Optimized breath detection algorithm in electrical impedance tomography.

OBJECTIVE: This paper defines a method for optimizing the breath delineation algorithms used in electrical impedance tomography (EIT). In lung EIT the identification of the breath phases is central for generating tidal impedance variation images, subsequent data analysis and clinical evaluation. The optimisation of these algorithms is particularly important in neonatal care since the existing breath detectors developed for adults may give insufficient reliability in neonates due to their very irregular breathing pattern. APPROACH: Our approach is generic in the sense that it relies on the definition of a gold standard and the associated definition of detector sensitivity and specificity, an optimisation criterion and a set of detector parameters to be investigated. The gold standard has been defined by 11 clinicians with previous experience with EIT and the performance of our approach is described and validated using a neonatal EIT dataset acquired within the EU-funded CRADL project. MAIN RESULTS: Three different algorithms are proposed that improve the breath detector performance by adding conditions on (1) maximum tidal breath rate obtained from zero-crossings of the EIT breathing signal, (2) minimum tidal impedance amplitude and (3) minimum tidal breath rate obtained from time-frequency analysis. As a baseline a zero-crossing algorithm has been used with some default parameters based on the Swisstom EIT device. SIGNIFICANCE: Based on the gold standard, the most crucial parameters of the proposed algorithms are optimised by using a simple exhaustive search and a weighted metric defined in connection with the receiver operating characterics. This provides a practical way to achieve any desirable trade-off between the sensitivity and the specificity of the detectors.

Torso shape detection to improve lung monitoring.

OBJECTIVE: Newborns with lung immaturity often require continuous monitoring and treatment of their lung ventilation in intensive care units, especially if born preterm. Recent studies indicate that electrical impedance tomography (EIT) is feasible in newborn infants and children, and can quantitatively identify changes in regional lung aeration and ventilation following alterations to respiratory conditions. Information on the patient-specific shape of the torso and its role in minimizing the artefacts in the reconstructed images can improve the accuracy of the clinical parameters obtained from EIT. Currently, only idealized models or those segmented from CT scans are usually adopted. APPROACH: This study presents and compares two methodologies that can detect the patient-specific torso shape by means of wearable devices based on (1) previously reported bend sensor technology, and (2) a novel approach based on the use of accelerometers. MAIN RESULTS: The reconstruction of different phantoms, taking into account anatomical asymmetries and different sizes, are produced for comparison. SIGNIFICANCE: As a result, the accelerometers are more versatile than bend sensors, which cannot be used on bigger cross-sections. The computational study estimates the optimal number of accelerometers required in order to generate an image reconstruction comparable to the use of a CT scan as the forward model. Furthermore, since the patient position is crucial to monitoring lung ventilation, the orientation of the phantoms is automatically detected by the accelerometer-based method.