Contrast-Enhanced EIT Robustly Tracks Regional Lung Perfusion Compared to Non-Enhanced EIT and Pulmonary CT

IEEE Transactions on Medical Imaging, vol. 44, pp. 3683–3693

Abstract

Regional perfusion monitoring, often performed by pulmonary perfusion computed tomography, is vital in intensive care units. Electrical impedance tomography, repeatable and of non-invasive nature, could provide an attractive alternative. This study compares non-enhanced and contrast-enhanced electrical impedance tomography to computed tomography under induced central to peripheral lung perfusion impairments and cardiac output modulation in 11 animals. A new algorithmic framework using multi-compartment modeling and tracer kinetics was developed to improve perfusion estimation. A multi-resolution mixed models analysis shows electrical impedance tomography agrees poorly with computed tomography in static monitoring, with limits of agreement exceeding relative errors of 100%. For trend tracking,contrast-enhancement with 5.85% NaCl yielded concordance rates above 80%, and over 90% for peripheral impairments, emerging as a robust tracker of coarse to fine perfusion changes. Non-enhanced electrical impedance tomography peaked around 60% under central impairment and cardiac modulation, proving to be less reliable.

Authors 8

1. Diogo Silva Aachen Chair for Medical Information Technology Chair for Medical Information Technology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Chair for Medical Information Technology, RWTH Aachen University Hospital, Aachen, Germany

   Chair for Medical Information Technology, RWTH Aachen University, Germany

2. Sebastian Daniel Reinartz

   Düsseldorf University Hospital

   Affiliation as printed

   Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany

   Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Germany

3. Thomas Muders

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany

4. Karin Wodack

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany

5. Christian Putensen

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany

6. Robert Malte Siepmann Aachen Department of Diagnostic and Interventional Radiology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany

   Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany

7. Benjamin Hentze Aachen Chair for Medical Information Technology

   University of Bonn · University Hospital Bonn · RWTH Aachen University

   Affiliation as printed

   Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

   Chair for Medical Information Technology, RWTH Aachen University, Germany

8. Steffen K. Leonhardt Aachen Chair for Medical Information Technology Chair for Medical Information Technology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Chair for Medical Information Technology, RWTH Aachen University Hospital, Aachen, Germany

   Chair for Medical Information Technology, RWTH Aachen University, Germany