Research progress on electrical impedance tomography in pulmonary perfusion_Journal of Biomedical Engineering

Authors：

SHE Linjun ¹ , ZHOU Rui ¹ , PAN Pan ² , LI Zhan ¹ , LIU Jihong ¹ ,  XIE Fei ^1,2

1. The First Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou 450000, P. R. China;
2. Department of Respiratory and Critical Care Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing 100091, P. R. China;

Corresponding author：

Keywords：

Electrical impedance tomography; Lung perfusion; Imaging method; Clinical application

DOI：

10.7507/1001-5515.202302025

Video：

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Electrical impedance tomography (EIT) is an emerging technology for real-time monitoring based on the impedance differences of different tissues and organs in the human body. It has been initially applied in clinical research as well as disease diagnosis and treatment. Lung perfusion refers to the blood flow perfusion function of lung tissue, and the occurrence and development of many diseases are closely related to lung perfusion. Therefore, real-time monitoring of lung perfusion is particularly important. The application and development of EIT further promote the monitoring of lung perfusion, and related research has made great progress. This article reviews the principles of EIT imaging, lung perfusion imaging methods, and their clinical applications in recent years, with the aim of providing assistance to clinical and scientific researchers.

Citation： SHE Linjun, ZHOU Rui, PAN Pan, LI Zhan, LIU Jihong, XIE Fei. Research progress on electrical impedance tomography in pulmonary perfusion. Journal of Biomedical Engineering, 2023, 40(6): 1249-1254. doi: 10.7507/1001-5515.202302025 Copy

1.	Frerichs I, Amato M B, van Kaam A H, et al. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT development study group. Thorax, 2017, 72(1): 83-93.
2.	Spinelli E, Kircher M, Stender B, et al. Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS. Crit Care, 2021, 25(1): 192.
3.	Kohli P, Kelly V J, Kehl E G, et al. Perfusion imaging distinguishes exercise pulmonary arterial hypertension at rest. Am J Respir Crit Care Med, 2019, 199(11): 1438-1441.
4.	Foronda F A K, Fernandes L R, Lahoz A L C, et al. Electrical impedance tomography clues to detect pulmonary thrombosis in a teenager with COVID-19. Pediatr Radiol, 2022, 52(1): 144-147.
5.	中国卫生信息与健康医疗大数据学会重症医学分会标准委员会, 北京肿瘤学会重症医学专业委员会,中国重症肺电阻抗工作组. 肺电阻抗成像技术在重症呼吸管理中的临床应用中国专家共识. 中华医学杂志, 2022, 102(9): 615-628.
6.	Mueller J L. Evaluation of pulmonary structure and function in patients with cystic fibrosis from electrical impedance tomography data. Methods Mol Biol, 2022, 2393: 733-750.
7.	Xu M, He H, Long Y. Lung perfusion assessment by bedside electrical impedance tomography in critically ill patients. Front Physiol, 2021, 12: 748724.
8.	Bluth T, Kiss T, Kircher M, et al. Measurement of relative lung perfusion with electrical impedance and positron emission tomography: an experimental comparative study in pigs. Br J Anaesth, 2019, 123(2): 246-254.
9.	Borges J B, Cronin J N, Crockett D C, et al. Real-time effects of PEEP and tidal volume on regional ventilation and perfusion in experimental lung injury. Intensive Care Med Exp, 2020, 8(1): 10.
10.	He H, Chi Y, Long Y, et al. Three broad classifications of acute respiratory failure etiologies based on regional ventilation and perfusion by electrical impedance tomography: a hypothesis-generating study. Ann Intensive Care, 2021, 11(1): 134.
11.	Frerichs I, Hinz J, Herrmann P, et al. Regional lung perfusion as determined by electrical impedance tomography in comparison with electron beam CT imaging. IEEE Trans Med Imaging, 2002, 21(6): 646-652.
12.	Kircher M, Elke G, Stender B, et al. Regional lung perfusion analysis in experimental ARDS by electrical impedance and computed tomography. IEEE Trans Med Imaging, 2021, 40(1): 251-261.
13.	Mauri T, Spinelli E, Scotti E, et al. Potential for lung recruitment and ventilation-perfusion mismatch in patients with the acute respiratory distress syndrome from coronavirus disease 2019. Crit Care Med, 2020, 48(8): 1129-1134.
14.	Kühnel G, Hahn G, Frerichs I, et al. Neue verfahren zur verbesserung der abbildungsqualität bei funktionellen EIT-Tomogrammen der lunge [New methods for improving the image quality of functional electric impedance tomography]. Biomedizinische Technik [Biomedizinische Technik], 1997, 42: 470.
15.	Stowe S, Boyle A, Sage M, et al. Comparison of bolus- and filtering-based EIT measures of lung perfusion in an animal model. Physiol Meas, 2019, 40(5): 054002.
16.	Braun F, Proença M, Adler A, et al. Accuracy and reliability of noninvasive stroke volume monitoring via ECG-gated 3D electrical impedance tomography in healthy volunteers. PLoS One, 2018, 13(1): e0191870.
17.	Braun F, Proença M, Wendler A, et al. Noninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography. J Clin Monit Comput, 2020, 34(5): 903-911.
18.	Koolman P M, Bukshtynov V. A multiscale optimization framework for reconstructing binary images using multilevel PCA-based control space reduction. Biomed Phys Eng Express, 2021, 7(2): 025005.
19.	Jang G Y, Jeong Y J, Zhang T, et al. Noninvasive, simultaneous, and continuous measurements of stroke volume and tidal volume using EIT: feasibility study of animal experiments. Sci Rep, 2020, 10(1): 11242.
20.	Fagerberg A, Stenqvist O, Aneman A. Monitoring pulmonary perfusion by electrical impedance tomography: an evaluation in a pig model. Acta Anaesthesiol Scand, 2009, 53(2): 152-158.
21.	Putensen C, Hentze B, Muenster S, et al. Electrical impedance tomography for cardio-pulmonary monitoring. J Clin Med, 2019, 8(8): 1176.
22.	Shin K, Mueller JL. Calderón's method with a spatial prior for 2-D EIT imaging of ventilation and perfusion. Sensors (Basel), 2021, 21(16): 5635.
23.	Li Z, Zhang J, Liu D, et al. CT image-guided electrical impedance tomography for medical imaging. IEEE Trans Med Imaging, 2020, 39(6): 1822-1832.
24.	Li Z, Qin S, Chen C, et al. Emerging trends and hot spots of electrical impedance tomography applications in clinical lung monitoring. Front Med (Lausanne), 2022, 8: 813640.
25.	Zantonelli G, Cozzi D, Bindi A, et al. Acute pulmonary embolism: prognostic role of computed tomography pulmonary angiography (CTPA). Tomography, 2022, 8(1): 529-539.
26.	Nguyen M D, Duong T L, McEwan A. An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage. Physiol Meas, 2022, 43(2). DOI: 10.1088/1361-6579/ac4830.
27.	He H, Chi Y, Long Y, et al. Bedside evaluation of pulmonary embolism by saline contrast electrical impedance tomography method: a prospective observational study. Am J Respir Crit Care Med, 2020, 202(10): 1464-1468.
28.	Wang X, Zhao H, Cui N. The role of electrical impedance tomography for management of high-risk pulmonary embolism in a postoperative patient. Front Med (Lausanne), 2021, 8: 773471.
29.	Prins S A, Weller D, Labout J A M, et al. Electrical impedance tomography as a bedside diagnostic tool for pulmonary embolism. Crit Care Explor, 2023, 5(1): e0843.
30.	Maron B A, Abman S H, Elliott C G, et al. Pulmonary arterial hypertension: diagnosis, treatment, and novel advances. Am J Respir Crit Care Med, 2021, 203(12): 1472-1487.
31.	Singh N, Mullin C J. Diagnosis of pulmonary hypertension. Rhode Island Medical Journal, 2021, 104(7): 30-35.
32.	Proença M, Braun F, Solà J, et al. Noninvasive pulmonary artery pressure monitoring by EIT: a model-based feasibility study. Med Biol Eng Comput, 2017, 55(6): 949-963.
33.	Proença M, Braun F, Lemay M, et al. Non-invasive pulmonary artery pressure estimation by electrical impedance tomography in a controlled hypoxemia study in healthy subjects. Sci Rep, 2020, 10(1): 21462.
34.	Hovnanian A L D, Costa E L V, Hoette S, et al. Electrical impedance tomography in pulmonary arterial hypertension. PLoS One, 2021, 16(3): e0248214.
35.	Matthay M A, Arabi Y, Arroliga A C, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med, 2023, DOI: 10.1164/rccm.202303-0558WS.
36.	Perier F, Tuffet S, Maraffi T, et al. Electrical impedance tomography to titrate positive end-expiratory pressure in COVID-19 acute respiratory distress syndrome. Crit Care, 2020, 24(1): 678.
37.	Victorino J A, Borges J B, Okamoto V N, et al. Imbalances in regional lung ventilation: a validation study on electrical impedance tomography. Am J Respir Crit Care Med, 2004, 169(7): 791-800.
38.	Pavlovsky B, Pesenti A, Spinelli E, et al. Effects of PEEP on regional ventilation-perfusion mismatch in the acute respiratory distress syndrome. Crit Care, 2022, 26(1): 211.
39.	Cao G, Wu Y, Zhao Y, et al. Assessment of extravascular lung water by measuring the number of pulmonary ultrasound B-lines before and after CBP in patients with MODS. Medicine (Baltimore), 2021, 100(1): e24181.
40.	Kunst P W, Vonk Noordegraaf A, Raaijmakers E, et al. Electrical impedance tomography in the assessment of extravascular lung water in noncardiogenic acute respiratory failure. Chest, 1999, 116(6): 1695-702.

1. Frerichs I, Amato M B, van Kaam A H, et al. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT development study group. Thorax, 2017, 72(1): 83-93.
2. Spinelli E, Kircher M, Stender B, et al. Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS. Crit Care, 2021, 25(1): 192.
3. Kohli P, Kelly V J, Kehl E G, et al. Perfusion imaging distinguishes exercise pulmonary arterial hypertension at rest. Am J Respir Crit Care Med, 2019, 199(11): 1438-1441.
4. Foronda F A K, Fernandes L R, Lahoz A L C, et al. Electrical impedance tomography clues to detect pulmonary thrombosis in a teenager with COVID-19. Pediatr Radiol, 2022, 52(1): 144-147.
5. 中国卫生信息与健康医疗大数据学会重症医学分会标准委员会, 北京肿瘤学会重症医学专业委员会,中国重症肺电阻抗工作组. 肺电阻抗成像技术在重症呼吸管理中的临床应用中国专家共识. 中华医学杂志, 2022, 102(9): 615-628.
6. Mueller J L. Evaluation of pulmonary structure and function in patients with cystic fibrosis from electrical impedance tomography data. Methods Mol Biol, 2022, 2393: 733-750.
7. Xu M, He H, Long Y. Lung perfusion assessment by bedside electrical impedance tomography in critically ill patients. Front Physiol, 2021, 12: 748724.
8. Bluth T, Kiss T, Kircher M, et al. Measurement of relative lung perfusion with electrical impedance and positron emission tomography: an experimental comparative study in pigs. Br J Anaesth, 2019, 123(2): 246-254.
9. Borges J B, Cronin J N, Crockett D C, et al. Real-time effects of PEEP and tidal volume on regional ventilation and perfusion in experimental lung injury. Intensive Care Med Exp, 2020, 8(1): 10.
10. He H, Chi Y, Long Y, et al. Three broad classifications of acute respiratory failure etiologies based on regional ventilation and perfusion by electrical impedance tomography: a hypothesis-generating study. Ann Intensive Care, 2021, 11(1): 134.
11. Frerichs I, Hinz J, Herrmann P, et al. Regional lung perfusion as determined by electrical impedance tomography in comparison with electron beam CT imaging. IEEE Trans Med Imaging, 2002, 21(6): 646-652.
12. Kircher M, Elke G, Stender B, et al. Regional lung perfusion analysis in experimental ARDS by electrical impedance and computed tomography. IEEE Trans Med Imaging, 2021, 40(1): 251-261.
13. Mauri T, Spinelli E, Scotti E, et al. Potential for lung recruitment and ventilation-perfusion mismatch in patients with the acute respiratory distress syndrome from coronavirus disease 2019. Crit Care Med, 2020, 48(8): 1129-1134.
14. Kühnel G, Hahn G, Frerichs I, et al. Neue verfahren zur verbesserung der abbildungsqualität bei funktionellen EIT-Tomogrammen der lunge [New methods for improving the image quality of functional electric impedance tomography]. Biomedizinische Technik [Biomedizinische Technik], 1997, 42: 470.
15. Stowe S, Boyle A, Sage M, et al. Comparison of bolus- and filtering-based EIT measures of lung perfusion in an animal model. Physiol Meas, 2019, 40(5): 054002.
16. Braun F, Proença M, Adler A, et al. Accuracy and reliability of noninvasive stroke volume monitoring via ECG-gated 3D electrical impedance tomography in healthy volunteers. PLoS One, 2018, 13(1): e0191870.
17. Braun F, Proença M, Wendler A, et al. Noninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography. J Clin Monit Comput, 2020, 34(5): 903-911.
18. Koolman P M, Bukshtynov V. A multiscale optimization framework for reconstructing binary images using multilevel PCA-based control space reduction. Biomed Phys Eng Express, 2021, 7(2): 025005.
19. Jang G Y, Jeong Y J, Zhang T, et al. Noninvasive, simultaneous, and continuous measurements of stroke volume and tidal volume using EIT: feasibility study of animal experiments. Sci Rep, 2020, 10(1): 11242.
20. Fagerberg A, Stenqvist O, Aneman A. Monitoring pulmonary perfusion by electrical impedance tomography: an evaluation in a pig model. Acta Anaesthesiol Scand, 2009, 53(2): 152-158.
21. Putensen C, Hentze B, Muenster S, et al. Electrical impedance tomography for cardio-pulmonary monitoring. J Clin Med, 2019, 8(8): 1176.
22. Shin K, Mueller JL. Calderón's method with a spatial prior for 2-D EIT imaging of ventilation and perfusion. Sensors (Basel), 2021, 21(16): 5635.
23. Li Z, Zhang J, Liu D, et al. CT image-guided electrical impedance tomography for medical imaging. IEEE Trans Med Imaging, 2020, 39(6): 1822-1832.
24. Li Z, Qin S, Chen C, et al. Emerging trends and hot spots of electrical impedance tomography applications in clinical lung monitoring. Front Med (Lausanne), 2022, 8: 813640.
25. Zantonelli G, Cozzi D, Bindi A, et al. Acute pulmonary embolism: prognostic role of computed tomography pulmonary angiography (CTPA). Tomography, 2022, 8(1): 529-539.
26. Nguyen M D, Duong T L, McEwan A. An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage. Physiol Meas, 2022, 43(2). DOI: 10.1088/1361-6579/ac4830.
27. He H, Chi Y, Long Y, et al. Bedside evaluation of pulmonary embolism by saline contrast electrical impedance tomography method: a prospective observational study. Am J Respir Crit Care Med, 2020, 202(10): 1464-1468.
28. Wang X, Zhao H, Cui N. The role of electrical impedance tomography for management of high-risk pulmonary embolism in a postoperative patient. Front Med (Lausanne), 2021, 8: 773471.
29. Prins S A, Weller D, Labout J A M, et al. Electrical impedance tomography as a bedside diagnostic tool for pulmonary embolism. Crit Care Explor, 2023, 5(1): e0843.
30. Maron B A, Abman S H, Elliott C G, et al. Pulmonary arterial hypertension: diagnosis, treatment, and novel advances. Am J Respir Crit Care Med, 2021, 203(12): 1472-1487.
31. Singh N, Mullin C J. Diagnosis of pulmonary hypertension. Rhode Island Medical Journal, 2021, 104(7): 30-35.
32. Proença M, Braun F, Solà J, et al. Noninvasive pulmonary artery pressure monitoring by EIT: a model-based feasibility study. Med Biol Eng Comput, 2017, 55(6): 949-963.
33. Proença M, Braun F, Lemay M, et al. Non-invasive pulmonary artery pressure estimation by electrical impedance tomography in a controlled hypoxemia study in healthy subjects. Sci Rep, 2020, 10(1): 21462.
34. Hovnanian A L D, Costa E L V, Hoette S, et al. Electrical impedance tomography in pulmonary arterial hypertension. PLoS One, 2021, 16(3): e0248214.
35. Matthay M A, Arabi Y, Arroliga A C, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med, 2023, DOI: 10.1164/rccm.202303-0558WS.
36. Perier F, Tuffet S, Maraffi T, et al. Electrical impedance tomography to titrate positive end-expiratory pressure in COVID-19 acute respiratory distress syndrome. Crit Care, 2020, 24(1): 678.
37. Victorino J A, Borges J B, Okamoto V N, et al. Imbalances in regional lung ventilation: a validation study on electrical impedance tomography. Am J Respir Crit Care Med, 2004, 169(7): 791-800.
38. Pavlovsky B, Pesenti A, Spinelli E, et al. Effects of PEEP on regional ventilation-perfusion mismatch in the acute respiratory distress syndrome. Crit Care, 2022, 26(1): 211.
39. Cao G, Wu Y, Zhao Y, et al. Assessment of extravascular lung water by measuring the number of pulmonary ultrasound B-lines before and after CBP in patients with MODS. Medicine (Baltimore), 2021, 100(1): e24181.
40. Kunst P W, Vonk Noordegraaf A, Raaijmakers E, et al. Electrical impedance tomography in the assessment of extravascular lung water in noncardiogenic acute respiratory failure. Chest, 1999, 116(6): 1695-702.

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