The HA layout performed very badly, with the best radial localization error of 0.8100 mm, compared to the SA layout with the worst error of 0.2486 mm. Some reconstructed anomalies located far from the electrodes in the posterior region were almost invisible or erroneous for the hemi-array layout; however, it is enhanced by using the semi-array layout. Finally, in vitro experiments were conducted on ovine models. In most of the experiments carried out by other researchers, since the location of the simulated anomalies was not known and the simulated blood was normally injected into the body or the head, localization of the anomalies was not considered and the quantity of the injected blood was investigated solely. In our new method of experiment, the position of the anomalies was known a priori and thus could be compared accurately to the EIT results. The full array and the semi-array layouts were compared in terms of detection, localisation and size estimation of haematomas. As expected, the full array layout was found to be more robust than the semi-array layout with the best mean value of the localization error of 0.0564 mm and the worst QI error of around 30%. Using a minimum number of electrodes in an optimised layout is always desirable in clinical applications. The semi-array 8-electrode layout prevents unnecessary movements and the electrode connections to the head would be very quick in emergency care. Although the semi-array 8-electrode layout reduced the sensitivity of the measurements, the findings from the experiments indicated its potential to detect and monitor haematomas and probably extend its application for emergency applications where the required accuracy is not critical

DICOM for EIT

With EIT starting to be used in routine clinical practice [1], it important that the clinically relevant information is portable between hospital data management systems. DICOM formats are widely used clinically and cover many imaging modalities, though not specifically EIT. We describe how existing DICOM specifications, can be repurposed as an interim solution, and basis from which a consensus EIT DICOM ‘Supplement’ (an extension to the standard) can be writte

Estimation of thorax shape for forward modelling in lungs EIT

The thorax models for pre-term babies are developed based on the CT scans from new-borns and their effect on image reconstruction is evaluated in comparison with other available models

Rapid generation of subject-specific thorax forward models

For real-time monitoring of lung function using accurate patient geometry, shape information needs to be acquired and a forward model generated rapidly. This paper shows that warping a cylindrical model to an acquired shape results in meshes of acceptable mesh quality, in terms of stretch and aspect ratio

Torso shape detection to improve lung monitoring

Two methodologies are proposed to detect the patient-specific boundary of the chest, aiming to produce a more accurate forward model for EIT analysis. Thus, a passive resistive and an inertial prototypes were prepared to characterize and reconstruct the shape of multiple phantoms. Preliminary results show how the passive device generates a minimum scatter between the reconstructed image and the actual shap

Nanoparticle electrical impedance tomography

We have developed a new approach to imaging with electrical impedance tomography (EIT) using gold nanoparticles (AuNPs) to enhance impedance changes at targeted tissue sites. This is achieved using radio frequency (RF) to heat nanoparticles while applying EIT imaging. The initial results using 5-nm citrate coated AuNPs show that heating can enhance the impedance in a solution containing AuNPs due to the application of an RF field at 2.60 GHz

Tecniche Elettrotomografiche per la caratterizzazione dei tessuti biologici

Electrical impedance tomography (EIT) is an imaging modality wherein the spatial map of conductivity and permittivity inside a medium is obtained from a set of surface electrical measurements. Electrodes are brought into contact with the surface of the object being imaged and a set of currents are applied and the corresponding voltages are measured. These voltages and currents are then used to estimate the electrical properties of the object using an image reconstruction algorithm which relies on an accurate model of the electrical interaction. The process of property estimation, called inverse problem, is highly ill-posed and it requires a Regularization method. The objective of this Thesis was to develop a device for imaging using the EIT technique, which was convenient, noninvasive, easily programmable, portable and relatively cheap in contrast to many other diagnostic tool. In this direction a simple EIT system and its hardware and software parts are developed. The data processing was accomplished by utilizing the EIDORS toolkit, which was developed for application to this nonlinear and ill-posed inverse problem. Experiments have indicated that the EIT system can reconstruct resistive and capacitive images of good contrast despite errors in the measurement are not taken in account