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Regional lung ventilation and perfusion by electrical impedance tomography compared to single-photon emission computed tomography
Rhein Westfal TH Aachen, Philips Chair Med Informat Technol, Pauwelsstr 20, D-52074 Aachen, Germany;Univ Bonn, Dept Anaesthesiol & Intens Care Med, Sigmund Freud Str 25, D-53105 Bonn, Germany.
Univ Bonn, Dept Anaesthesiol & Intens Care Med, Sigmund Freud Str 25, D-53105 Bonn, Germany.
Univ Bonn, Dept Anaesthesiol & Intens Care Med, Sigmund Freud Str 25, D-53105 Bonn, Germany.
Univ Hosp, Dept Hosp Phys, Uppsala, Sweden.
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2018 (English)In: Physiological Measurement, ISSN 0967-3334, E-ISSN 1361-6579, Vol. 39, no 6, article id 065004Article in journal (Refereed) Published
Abstract [en]

Objective: Electrical impedance tomography (EIT) is a noninvasive imaging modality that allows real-time monitoring of regional lung ventilation (<(V)over dot>) in intensive care patients at bedside. However, for improved guidance of ventilation therapy it would be beneficial to obtain regional ventilation-to-perfusion ratio (<(V)over dot> / <(Q)over dot>) by EIT.

Approach: In order to further explore the feasibility, we first evaluate a model-based approach, based on semi-negative matrix factorization and a gamma-variate model, to extract regional lung perfusion (<(Q)over dot>) from EIT measurements. Subsequently, a combined validation of both <(V)over dot> and <(Q)over dot> measured by EIT against single-photon emission computed tomography (SPECT) is performed on data acquired as part of a porcine animal trial. Four pigs were ventilated at two different levels of positive end-expiratory pressure (PEEP 0 and 15 cm H2O, respectively) in randomized order. Repeated injections of an EIT contrast agent (NaCl 10%) and simultaneous SPECT measurements of <(V)over dot> (81(m)Kr gas) and <(Q)over dot> (99(m)Tc-labeled albumin) were performed.

Main results: Both <(V)over dot> and <(Q)over dot> from EIT and SPECT were compared by correlation analysis. Very strong (r(2) = 0.94 to 0.95) correlations were found for <(V)over dot> and <(Q)over dot> in the dorsal-ventral direction at both PEEP levels. Moderate (r(2) = 0.36 to 0.46) and moderate to strong (r(2) = 0.61 to 0.82) correlations resulted for <(V)over dot> and <(Q)over dot> in the right-left direction, respectively.

Significance: The results of combined validation indicate that monitoring of <(V)over dot> and <(Q)over dot> by EIT is possible. However, care should be taken when trying to quantify <(V)over dot> / <(Q)over dot> by EIT, as imaging artefacts and model bias may void necessary spatial matching.

Place, publisher, year, edition, pages
IOP PUBLISHING LTD , 2018. Vol. 39, no 6, article id 065004
Keywords [en]
electrical impedance tomography, regional lung ventilation, regional lung perfusion, indicator dilution, functional imaging, gas exchange, single-photon emission computed tomography
National Category
Physiology
Identifiers
URN: urn:nbn:se:uu:diva-358530DOI: 10.1088/1361-6579/aac7aeISI: 000435872300002PubMedID: 29794336OAI: oai:DiVA.org:uu-358530DiVA, id: diva2:1244829
Funder
German Research Foundation (DFG), PU 219/2-1Available from: 2018-09-03 Created: 2018-09-03 Last updated: 2018-09-03Bibliographically approved

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Hedenstierna, Göran

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