title: Comparison of different methods to define regions of interest for evaluation of regional lung ventilation by EIT.
abstract: The measurement of regional lung ventilation by electrical impedance tomography (EIT) has been evaluated in many experimental studies. However, EIT is not routinely used in a clinical setting, which is attributable to the fact that a convenient concept for how to quantify the EIT data is missing. The definition of region of interest (ROI) is an essential point in the data analysis. To date, there are only limited data available on the different approaches to ROI definition to evaluate regional lung ventilation by EIT. For this survey we examined ten patients (mean age +/- SD: 60 +/- 10 years) under controlled ventilation. Regional tidal volumes were quantified as pixel values of inspiratory-to-expiratory impedance differences and four types of ROIs were subsequently applied. The definition of ROI contours was based on the calculation of the pixel values of (1) standard deviation from each pixel set of impedance data and (2) the regression coefficient from linear regression equations between the individual local (pixel) and average (whole scan) impedance signals. Additionally, arbitrary ROIs (four quadrants and four anteroposterior segments of equal height) were used. Our results indicate that both approaches to ROI definition using statistical parameters are suitable when impedance signals with high sensitivity to ventilation-related phenomena are to be analyzed. The definition of the ROI contour as 20-35% of the maximum standard deviation or regression coefficient is recommended. Simple segmental ROIs are less convenient because of the low ventilation-related signal component in the dorsal region.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. pulletz@anaesthesie.uni-kiel.de
authors.forename: Sven
authors.initials: S
authors.lastname: Pulletz
authors.forename: Huibert R
authors.initials: HR
authors.lastname: van Genderingen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Schmitz
authors.forename: Günther
authors.initials: G
authors.lastname: Zick
authors.forename: Dirk
authors.initials: D
authors.lastname: Schädler
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Norbert
authors.initials: N
authors.lastname: Weiler
authors.forename: Inez
authors.initials: I
authors.lastname: Frerichs
mesh_terms: D000465:Algorithms; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008168:Lung / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010992:Plethysmography, Impedance / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000379:methods*; D012680:Sensitivity and Specificity; D014054:Tomography / Q000379:methods*