Real-Time Assessment of Lung Structure and Function in CF Patients using Electrical Impedance Tomography

项目摘要 囊性纤维化是一种以肺结构进行性衰退为特征的遗传性肺病， 功能使用CT扫描和肺功能测试（PFT）的金标准来评估 肺的结构和功能分别受到施加到肺的电离辐射的阻碍。 患者在CT扫描中，以及非常年轻的患者无法进行PFT。的目标 这项研究是为了确定电阻抗断层扫描（EIT）是否可以提供灵敏的 测量所有年龄CF患者的肺结构和功能变化。为了验证这一假设 我们将研究EIT图像和衍生措施的能力，以检测结构变化， 一项为期3年的纵向研究以及急性PE治疗前后的变化。这个项目是 长期目标的一部分是开发用于对患有慢性肺病的患者进行成像的EIT系统。 EIT是一种非侵入性、非电离的功能成像技术，其中图像由 在身体电极上测量的电压，由不可感知的外加电流产生。以来 EIT是一种安全、便携的技术，没有破坏性的副作用，可以根据需要使用。这 这项研究建立在先前一项研究的基础上，在这项研究中， 在CF患者中，EIT衍生的肺功能测量值和PFT输出测量值之间， 并且证明了识别空气滞留的能力。 在这项工作中，新的EIT硬件和算法将被开发，以获得三维重建 具有在所有电极上提供最高信噪比（SNR）的电流模式。的 该改进的高性能EIT系统的设计和验证是第一个具体目标。 第二个具体的目标是开发算法在3-D的计算区域曝气 和通气灌注比（V/Q）图，并用于识别和量化 空气滞留和凝固的区域。第三个目标是确定EIT的能力， 识别随着疾病进展发生的功能和结构生理变化， 一项具有以下子目标的临床研究：确定EIT是否可以作为选择性的 CT识别空气滞留和实变区域的替代方法，EIT是否可以提供 关于急性PE治疗反应的临床有用信息，以及EIT是否可以 提供有关肺结构变化的纵向信息。 1

Project Summary Cystic fibrosis is a genetic lung disease marked by progressive decline in lung structure and function. Use of the gold standards of CT scans and pulmonary function tests (PFT's) to assess lung structure and function, respectively, are hindered by the ionizing radiation applied to the patient in CT scanning, and the inability of very young patients to perform PFTs. The goal of this research is to determine whether electrical impedance tomography (EIT) can provide sensitive measures of changes in lung structure and function in CF patients of all ages. To test this hypothesis we will study the ability of EIT images and derived measures to detect structural changes through a 3 year longitudinal study and changes pre and post-treatment for an acute PE. This project is part of a long term goal to develop an EIT system for imaging patients with chronic lung disease. EIT is a noninvasive, non-ionizing functional imaging technique in which images are formed from voltages measured on electrodes on the body arising from imperceptible applied currents. Since EIT is a safe and portable technology with no damaging side effects, it can be used as needed. This research builds on the results of a previous grant in which a strong correlation was demonstrated between EIT-derived measures of pulmonary function and PFT output measures in CF patients, and the ability to identify air trapping was demonstrated. In this work, novel EIT hardware and algorithms will be developed to obtain 3-D reconstructions with current patterns that provide the highest signal-to-noise ratio (SNR) on all electrodes. The design and validation of this improved high performance EIT system is the first specific aim. The second specific aim is to develop algorithms in 3-D for the computation of regional aeration and ventilation perfusion ratio (V/Q) maps in 3-D, and for the identification and quantification of regions of air trapping and consolidation. The third aim is to determine the ability of EIT to identify functional and structural physiological changes that occur with disease progression through a clinical study with the following subaims: to determine whether EIT can serve as a selective alternative for CT to identify regions of air trapping and consolidation, whether EIT can provide clinically useful information about response to treatment for an acute PE, and whether EIT can provide longitudinal information about structural changes in the lung. 1