Real-time conductivity imaging of temperature and tissue property changes during radiofrequency ablation: an ex vivo model using weighted frequency difference.

We demonstrated the feasibility of time difference and weighted frequency difference conductivity imaging for real-time monitoring of temperature distribution and ablation region estimation during radiofrequency (RF) ablation. The electrical conductivity spectrum of biological tissue reflects mobility of ions in intra- and extra-cellular fluids and changes in cellular morphology induced by heating. The time series conductivity spectra were measured in an ex vivo bovine liver by a high-speed electrical impedance tomography (EIT) system. The EIT system was protected by filters to suppress RF energy and allow interleaved real-time imaging. We recorded time and weighted frequency-difference conductivity images and direct temperature variations at the ablation region and control region during 8 min ablation and for the following 66 min of cooling. Conductivity variation in regions of interest was compared with temperature recordings. Contours of conductivity change were visualized and compared to estimate the ablation area. EIT images confirmed increase of conductivity at all frequencies and loss of frequency conductivity change associated with loss of cellular structure. Time difference conductivity images showed changes due to both heating during ablation and heat dissipation following ablation together with tissue property changes. Weighted frequency-difference images presented persistent changes following heating due to the morphological change in the ablation zone.

Conductivity image enhancement in MREIT using adaptively weighted spatial averaging filter.

BACKGROUND: In magnetic resonance electrical impedance tomography (MREIT), we reconstruct conductivity images using magnetic flux density data induced by externally injected currents. Since we extract magnetic flux density data from acquired MR phase images, the amount of measurement noise increases in regions of weak MR signals. Especially for local regions of MR signal void, there may occur excessive amounts of noise to deteriorate the quality of reconstructed conductivity images. In this paper, we propose a new conductivity image enhancement method as a postprocessing technique to improve the image quality. METHODS: Within a magnetic flux density image, the amount of noise varies depending on the position-dependent MR signal intensity. Using the MR magnitude image which is always available in MREIT, we estimate noise levels of measured magnetic flux density data in local regions. Based on the noise estimates, we adjust the window size and weights of a spatial averaging filter, which is applied to reconstructed conductivity images. Without relying on a partial differential equation, the new method is fast and can be easily implemented. RESULTS: Applying the novel conductivity image enhancement method to experimental data, we could improve the image quality to better distinguish local regions with different conductivity contrasts. From phantom experiments, the estimated conductivity values had 80% less variations inside regions of homogeneous objects. Reconstructed conductivity images from upper and lower abdominal regions of animals showed much less artifacts in local regions of weak MR signals. CONCLUSION: We developed the fast and simple method to enhance the conductivity image quality by adaptively adjusting the weights and window size of the spatial averaging filter using MR magnitude images. Since the new method is implemented as a postprocessing step, we suggest adopting it without or with other preprocessing methods for application studies where conductivity contrast is of primary concern.

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.

Design of a microscopic electrical impedance tomography system for 3D continuous non-destructive monitoring of tissue culture.

BACKGROUND: Non-destructive continuous monitoring of regenerative tissue is required throughout the entire period of in vitro tissue culture. Microscopic electrical impedance tomography (micro-EIT) has the potential to monitor the physiological state of tissues by forming three-dimensional images of impedance changes in a non-destructive and label-free manner. We developed a new micro-EIT system and report on simulation and experimental results of its macroscopic model. METHODS: We propose a new micro-EIT system design using a cuboid sample container with separate current-driving and voltage sensing electrodes. The top is open for sample manipulations. We used nine gold-coated solid electrodes on each of two opposing sides of the container to produce multiple linearly independent internal current density distributions. The 360 voltage sensing electrodes were placed on the other sides and base to measure induced voltages. Instead of using an inverse solver with the least squares method, we used a projected image reconstruction algorithm based on a logarithm formulation to produce projected images. We intended to improve the quality and spatial resolution of the images by increasing the number of voltage measurements subject to a few injected current patterns. We evaluated the performance of the micro-EIT system with a macroscopic physical phantom. RESULTS: The signal-to-noise ratio of the developed micro-EIT system was 66 dB. Crosstalk was in the range of -110.8 to -90.04 dB. Three-dimensional images with consistent quality were reconstructed from physical phantom data over the entire domain. From numerical and experimental results, we estimate that at least 20 × 40 electrodes with 120 µm spacing are required to monitor the complex shape of ingrowth neotissue inside a scaffold with 300 µm pore. CONCLUSION: The experimental results showed that the new micro-EIT system with a reduced set of injection current patterns and a large number of voltage sensing electrodes can be potentially used for tissue culture monitoring. Numerical simulations demonstrated that the spatial resolution could be improved to the scale required for tissue culture monitoring. Future challenges include manufacturing a bioreactor-compatible container with a dense array of electrodes and a larger number of measurement channels that are sensitive to the reduced voltage gradients expected at a smaller scale.

Fast conductivity imaging in magnetic resonance electrical impedance tomography (MREIT) for RF ablation monitoring.

PURPOSE: This study shows the potential of magnetic resonance electrical impedance tomography (MREIT) as a non-invasive RF ablation monitoring technique. MATERIALS AND METHODS: We prepared bovine muscle tissue with a pair of needle electrodes for RF ablation, a temperature sensor, and two pairs of surface electrodes for conductivity image reconstructions. We used the injected current non-linear encoding with multi-echo gradient recalled echo (ICNE-MGRE) pulse sequence in a series of MREIT scans for conductivity imaging. We acquired magnetic flux density data induced by externally injected currents, while suppressing other phase artefacts. We used an 8-channel RF head coil and 8 echoes to improve the signal-to-noise ratio (SNR) in measured magnetic flux density data. Using the measured data, we reconstructed a time series of 180 conductivity images at every 10.24 s during and after RF ablation. RESULTS: Tissue conductivity values in the lesion increased with temperature during RF ablation. After reaching 60 °C, a steep increase in tissue conductivity values occurred with relatively little temperature increase. After RF ablation, tissue conductivity values in the lesion decreased with temperature, but to values different from those before ablation due to permanent structural changes of tissue by RF ablation. CONCLUSION: We could monitor temperature and also structural changes in tissue during RF ablation by producing spatio-temporal maps of tissue conductivity values using a fast MREIT conductivity imaging method. We expect that the new monitoring method could be used to estimate lesions during RF ablation and improve the efficacy of the treatment.

Electrical impedance spectroscopy for electro-mechanical characterization of conductive fabrics.

When we use a conductive fabric as a pressure sensor, it is necessary to quantitatively understand its electromechanical property related with the applied pressure. We investigated electromechanical properties of three different conductive fabrics using the electrical impedance spectroscopy (EIS). We found that their electrical impedance spectra depend not only on the electrical properties of the conductive yarns, but also on their weaving structures. When we apply a mechanical tension or compression, there occur structural deformations in the conductive fabrics altering their apparent electrical impedance spectra. For a stretchable conductive fabric, the impedance magnitude increased or decreased under tension or compression, respectively. For an almost non-stretchable conductive fabric, both tension and compression resulted in decreased impedance values since the applied tension failed to elongate the fabric. To measure both tension and compression separately, it is desirable to use a stretchable conductive fabric. For any conductive fabric chosen as a pressure-sensing material, its resistivity under no loading conditions must be carefully chosen since it determines a measurable range of the impedance values subject to different amounts of loadings. We suggest the EIS method to characterize the electromechanical property of a conductive fabric in designing a thin and flexible fabric pressure sensor.

High density trans-admittance mammography development and preliminary phantom tests.

BACKGROUND: Malignant breast tumor tissue has a significantly different electrical impedance spectrum than surrounding normal tissues. This has led to the development of impedance imaging as a supplementary or alternative method to X-ray mammography for screening and assessment of breast cancers. However low spatial resolution and poor signal to noise ratio has limited the clinical application. METHODS: In order to improve spatial resolution we developed a trans-admittance mammography (TAM) system including an array of 60×60 current sensing electrodes. We adopted a similar setup to X-ray mammography where the breast is situated between two holding plates. The top plate is a large solid metal electrode for applying a sinusoidal voltage over a range of frequencies from 50 Hz to 500 kHz. The bottom plate has 3600 current sensing electrodes that are kept at the ground potential. Currents are generated from the top voltage-applying electrode and spread throughout the breast, entering the TAM system through the array of current sensing electrodes on the bottom plate. The TAM system measures the exit currents through 6 switching modules connected to 600 electrodes each. Each switching module is connected to 12 ammeter channels which are switched sequentially to 50 of the 600 electrodes each measurement time. Each ammeter channel is comprised of a current-to-voltage converter, a gain amplifier, filters, an analog to digital converter, and a digital phase sensitive demodulator. RESULTS: We found an average noise level of 38 nA, amplitude stability of less than 0.2%, crosstalk of better than -60 dB and 70 dB signal to noise ratio over all channels and operating frequencies. Images were obtained in time difference and frequency difference modes in a saline phantom. CONCLUSION: We describe the design, construction, and calibration of a high density TAM system in detail. Successful high resolution time and frequency difference images showed regions of interest with the expected admittivity changes in the frequency spectrum.

Portable multi-parameter electrical impedance tomography for sleep apnea and hypoventilation monitoring: feasibility study.

OBJECTIVE: Quantitative ventilation monitoring and respiratory event detection are needed for the diagnosis of sleep apnea and hypoventilation. We developed a portable device with a chest belt, nasal cannula and finger sensor to continuously acquire multi-channel signals including tidal volume, nasal pressure, respiratory effort, body position, snoring sound, ECG and SpO2. The unique feature of the device is the continuous tidal volume signal obtained from real-time lung ventilation images produced by the electrical impedance tomography (EIT) technique. APPROACH: The chest belt includes 16 electrodes for real-time time-difference EIT imaging and ECG data acquisitions. It also includes a microphone, accelerometer, gyroscope, magnetometer and pressure sensor to acquire, respectively, snoring sound, respiratory effort, body position and nasal pressure signals. A separate finger sensor is used to measure SpO2. The minute ventilation signal is derived from the tidal volume signal and respiration rate. MAIN RESULTS: The experimental results from a conductivity phantom, four swine subjects and one human volunteer show that the developed multi-parameter EIT device could supplement existing polysomnography (PSG) and home sleep test (HST) devices to improve the accuracy of sleep apnea diagnosis. The portable device could be also used as a new tool for continuous hypoventilation monitoring of non-intubated patients with respiratory depression. SIGNIFICANCE: Following the feasibility study in this paper, future validation studies in comparison with in-lab PSG, HST and end-tidal CO2 devices are suggested to find its clinical efficacy as a sleep apnea diagnosis and hypoventilation monitoring tool.

Feasibility of anomaly detection and characterization using trans-admittance mammography with 60 × 60 electrode array.

Electrical impedance imaging has the potential to detect an early stage of breast cancer due to higher admittivity values compared with those of normal breast tissues. The tumor size and extent of axillary lymph node involvement are important parameters to evaluate the breast cancer survival rate. Additionally, the anomaly characterization is required to distinguish a malignant tumor from a benign tumor. In order to overcome the limitation of breast cancer detection using impedance measurement probes, we developed the high density trans-admittance mammography (TAM) system with 60 × 60 electrode array and produced trans-admittance maps obtained at several frequency pairs. We applied the anomaly detection algorithm to the high density TAM system for estimating the volume and position of breast tumor. We tested four different sizes of anomaly with three different conductivity contrasts at four different depths. From multifrequency trans-admittance maps, we can readily observe the transversal position and estimate its volume and depth. Specially, the depth estimated values were obtained accurately, which were independent to the size and conductivity contrast when applying the new formula using Laplacian of trans-admittance map. The volume estimation was dependent on the conductivity contrast between anomaly and background in the breast phantom. We characterized two testing anomalies using frequency difference trans-admittance data to eliminate the dependency of anomaly position and size. We confirmed the anomaly detection and characterization algorithm with the high density TAM system on bovine breast tissue. Both results showed the feasibility of detecting the size and position of anomaly and tissue characterization for screening the breast cancer.

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.

Evaluation of anomaly detection algorithm using trans-admittance mammography with 60 × 60 electrode array.

Electrical impedance imaging has a potential to detect an early stage of breast cancer due to higher admittivity values compared with those of normal breast tissues. Specially, tumor size and extent of axillary lymph node involvement are important parameters to evaluate the breast cancer survival rate. We applied the anomaly detection algorithm to the high density trans-admittance mammography system for estimating the size and position of breast cancer. We tested 4 different size of anomaly with 3 different conductivity contrasts at 5 different depths. From a frequency difference trans-admittance map, we can readily observe the transversal position and estimate its size and depth. However, the size estimation was dependent on the admittivity contrast between anomaly and background. It requires the robust detection algorithm regardless of the conductivity contrast.

An amplitude-to-time conversion technique suitable for multichannel data acquisition and bioimpedance imaging.

In this paper we exploit the high timing resolution offered by microprocessors to develop an amplitude measurement approach that is convenient for high channel count portable sinusoidal recording systems such as the bioimpedance measurements used in impedance imaging. This approach reduces the number of components required per channel, reducing cost, size and power consumption compared to the traditional approaches. The setup uses two high performance comparators to convert amplitude difference to a timing difference. This is captured by a high speed microprocessor. A straightforward algorithm removes DC and timing offsets. We suggest three modes of operation: fast: less than one period of the input, normal: exactly one input period and high precision: multiple input periods. The mean signal-to-noise ratio was 40, 81, and 112.4 dB in fast, normal, and high precision mode respectively for a range of resistive loads.

Nanofiber web textile dry electrodes for long-term biopotential recording.

Electrode properties are key to the quality of measured biopotential signals. Ubiquitous health care systems require long-term monitoring of biopotential signals from normal volunteers and patients in home or hospital environments. In these settings it is appropriate to use dry textile electrode networks for monitoring purposes, rather than the gel or saline-sponge skin interfaces used with Ag/AgCl electrodes. In this study, we report performance test results of two different electrospun conductive nanofiber webs, and three metal plated fabrics. We evaluated contact impedance, step response, noise and signal fidelity performance indices for all five dry electrodes, and compared them to those of conventional Ag/AgCl electrodes. Overall, we found nanofiber web electrodes matched Ag/AgCl electrode performance more closely than metal plated fabric electrodes, with the contact resistance and capacitance of Ag plated PVDF nanofiber web electrodes being most similar to Ag/AgCl over the 10 Hz to 500 kHz frequency range. We also observed that step responses of all three metal-plated fabrics were poorer than those for nanofiber web electrodes and Ag/AgCl. Further, noise standard deviation and noise power spectral densities were generally lower in nanofiber web electrodes than metal plated fabrics; and waveform fidelity of ECG-like traces recorded from nanofiber web electrodes was higher than for metal plated fabrics. We recommend textile nanofiber web electrodes in applications where flexibility, comfort and durability are required in addition to good electrical characteristics.

Design of a microscopic electrical impedance tomography system using two current injections.

We describe a novel design of a microscopic electrical impedance tomography (micro-EIT) system for long-term noninvasive monitoring of cell or tissue cultures. The core of the micro-EIT system is a sample container including two pairs of current-injection electrodes and 360 voltage-sensing electrodes. In designing the container, we took advantage of a hexagonal structure with fixed dimensions and electrode configuration. This eliminated technical difficulties related to the unknown irregular boundary geometry of an imaging object in conventional medical EIT. Attaching a pair of large current-injection electrodes fully covering the left and right sides of the hexagonal container, we generated uniform parallel current density inside the container filled with saline. The 360 voltage-sensing electrodes were placed on the front, bottom and back sides of the hexagonal container in three sets of 8 × 15 arrays with equal gaps between them. We measured voltage differences between all neighboring pairs along the direction of the parallel current pathway. For the homogeneous container, all measured voltages must be the same since the voltage changes linearly along that direction. Any anomaly in the container perturbed the current pathways and therefore equipotential lines to produce different differential voltage data. For conductivity image reconstructions, we adopted a lately developed image reconstruction algorithm for this electrode configuration to first produce projected conductivity images on the front, bottom and back sides. Using a backprojection method, we reconstructed three-dimensional conductivity images from those projection images. To improve the image quality and also to meet the mathematical requirement on the uniqueness of a reconstructed image, we used a second pair of thin and long current-injection electrodes located at the middle of the front and back sides. This paper describes the design and construction of such a micro-EIT system with experimental results. Proposing the novel micro-EIT system design, we suggest future studies of miniaturizing the sample container for true microscopic conductivity imaging of cell or tissue cultures.

A fully parallel multi-frequency EIT system with flexible electrode configuration: KHU Mark2.

We report the development of a new multi-frequency electrical impedance tomography (EIT) system called the KHU Mark2. It is descended from the KHU Mark1 in terms of technical details such as digital waveform generation, Howland current source with multiple generalized impedance converters and digital phase-sensitive demodulators. New features include flexible electrode configurations to accommodate application-specific requirements, multiple independent current sources and voltmeters for fully parallel operations, improved data acquisition speeds for faster frame rates and compact mechanical design. Given an electrode configuration, we can design an analog backplane in such a way that both current injections and voltage measurements can be done without using any switch. The KHU Mark2 is based on an impedance measurement module (IMM) comprising a current source and a voltmeter. Using multiple IMMs, we can construct a multi-channel system with 16, 32 or 64 channels, for example. Adopting a pipeline structure, it has the maximum data acquisition speed of 100 scans s(-1) with the potential to detect fast physiological changes during respiration and cardiac activity. Measuring both in-phase and quadrature components of trans-impedances at multiple frequencies simultaneously, the KHU Mark2 is apt at spectroscopic EIT imaging. In this paper, we describe its design, construction, calibration and performance evaluation. It has about 84 dB signal-to-noise ratio and 0.5% reciprocity error. Time-difference images of an admittivity phantom are presented showing spectroscopic admittivity images. Future application studies using the KHU Mark2 are briefly discussed.