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  • Title: Regional lung ventilation and perfusion by electrical impedance tomography compared to single-photon emission computed tomography.
    Author: Hentze B, Muders T, Luepschen H, Maripuu E, Hedenstierna G, Putensen C, Walter M, Leonhardt S.
    Journal: Physiol Meas; 2018 Jun 20; 39(6):065004. PubMed ID: 29794336.
    Abstract:
    OBJECTIVE: Electrical impedance tomography (EIT) is a noninvasive imaging modality that allows real-time monitoring of regional lung ventilation ([Formula: see text]) in intensive care patients at bedside. However, for improved guidance of ventilation therapy it would be beneficial to obtain regional ventilation-to-perfusion ratio ([Formula: see text]) 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 ([Formula: see text]) from EIT measurements. Subsequently, a combined validation of both [Formula: see text] and [Formula: see text] 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 [Formula: see text] (81mKr gas) and [Formula: see text] (99mTc-labeled albumin) were performed. MAIN RESULTS: Both [Formula: see text] and [Formula: see text] from EIT and SPECT were compared by correlation analysis. Very strong (r 2  =  0.94 to 0.95) correlations were found for [Formula: see text] and [Formula: see text] 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 [Formula: see text] and [Formula: see text] in the right-left direction, respectively. SIGNIFICANCE: The results of combined validation indicate that monitoring of [Formula: see text] and [Formula: see text] by EIT is possible. However, care should be taken when trying to quantify [Formula: see text] by EIT, as imaging artefacts and model bias may void necessary spatial matching.
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