Characterization of tissue properties in epidural needle insertion on human specimen and synthetic materials.

The force experienced while inserting an 18-gauge Tuohy needle into the epidural space or dura is one of only two feedback components perceived by an anaesthesiologist to deduce the needle tip position in a patient's spine. To the best of the authors knowledge, no x-ray validated measurements of these forces are currently available to the public. A needle insertion force recording during an automated insertion of an 18-gauge Tuohy needle into human vertebral segments of four female donors was conducted. During the measurements, x-ray images were recorded simultaneously. The force peaks due to the penetration of the ligamentum supraspinale and ligamentum flavum were measured and compared to the measurements of an artificial patient phantom for a hybrid patient simulator. Based on these force peaks and the slope of the ligamentum interspinale, a mathematical model was developed. The model parameters were used to compare human specimens and artificial patient phantom haptics. The force peaks for the ligamenta supraspinale and flavum were 7.55 ± 3.63 N and 15.18 ± 5.71 N, respectively. No significant differences were found between the patient phantom and the human specimens for the force peaks and four of six physical model parameters. The patient phantom mimics the same resistive force against the insertion of an 18-gauge Tuohy needle. However, there was a highly significant (p < 0.001, effsize = 0.949 and p < 0.001, effsize = 0.896) statistical difference observed in the insertion depth where the force peaks of the ligamenta supraspinale and flavum were detected between the measurements on the human specimens and the patient phantom. Within this work, biomechanical evidence was identified for the needle insertion force into human specimens. The comparison of the measured values of the human vertebral segments and the artificial patient phantom showed promising results.

Magnetic induction tomography: comparison of the image quality using different types of receivers.

Magnetic induction tomography is used to image the electrical properties inside a region of interest. The systems differ in the construction of the receiver channels which can be composed of coils or gradiometers. We will compare and discuss the image quality subject to two different types of receivers, different arrangements for the exciters and receivers and different signal-to-noise ratios. In order to evaluate the image quality, the point-spread function (PSF) was determined which is used for the calculation of the resolution and the correctness of the location of a perturbation. The results show that the PSF depends on (a) the location inside the object, (b) the type of receivers and (c) the configuration used, especially the location of the receiving and excitation channels. According to this, the local resolution is changed and has the maximum near the border of the object and decreases towards the centre of the object. In addition, the evaluation of the PSF shows a dislocation with respect to the underlying point-source position.

Magnetic induction tomography: evaluation of the point spread function and analysis of resolution and image distortion.

Magnetic induction tomography (MIT) is a low-resolution imaging modality used for reconstructing the changes of the passive electrical properties in a target object. For an imaging system, it is very important to give forecasts about the image quality. Both the maximum resolution and the correctness of the location of the inhomogeneities are of major interest. Furthermore, the smallest object which can be detected for a certain noise level is a criterion for the diagnostic value of an image. The properties of an MIT image are dependent on the position inside the object, the conductivity distribution and of course on the location and the number of excitation coils and receiving coils. Quantitative statements cannot be made in general but it is feasible to predict the image quality for a selected problem. For electrical impedance tomography (EIT), the theoretical limits of image quality have been studied carefully and a comprehensive analysis for MIT is necessary. Thus, a simplified analysis on resolution, dimensions and location of an inhomogeneity was carried out by means of an evaluation of the point spread function (PSF). In analogy to EIT the PSF depends strongly on the location, showing the broadest distribution in the centre of the object. Increasing the amount of regularization according to increasing measurement noise, the PSF broadens and its centre is shifted towards the borders of the object. The resolution is indirectly proportional to the width of the PSF and increases when moving from the centre towards the border of the object and decreases with increasing noise.

Single-step 3-d image reconstruction in magnetic induction tomography: theoretical limits of spatial resolution and contrast to noise ratio.

Magnetic induction tomography (MIT) is a low-resolution imaging modality for reconstructing the changes of the complex conductivity in an object. MIT is based on determining the perturbation of an alternating magnetic field, which is coupled from several excitation coils to the object. The conductivity distribution is reconstructed from the corresponding voltage changes induced in several receiver coils. Potential medical applications comprise the continuous, non-invasive monitoring of tissue alterations which are reflected in the change of the conductivity, e.g. edema, ventilation disorders, wound healing and ischemic processes. MIT requires the solution of an ill-posed inverse eddy current problem. A linearized version of this problem was solved for 16 excitation coils and 32 receiver coils with a model of two spherical perturbations within a cylindrical phantom. The method was tested with simulated measurement data. Images were reconstructed with a regularized single-step Gauss-Newton approach. Theoretical limits for spatial resolution and contrast/noise ratio were calculated and compared with the empirical results from a Monte-Carlo study. The conductivity perturbations inside a homogeneous cylinder were localized for a SNR between 44 and 64 dB. The results prove the feasibility of difference imaging with MIT and give some quantitative data on the limitations of the method.

Reconstruction of the shape of conductivity spectra using differential multi-frequency magnetic induction tomography.

Magnetic induction tomography (MIT) of biological tissue is used for the reconstruction of the complex conductivity distribution kappa inside the object under investigation. It is based on the perturbation of an alternating magnetic field caused by the object and can be used in all applications of electrical impedance tomography (EIT) such as functional lung monitoring and assessment of tissue fluids. In contrast to EIT, MIT does not require electrodes and magnetic fields can also penetrate non-conducting barriers such as the skull. As in EIT, the reconstruction of absolute conductivity values is very difficult because of the method's sensitivity to numerical errors and noise. To overcome this problem, image reconstruction in EIT is often done differentially. Analogously, this concept has been adopted for MIT. Two different methods for differential imaging are applicable. The first one is state-differential, for example when the conductivity change between inspiration and expiration in the lung regions is being detected. The second one is frequency-differential, which is of high interest in motionless organs like the brain, where a state-differential method cannot be applied. An equation for frequency-differential MIT was derived taking into consideration the frequency dependence of the sensitivity matrix. This formula is valid if we can assume that only small conductivity changes occur. In this way, the non-linear inverse problem of MIT can be approximated by a linear one (depending only on the frequency), similar to in EIT. Keeping this limitation in mind, the conductivity changes between one or more reference frequencies and several measurement frequencies were reconstructed, yielding normalized conductivity spectra. Due to the differential character of the method, these spectra do not provide absolute conductivities but preserve the shape of the spectrum. The validity of the method was tested with artificial data generated with a spherical perturbation within a conducting cylinder as well as for real measurement data. The measurement data were obtained from a potato immersed in saline. The resulting spectra were compared with reference measurements and the preservation of the shape of the spectra was analyzed.

Solution of the inverse problem of magnetic induction tomography (MIT) with multiple objects: analysis of detectability and statistical properties with respect to the reconstructed conducting region.

Magnetic induction tomography (MIT) is a technique to image the passive electrical properties (i.e. conductivity, permittivity, permeability) of biological tissues. The inverse eddy current problem is nonlinear and ill-posed, thus a Gauss-Newton one-step method in combination with four different regularization schemes is used to obtain stable solutions. Simulations with 16 excitation coils, 32 receiving coils and different spherical perturbations inside a homogeneous cylinder were computed. In order to compare the statistical properties of the reconstructed results a Monte Carlo study with a SNR of 40 dB and 20 dB was carried out. Simulated conductivity perturbations inside a homogeneous cylinder can be localized and resolved and the results prove the feasibility of difference imaging with MIT.

Direct reconstruction of tissue parameters from differential multifrequency EIT in vivo.

The basic purpose of electrical impedance tomography (EIT) is the reconstruction of conductivity distributions. While multifrequency measurements are of common use, the majority of reconstructed images are still conductivity distributions from one single frequency. More interesting than conductivities at each frequency are electrical tissue parameters, which describe the frequency-dependent conductivity changes of tissue. These parameters give information about physiological or electrical properties of tissues. By using this spectral information, a classification of different tissue types is possible. To get a distribution of tissue parameters, usually a posterior fitting of a tissue model to the conductivity spectra obtained with classical reconstruction algorithms at various frequencies is used. In this work, a single-step reconstruction algorithm for differential imaging was developed for the direct estimation of Cole parameters. This method is termed differential parametric reconstruction. The Cole model was used as the underlying tissue model, where only the relative changes of the two conductivity parameters sigma(0) and sigma(infinity) were reconstructed and the other two parameters of the model which are less identifiable were set to constant values. The reconstruction algorithm was tested with simulated noisy datasets and real measurement data from EIT measurements on the human thorax. These measurements were taken from healthy subjects and from patients with a serious lung injury. The new method yields a good image quality and higher robustness against noise compared to conventional reconstruction methods.

Monitoring of lung edema using focused impedance spectroscopy: a feasibility study.

Currently only ionizing or invasive methods are used in clinical applications for the monitoring of extracellular lung water. Alternatively a method called focused conductivity spectroscopy (FCS) is suggested, which aims at reconstructing a pulmonary edema index (PEIX) by measuring the electrical conductivity of the region of interest (ROI) at several frequencies. In contrast to electrical impedance tomography (EIT) a minimum number of strategically placed electrodes is used. The goals of this study were the analysis of the sensitivity for the PEIX, an estimate of the optimal electrode configuration and the determination of the required frequencies. In order to calculate the solution of the FCS forward problem a realistic 3D model of a human torso was developed containing both lungs, the heart, the liver and the thorax musculature. The bioelectrical properties for each compartment were described with appropriate tissue models which relate the conductivity spectra to physiological parameters. The PEIX was defined as the interstitial volume fraction of the alveolar septa. Furthermore the model includes 48 electrodes subdivided into three layers. The optimal electrode configuration was selected by minimizing the number of electrodes, among certain subsets of these electrodes. The analysis shows that eight to ten electrodes and six frequencies are theoretically sufficient to obtain a coefficient of variation.

Solution of the inverse problem of magnetic induction tomography (MIT).

Magnetic induction tomography (MIT) of biological tissue is used to reconstruct the changes in the complex conductivity distribution inside an object under investigation. The measurement principle is based on determining the perturbation DeltaB of a primary alternating magnetic field B0, which is coupled from an array of excitation coils to the object under investigation. The corresponding voltages DeltaV and V0 induced in a receiver coil carry the information about the passive electrical properties (i.e. conductivity, permittivity and permeability). The reconstruction of the conductivity distribution requires the solution of a 3D inverse eddy current problem. As in EIT the inverse problem is ill-posed and on this account some regularization scheme has to be applied. We developed an inverse solver based on the Gauss-Newton-one-step method for differential imaging, and we implemented and tested four different regularization schemes: the first and second approaches employ a classical smoothness criterion using the unit matrix and a differential matrix of first order as the regularization matrix. The third method is based on variance uniformization, and the fourth method is based on the truncated singular value decomposition. Reconstructions were carried out with synthetic measurement data generated with a spherical perturbation at different locations within a conducting cylinder. Data were generated on a different mesh and 1% random noise was added. The model contained 16 excitation coils and 32 receiver coils which could be combined pairwise to give 16 planar gradiometers. With 32 receiver coils all regularization methods yield fairly good 3D-images of the modelled changes of the conductivity distribution, and prove the feasibility of difference imaging with MIT. The reconstructed perturbations appear at the right location, and their size is in the expected range. With 16 planar gradiometers an additional spurious feature appears mirrored with respect to the median plane with negative sign. This demonstrates that a symmetrical arrangement with one ring of planar gradiometers cannot distinguish between a positive conductivity change at the true location and a negative conductivity change at the mirrored location.

A new type of gradiometer for the receiving circuit of magnetic induction tomography (MIT).

Magnetic induction tomography (MIT) is a low-resolution imaging modality which aims at the three-dimensional (3D) reconstruction of the electrical conductivity in objects from alternating magnetic fields. In MIT systems the magnetic field perturbations to be detected are very small when compared to the excitation field (ppm range). The voltage which is induced by the excitation field in the receiver coils must be suppressed for providing sufficient dynamic range. In the past, two very efficient strategies were proposed: adjusted planar gradiometers (PGRAD) and the orientation of a receiver coil with respect to the excitation coil such that the net magnetic flow is zero (zero flow coil, ZFC). In contrast to the PGRAD no voltage is induced in the ZFC by the main field. This is advantageous because two comparatively high voltages in the two gradiometer coils can never be subtracted perfectly, thus leaving a residual voltage which is prone to drift. However, a disadvantage of the ZFC is the higher susceptibility to interferences from far RF sources. In contrast, in the gradiometer such interferences are cancelled to a high degree. We developed a new type of gradiometer (zero flow gradiometer, ZFGRAD) which combines the advantages of ZFC and PGRAD. All three systems were compared with respect to sensitivity and perturbation to signal ratio (PSR) defined as the ratio of the signal change due to a magnetic perturbation field at the carrier frequency and the signal change due to shifting a metallic sphere between two test points. The spatial sensitivity of the three systems was found to be very similar. The PSR of the ZFGRAD was more than 12 times lower than that of the ZFC. Finally, the feasibility of image reconstruction with two arrays of eight excitation coils and eight ZFGRAD, respectively, was shown with a single-step Gauss-Newton reconstructor and simulated measurement data generated for a cylindrical tank with a spherical perturbation. The resulting images show a clear, bright feature at the correct position of the sphere and are comparable to those with PGRAD arrays.

Planar gradiometer for magnetic induction tomography (MIT): theoretical and experimental sensitivity maps for a low-contrast phantom.

Planar gradiometers (PGRAD) have particular advantages compared to solenoid receiver coils in magnetic induction tomography (MIT) for biological objects. A careful analysis of the sensitivity maps has to be carried out for perturbations within conducting objects in order to understand the performance of a PGRAD system and the corresponding implications for the inverse problem of MIT. We calculated and measured sensitivity maps for a single MIT-channel and a cylindrical tank (diameter 200 mm) with a spherical perturbation (diameter 50 mm) and with conductivities in the physiological range (0.4-0.8 S m(-1)). The excitation coil (EXC) was a solenoid (diameter 100 mm) with its axis perpendicular to the cylinder axis. As receiver a PGRAD was used. Calculations were carried out with a finite element model comparing the PGRAD and a solenoid receiver coil with its axis perpendicular to the excitation coil axis (SC90). The measured and simulated sensitivity maps agree satisfactorily within the limits of unavoidable systematic errors. In PGRAD the sensitivity is zero on the coil axis, exhibiting two local extrema near the receiver and a strong increase of the sensitivity with the distance from the coil axis. In SC90 the sensitivity map is morphologically very similar to that of the PGRAD. The maps are completely different from those known in EIT and may thus cause different implications for the inverse problem. The SC90 can, in principle, replace the mechanically and electrically more complicated PGRAD, however, the immunity to far sources of electromagnetic interference is worse, thus requiring magnetic shielding of the system.

Detection of brain oedema using magnetic induction tomography: a feasibility study of the likely sensitivity and detectability.

The detection and continuous monitoring of brain oedema is of particular interest in clinical applications because existing methods (invasive measurement of the intracranial pressure) may cause considerable distress for the patients. A new non-invasive method for continuous monitoring of an oedema promises the use of multi-frequency magnetic induction tomography (MIT). MIT is an imaging method for reconstructing the changes of the conductivity deltakappa in a target object. The sensitivity of a single MIT-channel to a spherical oedematous region was analysed with a realistic model of the human brain. The model considers the cerebrospinal fluid around the brain, the grey matter, the white matter, the ventricle system and an oedema (spherical perturbation). Sensitivity maps were generated for different sizes and positions of the oedema when using a coaxial coil system. The maps show minimum sensitivity along the coil axis, and increasing values when moving the perturbation towards the brain surface. Parallel to the coil axis, however, the sensitivity does not vary significantly. When assuming a standard deviation of 10(-7) for the relative voltage change due to the system's noise, a centrally placed oedema with a conductivity contrast of 2 with respect to the background and a radius of 20 mm can be detected at 100 kHz. At higher frequencies the sensitivity increases considerably, thus suggesting the capability of multi-frequency MIT to detect cerebral oedema.

Direct estimation of Cole parameters in multifrequency EIT using a regularized Gauss-Newton method.

A major drawback of electrical impedance tomography is the poor quality of the conductivity images, i.e., the low spatial resolution as well as large errors in the reconstructed conductivity values. The main reason is the necessity for regularization of the ill-conditioned inverse problem which results in excessive spatial low-pass filtering. A novel regularization method (SMORR (spectral modelling regularized reconstructor)) is proposed, which is based on the inclusion of spectral a priori information in the form of appropriate tissue models (e.g. Cole models). This approach reduces the ill-posedness of the inverse problem, when multifrequency data are available. An additional advantage is the direct reconstruction of the (physiological) tissue parameters of interest instead of the conductivities. SMORR was compared with posterior fitting of a Cole model to the conductivity spectra obtained with a classical iterative reconstruction scheme at various frequencies. SMORR performed significantly better than the reference method concerning robustness against noise in the data.

Numerical solution of the general 3D eddy current problem for magnetic induction tomography (spectroscopy).

Magnetic induction tomography (MIT) is used for reconstructing the changes of the conductivity in a target object using alternating magnetic fields. Applications include, for example, the non-invasive monitoring of oedema in the human brain. A powerful software package has been developed which makes it possible to generate a finite element (FE) model of complex structures and to calculate the eddy currents in the object under investigation. To validate our software a model of a previously published experimental arrangement was generated. The model consists of a coaxial coil system and a conducting sphere which is moved perpendicular to the coil axis (a) in an empty space and (b) in a saline-filled cylindrical tank. The agreement of the measured and simulated data is very good when taking into consideration the systematic measurement errors in case (b). Thus the applicability of the simulation algorithm for two-compartment systems has been demonstrated even in the case of low conductivities and weak contrast. This can be considered an important step towards the solution of the inverse problem of MIT.