The invention relates to electrical impedance tomography (EIT) based diagnostic systems and methods.
Electrical impedance tomography is a medical imaging technique that can be used for determining electrical conductivity, permittivity, and/or impedance of a body part of a subject (animal, human, etc.).
In a first aspect, there is provided a computer-implemented method, comprising: processing a EIT data set of a subject to determine one or more conductivity characteristics associated with a tissue or organ of the subject; and determining, based on at least the one or more determined conductivity characteristics, a health state or condition of the tissue or organ of the subject.
Optionally, the determining comprises: determining, based on at least the one or more determined conductivity characteristics, whether the subject has a disease associated with the tissue or organ, and optionally: further classifying a stage or a severity of the disease associated with the tissue or organ.
Optionally, the determining comprises: processing, at least, the one or more determined conductivity characteristics of the subject and one or more anthropometric characteristics of the subject, using a machine learning based processing model, to determine a quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject.
Optionally, the determining comprises: processing, using a machine learning based processing model, (i) the one or more determined conductivity characteristics of the subject, (ii) one or more anthropometric characteristics of the subject, and (iii) one or more determined conductivity characteristics of one or more reference subjects and/or of a group containing the subject and the one or more reference subjects, to determine a quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject.
Optionally, the machine learning based processing model comprises a regression model. Optionally, the machine learning based processing model comprises a classification model. The machine learning based processing model may be recurrent models or non-recurrent models. The machine learning based processing model may include, e.g., recursive neural network, recurrent neural network, long-short term memory model, Markov process, reinforcement learning, gated recurrent unit model, deep neural network, convolutional neural network, support vector machines, principle component analysis, logistic regression, decision trees/forest, ensemble method (combining model), regression (Bayesian/polynomial/regression), stochastic gradient descent, linear discriminant analysis, nearest neighbor classification or regression, naive Bayes, etc. The machine learning based processing model can be trained to perform a particular processing or classification task associated with the diagnostic application.
Optionally, the one or more anthropometric characteristics comprise, or are related to, one or more of: age of the subject, weight of the subject, height of the subject, waist circumference of the subject, waist-over-height ratio of the subject, body mass index (BMI) of the subject, gender of the subject, and race of the subject. Other anthropometric characteristic(s) are possible.
Optionally, the quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject comprises: a value associated with an estimated performance of the tissue or organ of the subject. For example, in respect of kidney, the value may be an estimated glomerular filtration rate (eGFR) or a related value (e.g., arithmetically related). For example, in respect of liver, the value may be a controlled attenuation parameter (CAP) score or a related value (e.g., arithmetically related).
Optionally, the determining further comprises: comparing the quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject with reference parameter data to determine whether the subject has a disease associated with the tissue or organ.
Optionally, the determining further comprises: classifying, based on the comparing, a stage or a severity of the disease associated with the tissue or organ.
Optionally, the EIT data set contains EIT data obtain from a region of the subject containing the tissue or organ. Optionally, the EIT data set is obtained by (a) providing excitation signals at a frequency to the subject via electrodes attached to the region of the subject, (b) measuring responsive signals received via the electrodes as a result of the providing of the excitation signals, and (c) repeating steps (a) and (b) for a plurality of frequencies. The EIT data set comprises a plurality of EIT data subsets each associated with a respective one of the plurality of frequencies.
Optionally, the processing comprises: (i) processing the EIT data set to obtain a frequency difference EIT data set, the frequency difference EIT data set includes a plurality of frequency difference EIT data subsets; (ii) performing a group source separation operation using the frequency difference EIT data set and one or more reference frequency difference EIT data sets of corresponding one or more reference subjects to determine component of the frequency difference EIT data set related to the tissue or organ and component of each of the one or more reference frequency difference EIT data sets related to the tissue or organ; and (iii) performing a conductivity characteristics extraction operation using the component of the frequency difference EIT data set related to the tissue or organ and optionally the component of each of the one or more reference frequency difference EIT data sets related to the tissue or organ to determine at least the one or more conductivity characteristics of the subject.
Optionally, the processing further comprises: pre-processing the EIT data set before the processing in (i) so that the EIT data set processed in (i) is a pre-processed EIT data set.
Optionally, the pre-processing of the EIT data set comprises: filtering and/or smoothing each of the plurality of EIT data subsets.
Optionally, the pre-processing of the EIT data set comprises: processing the EIT data set using a classifier model to determine respective performance of each of the plurality of electrodes, the performance being associated with quality of responsive signals or data obtained from the respective electrode; and preventing the responsive signals or data obtained via any one or more of the plurality of electrodes determined to have insufficient performance from being included in the processed EIT data set.
Optionally, the processing of the EIT data set in (ii) comprises: determining, for each respective one or more of the plurality of processed EIT data subsets, respective difference between the respective processed EIT data subset and a reference EIT data subset, so as to obtain the plurality of frequency difference EIT data subsets each associated with a respective one of a difference between the respective processed EIT data subset and a reference EIT data subset.
Optionally, the reference EIT data subset comprises at least one of the plurality of processed EIT data subsets.
Optionally, the performing of the group source separation operation comprises: performing a dimensionality reduction operation on the frequency difference EIT data set and one or more reference frequency difference EIT data sets of corresponding one or more reference subjects.
Optionally, the performing of the conductivity characteristics extraction operation comprises: determining, using the component of the frequency difference EIT data set related to the tissue or organ, the one or more conductivity characteristics of the subject. The one or more conductivity characteristics of the subject may include one or more statistical conductivity characteristics of the subject (e.g., mean, median, mode, standard deviation, etc., of any part of the fd-EIT data or EIT data of the subject (that can be represented as conductivity map or image).
Optionally, the performing of the conductivity characteristics extraction operation comprises: determining, using the component of the frequency difference EIT data set related to the tissue or organ and respective component of each of the one or more reference frequency difference EIT data sets related to the tissue or organ, one or more conductivity characteristics of a group containing the subject and the one or more reference subjects. The determining of the health state or condition of the tissue or organ of the subject is further based on the one or more conductivity characteristics of the group. The one or more conductivity characteristics of the subject may include one or more statistical conductivity characteristics of the group (e.g., mean, median, mode, standard deviation, etc., of any part of the fd-EIT data or EIT data of the group (that can be represented as conductivity map or image).
Optionally, the determining of the health state or condition of the tissue or organ of the subject is further based on the one or more conductivity characteristics of the one or more reference subjects. The one or more conductivity characteristics of the one or more reference subjects may include one or more statistical conductivity characteristics of the group (e.g., mean, median, mode, standard deviation, etc., of any part of the fd-EIT data or EIT data of the one or more reference subjects (that can be represented as conductivity map or image).
Optionally, the tissue or organ comprises a lung, a kidney, a liver, or a heart.
In a second aspect, there is provided a system comprising one or more processors and memory storing one or more programs configured to be executed by the one or more processors. The one or more programs include instructions for performing or facilitating performing of the computer-implemented method of the first aspect.
In a third aspect, there is provided a non-transitory computer-readable storage medium storing one or more programs configured to be executed by one or more processors. The one or more programs include instructions for performing or facilitating performing of the computer-implemented method of the first aspect.
In a fourth aspect, there is provided a computer program product comprising instructions which, when the computer program is executed by a computer, cause or facilitate the computer to carry out the computer-implemented method of the first aspect.
In a fifth aspect, there is provided a computer-implemented method, comprising: processing electrical impedance tomography data obtained from a subject, the electrical impedance tomography data including a plurality of electric potential data sets, each electric potential data set being obtained at electrodes attached (directly or indirectly) to the subject in response to excitation signal (e.g., current) of a set frequency sequentially applied to each of the electrodes, the set frequency applied is different for different data sets and is the same of the same data set; and determining, based on the processing, whether the subject has a disease.
Optionally, the plurality of electric potential data sets comprises, at least, a first electric potential data set associated with excitation signal (e.g., current) of a first frequency, a second electric potential data set associated with excitation signal (e.g., current) of a second frequency, and a third electric potential data set associated with excitation signal (e.g., current) of a third frequency. Optionally, the processing comprises: determining a difference between the first and second electric potential data sets to obtain a first electric potential difference data set; determining a difference between the first and third second electric potential data sets to obtain a second electric potential difference data set; applying the first and second electric potential difference data sets to a spectral unmixing model to determine parameters indicative of impact caused by tissue type i on the first and second electric potential difference data sets; and determining a value of a parameter associated with the disease based on the first and second corrected electric potential difference data sets and one or more anthropometric measures of the subject. In this example, the first electric potential data set is used as a reference data set. The reference data set may have the highest signal to noise ratio among all the data sets.
Optionally, the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω)+∈, where ΔV(ω) is the first and second electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types, ∈ is an error term. In one example the error term is 0, in which case the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω), where ΔV(ω) is the first and second electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types.
Optionally, the plurality of electric potential data sets comprises, at least, a first electric potential data set associated with excitation signal (e.g., current) of a first frequency, a second electric potential data set associated with excitation signal (e.g., current) of a second frequency, and a third electric potential data set associated with excitation signal (e.g., current) of a third frequency, a fourth electric potential data set associated with excitation signal (e.g., current) of a fourth frequency. Optionally, the processing comprises: determining a difference between the first and second electric potential data sets to obtain a first electric potential difference data set; determining a difference between the first and third second electric potential data sets to obtain a second electric potential difference data set; determining a difference between the first and fourth second electric potential data sets to obtain a third electric potential difference data set; applying the first, second, and third electric potential difference data sets to a spectral unmixing model to determine parameters indicative of impact caused by tissue type i on the first, second, and third electric potential difference data sets; and determining a value of a parameter associated with the disease based on the first, second, and third corrected electric potential difference data sets and one or more anthropometric measures of the subject.
Optionally, the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω)+∈, where ΔV(ω) is the first, second, and third electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types, ∈ is an error term. In one example the error term is 0, in which case the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω), where ΔV(ω) is the first and second electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types.
Optionally, determining whether the subject has a disease includes comparing the determined value with a predetermined reference scale. The predetermined reference scale may include predetermined values of the parameter classified according to presence or absence of the disease, and optionally, severity of the disease.
Optionally, the first electric potential difference data set can be processed to provide a conductivity change map (e.g., average conductivity change map) of the subject. Optionally, the second electric potential difference data set can be processed to provide a conductivity change map (e.g., average conductivity change map) of the subject.
Optionally, the parameter associated with the disease comprises a controlled attenuation parameter.
Optionally, the one or more anthropometric measures of the subject comprises a waist circumference over height (i.e., waist circumference of the subject divided by height of the subject) measure. Optionally, the one or more anthropometric measures of the subject comprises age of the subject. Optionally, the one or more anthropometric measures of the subject comprises chest circumference of the subject.
Optionally, the processing further comprises filtering the electric potential data sets prior to determining the differences. The filtering may remove outlier(s).
Optionally, the computer-implemented method further comprises obtaining the electrical impedance tomography data from the subject.
Optionally, the disease comprises a liver disease, a lung disease, a kidney disease, etc. In one example, the disease comprises a fatty liver disease (e.g., nonalcoholic fatty liver disease).
Optionally, the computer-implemented method further comprises determining, based on the processing, a severity of the disease.
Optionally, the computer-implemented method further comprises presenting the determination result to the user. The presenting may include displaying the result to the user. The result may include a “yes/no” result (as to whether the subject has a disease) and optionally a severity of the disease.
Optionally, the subject is human being. Optionally the subject is a non-human animal.
In a sixth aspect, there is provided a system, comprising: one or more processors arranged to process electrical impedance tomography data obtained from a subject, the electrical impedance tomography data including a plurality of electric potential data sets, each electric potential data set being obtained at electrodes attached (directly or indirectly) to the subject in response to excitation signal (e.g., current) of a set frequency sequentially applied to each of the electrodes, the set frequency applied is different for different data sets and is the same of the same data set; and determine, based on the processing, whether the subject has a disease.
Optionally, the plurality of electric potential data sets comprises, at least, a first electric potential data set associated with excitation signal (e.g., current) of a first frequency, a second electric potential data set associated with excitation signal (e.g., current) of a second frequency, and a third electric potential data set associated with excitation signal (e.g., current) of a third frequency. Optionally, the one or more processors are arranged to: determine a difference between the first and second electric potential data sets to obtain a first electric potential difference data set; determine a difference between the first and third second electric potential data sets to obtain a second electric potential difference data set; apply the first and second electric potential difference data sets to a spectral unmixing model to determine parameters indicative of impact caused by tissue type i on the first and second electric potential difference data sets; and determine a value of a parameter associated with the disease based on the first and second corrected electric potential difference data sets and one or more anthropometric measures of the subject. In this example, the first electric potential data set is used as a reference data set. The reference data set may have the highest signal to noise ratio among all the data sets.
Optionally, the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω)+∈, where ΔV(ω) is the first and second electric potential difference data sets, α1 is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types, e is an error term. In one example the error term is 0, in which case the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω), where ΔV(ω) is the first and second electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types. The system may include a memory that stores the spectral unmixing model and is operably connected with the one or more processors.
Optionally, the plurality of electric potential data sets comprises, at least, a first electric potential data set associated with excitation signal (e.g., current) of a first frequency, a second electric potential data set associated with excitation signal (e.g., current) of a second frequency, and a third electric potential data set associated with excitation signal (e.g., current) of a third frequency, a fourth electric potential data set associated with excitation signal (e.g., current) of a fourth frequency. Optionally, the one or more processors are arranged to: determine a difference between the first and second electric potential data sets to obtain a first electric potential difference data set; determine a difference between the first and third second electric potential data sets to obtain a second electric potential difference data set; determine a difference between the first and fourth second electric potential data sets to obtain a third electric potential difference data set; apply the first, second, and third electric potential difference data sets to a spectral unmixing model to determine parameters indicative of impact caused by tissue type i on the first, second, and third electric potential difference data sets; and determine a value of a parameter associated with the disease based on the first, second, and third corrected electric potential difference data sets and one or more anthropometric measures of the subject.
Optionally, the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω)+∈, where ΔV(ω) is the first, second, and third electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types, ∈ is an error term. In one example the error term is 0, in which case the spectral unmixing model includes ΔV(ω)=Σi=1M αiΔσi(ω), is the first and second electric potential difference data sets, αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types. The system may include a memory that stores the spectral unmixing model and is operably connected with the one or more processors.
Optionally, the one or more processors are arranged to compare the determined value with a predetermined reference scale to determine whether the subject has a disease. The predetermined reference scale may include predetermined values of the parameter classified according to presence or absence of the disease, and optionally, severity of the disease.
Optionally, the one or more processors are arranged to process the electric potential difference data sets to provide a conductivity change map (e.g., average conductivity change map) of the subject.
Optionally, the parameter associated with the disease comprises a controlled attenuation parameter.
Optionally, the one or more anthropometric measures of the subject comprises a waist circumference over height (i.e., waist circumference of the subject divided by height of the subject) measure. Optionally, the one or more anthropometric measures of the subject comprises age of the subject. Optionally, the one or more anthropometric measures of the subject comprises chest circumference of the subject.
Optionally, the one or more processors are arranged to filter the electric potential data sets prior to determining the differences. The filtering may remove outlier(s).
Optionally, the disease comprises a liver disease, a lung disease, a kidney disease, etc. In one example, the disease comprises a fatty liver disease (e.g., nonalcoholic fatty liver disease).
Optionally, the one or more processors are arranged to determine, based on the processing, a severity of the disease.
Optionally, the system further comprises an output device, such as a display, arranged to present the determination result to the user. The presenting may include displaying the result to the user. The result may include a “yes/no” result (as to whether the subject has a disease) and optionally a severity of the disease.
Optionally, the subject is human being. Optionally the subject is a non-human animal.
In a seventh aspect, there is provided a non-transitory computer-readable medium storing computer instructions that, when executed by one or more processors, causes the one or more processors to perform the method of the fourth aspect.
In an eighth aspect, there is provided a computer program product comprising instructions which, when the program is executed by a computer, cause the computer to carry out the method of the fourth aspect.
Other features and aspects of the invention will become apparent by consideration of the detailed description and accompanying drawings. Any feature(s) described herein in relation to one aspect or embodiment may be combined with any other feature(s) described herein in relation to any other aspect or embodiment as appropriate and applicable.
Terms of degree such that “generally”, “about”, “substantially”, or the like, are used, depending on context, to account for manufacture tolerance, degradation, trend, tendency, imperfect practical condition(s), etc. For example, when a value is modified by terms of degree, such as “about”, such expression may include the stated value ±10%, ±5%, ±2%, or ±1%.
Unless otherwise specified, the terms “connected”, “coupled”, “mounted”, and the like, are intended to encompass both direct and indirect connection, coupling, mounting, etc. Unless other specified, or context required otherwise, the term “conductivity”, and the like, means electrical conductivity or bio-conductivity.
Embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings in which:
In some embodiments, the EIT data set contains EIT data obtain from a region (a body part) of the subject containing the organ or tissue of interest. The region may be a chest region, an abdominal region, etc. In some embodiments, the EIT data set is obtained by (a) providing excitation signals (voltage, potential, current, etc.) at a frequency to the subject via electrodes attached to the region of the subject, (b) measuring responsive signals (voltage, potential, current, etc.) received via the electrodes as a result of the providing of the excitation signals, and (c) repeating steps (a) and (b) for different frequencies. The EIT data set may comprise multiple EIT data subsets each associated with a respective one of the frequencies.
In some embodiments, step 102 may include one or more or all of:
In some embodiments, (i) in step 102 may include filtering and/or smoothing each of the EIT data subsets.
In some embodiments, (i) in step 102 may additionally or alternatively include processing the EIT data set using a classifier model (e.g., a machine learning based processing model) to determine respective performance of each of the electrodes (the performance is associated with quality of responsive signals or data obtained from the respective electrode) when the EIT data is obtained and preventing the responsive signals or data obtained via any one or more of the electrodes determined to have insufficient performance from being included in the processed EIT data set. In some examples, a respective performance score is determined for each of the electrodes and the respective performance scores are compared with a reference data to determine whether the any of (and if so which) of the electrodes provided insufficient performance when the data is taken. In some examples, the classification model can determine the electrodes that have insufficient performance when the data is taken.
In some embodiments, (ii) in step 102 may include determining, for each respective one or more of the processed EIT data subsets, respective difference between the respective processed EIT data subset and a reference EIT data subset, so as to obtain the frequency difference EIT data subsets each associated with a respective one of a difference between the respective processed EIT data subset and a reference EIT data subset. At least one of the processed EIT data subsets may be respectively used as the reference EIT data subset.
In some embodiments, (iii) in step 102 may include performing a dimensionality reduction operation on the frequency difference EIT data set and one or more reference frequency difference EIT data sets of corresponding one or more reference subjects to determine component of the frequency difference EIT data set related to the tissue or organ of the subject and respective component of each of the one or more reference frequency difference EIT data sets related to the tissue or organ of the one or more reference subjects.
In some embodiments, (iv) in step 102 may include determining, using the component of the frequency difference EIT data set related to the tissue or organ of the subject, the one or more (e.g., statistical) conductivity characteristics related to the tissue or organ of the subject. For example, the one or more (e.g., statistical) conductivity characteristics related to the tissue or organ of the subject may include one or more of: an average of conductivity characteristics in a defined tissue or organ region within an area, an average of conductivity characteristics outside the defined tissue or organ region within the area, and an average of conductivity characteristics within the area. The area may be an area within the conductivity map. In some embodiments, other statistical conductivity characteristics related to the tissue or organ of the subject, such as median, mode, standard deviation, etc., may be used instead of the mean.
In some embodiments, (iv) in step 102 may include determining, using the component of the frequency difference EIT data set related to the tissue or organ of the subject and respective component of each of the one or more reference frequency difference EIT data sets related to the tissue or organ of the one or more reference subjects, one or more (e.g., statistical) conductivity characteristics related to the tissue or organ of a group containing the subject and the one or more reference subjects. And, the determining of the health state or condition of the tissue or organ of the subject may be further based on the one or more conductivity characteristics related to the tissue or organ of the group. For example, the one or more (e.g., statistical) conductivity characteristics related to the tissue or organ of the group may include one or more of: an average of conductivity characteristics in a defined tissue or organ region within an area, an average of conductivity characteristics outside the defined tissue or organ region within the area, and an average of conductivity characteristics both in and outside the defined tissue or organ region within the area. The area may be an area within the conductivity map (e.g., averaged conductivity map determined from the conductivity maps). In some embodiments, other statistical conductivity characteristics related to the tissue or organ, such as median, mode, standard deviation, etc., may be used instead of the mean.
In some embodiments, step 104 includes: determining, based on at least the one or more determined conductivity characteristics, whether the subject has a disease associated with the tissue or organ. In some embodiments, step 104 also includes classifying a stage or a severity of the disease associated with the tissue or organ.
In some embodiments, step 104 includes: determining, based on at least the one or more determined conductivity characteristics, a value associated with an estimated performance of the tissue or organ of the subject. For example, in respect of kidney, the value may be an estimated glomerular filtration rate or a related value (e.g., arithmetically related). For example, in respect of liver, the value may be a controlled attenuation parameter (CAP) score or a related value (e.g., arithmetically related).
In some embodiments, step 104 includes: processing, at least, the one or more determined conductivity characteristics of the subject and one or more anthropometric characteristics of the subject, using a machine learning based processing model, to determine a quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject.
In some embodiments, step 104 includes: processing, using a machine learning based processing model, (i) the one or more determined conductivity characteristics of the subject, (ii) one or more anthropometric characteristics of the subject, and (iii) one or more determined conductivity characteristics of one or more reference subjects and/or one or more determined conductivity characteristics of a group containing the subject and the one or more reference subjects, to determine a quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject. Preferably, the one or more reference subjects do not suffer from any disease associated with the tissue or organ.
The machine learning based processing model may include a regression model, a classification model, etc. The regression model may include a linear regression model or a non-linear regression model.
The one or more anthropometric characteristics may include or be related to one or more of, e.g.: age of the subject, weight of the subject, height of the subject, and waist circumference of the subject, waist-over-height ratio of the subject, body mass index (BMI) of the subject, gender of the subject, and race of the subject.
The quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject may include a value associated with an estimated performance of the tissue or organ of the subject. For example, in respect of kidney, the value may be an estimated glomerular filtration rate or a related value (e.g., arithmetically related). For example, in respect of liver, the value may be a controlled attenuation parameter (CAP) score or a related value (e.g., arithmetically related).
In some embodiments, step 104 includes: comparing the quantitative or qualitative parameter associated with the health state or condition of the tissue or organ of the subject with reference parameter data (reference parameter value(s) or range(s)) to determine whether the subject has a disease associated with the tissue or organ. In some embodiments, step 104 further includes: classifying, based on the comparing, a stage or a severity of the disease associated with the tissue or organ.
The method 200 includes, in step 202A, performing an initial processing (pre-processing) on a EIT data set of a subject to obtain a processed EIT data set. The EIT data set includes EIT data obtained from the subject's region containing a tissue or organ of interest. The EIT data set may be obtained using the method 100 described above with reference to
The method 200 includes, in step 204A, performing a fd-EIT processing operation on the processed EIT data set to obtain a fd-EIT data set of the subject. The fd-EIT processing operation may include the processing mentioned with respect to step 102, (ii), in the method 100 described above with reference to
The method 200 may also include, in step 202B, performing an initial processing (pre-processing) on EIT data sets of reference subjects (who do not has any disease associated with the tissue or organ of interest) to obtain a processed EIT data set. The EIT data sets each includes EIT data obtained from a respective reference subject's region containing the tissue or organ of interest. The EIT data sets may be obtained using the method 100 described above with reference to
The method 200 may also include, in step 204B, performing a fd-EIT processing operation on the processed EIT data sets to obtain fd-EIT data sets of the reference subjects. The fd-EIT processing operation may include the processing mentioned with respect to step 102, (ii), in the method 100 described above with reference to
The method 200 includes, in step 206, performing a group source separation operation using the fd-EIT data set of the subject and fd-EIT data sets of reference subjects. The main aim of the group source separation operation is to separate or extract the source signals (i.e., the signals or data related to the tissue or organ of interest) from the fd-EIT data set of the subject and fd-EIT data sets of reference subjects, which may include signals of other organs or tissues. The result of step 206 is the obtaining of components of fd-EIT data sets related to the tissue or organ of the reference subjects and component of fd-EIT data set related to the tissue or organ of the subject. In one example, if the one fd-EIT data set of the subject and two fd-EIT data sets of reference subjects, then after the group source separation operation, one set of data (a map) containing component of fd-EIT data set related to the tissue or organ of the subject and two sets of data (two maps) containing components of fd-EIT data set related to the tissue or organ of the reference subjects will be obtained. The group source separation operation may include the processing mentioned with respect to step 102, (iii), in the method 100 described above with reference to
The method 200 includes, in step 208, performing EIT feature(s) extraction operation using the components of fd-EIT data sets related to the tissue or organ of the reference subjects and component of fd-EIT data set related to the tissue or organ of the subject. Here, the EIT feature(s) correspond to the conductivity characteristic(s) or feature(s). The result of step 206 is the obtaining of feature(s) (conductivity characteristic(s)) of the subject and optionally of the reference subjects. The EIT feature(s) extraction operation may include the processing mentioned with respect to step 102, (iv) and (v), in the method 100 described above with reference to
For example, a statistical operation may be performed on only part of the map of containing component of fd-EIT data set related to the tissue or organ of the subject to obtain an average, mean, median, etc., of conductivity of that part of the map. For example, a statistical operation may be performed on all of the maps containing components of fd-EIT data set related to the tissue or organ of the subject and the reference subjects to obtain an average, mean, median, etc., of conductivity of the aggregate of maps. For example, a delineation operation (e.g., thresholding) may be performed on the map of containing component of fd-EIT data set related to the tissue or organ of the subject to define a region of interest and obtain an average, mean, median, etc., of conductivity of that region of interest of the map. These can all be obtained as the EIT feature(s). In some examples, the processed EIT data set of the subject and/or the processed EIT data sets of the reference subjects can also be used in the performing of the EIT feature(s) extraction operation.
The following provide some example embodiments of the invention. These embodiments may be considered as specific example implementations of the method 100 in
Example 1 can be considered as a specific example implementation of the method 100 of
Nonalcoholic fatty liver disease (NAFLD), also known as hepatic steatosis, is the apparition of fat around hepatocytes (liver cells). NAFLD is typically associated with sedentary lifestyle.
Currently various techniques are used to diagnose NAFLD. One technique is liver biopsy. This technique, while useful, is invasive, relatively expensive, prone to sampling error, often painful, and might result in some severe complications. Non-invasive techniques based on ultrasound-based devices and vibration-controlled transient elastography are also used to diagnose NAFLD. These techniques measure liver elasticity to infer hepatic steatosis in NAFLD quantified using the controlled attenuation parameter.
In this embodiment, frequency sweeping (i.e., multiple measurements each at a different frequency) in EIT is applied to predict controlled attenuation parameter from cross-sectional EIT measurement across the liver, with both the classic frequency difference and the spectral unmixing model.
Electrical impedance tomography (EIT) is a noninvasive imaging method based on measuring electrical impedance of living tissue (i.e., bio-impedance). Typically a small electrical current (e.g., about 1 mA, or any other value, which does not affect normal physiology) is applied into the body through electrodes (e.g., on a belt) at frequencies ranging typically from 1 kHz to 1 MHz (other frequencies are also possible). This electrical current induces an electric potential that is measured at each electrode. Using this input, a map of the conductivity inside the body is reconstructed. These changes in conductivity are used to predict controlled attenuation parameter values. In the remainder of this section, we briefly describe the EIT reconstruction problem.
Assume that a current is applied to the body (of a subject) through a source electrode and a responsive signal (e.g., electric potential) is received at a sink electrode. If the conductivity inside the body is known, it would be possible to compute the electric potential inside the body using Maxwell's equations
where σ denotes the conductivity inside the body and V the electric potential. This equation can be simulated quite accurately.
The main challenge of EIT is that neither the conductivity a nor the potential V inside the body is known. Instead, they must be recovered from boundary measurements Vmes, and this leads to an inverse problem. This example aims to recover only the change in conductivity between two frequencies (
This relationship is not enough to recover a from boundary measurement, because of the ill-posedness of the problem. A regularization term and a prior information are incorporated, so that the discretized final expression of the conductivity is
where R is the Kotre diagonal sensitivity matrix, α and p two regularization parameter and Wx a matrix that incorporates prior information.
Tests are performed on a total of 11 human subjects including 3 females and 8 males, from 20 to 65 years old, with a waist circumference from 71 cm to 110 cm. Individual clinical demographics and physical characteristics, including gender, BMI, age, waist circumference, height, weight, and liver disease history (if any), are collected.
Each of the subjects is first tested for 5-10 minutes liver FibroScan® session (Echosens, France) to obtain the controlled attenuation parameter (CAP) value. EIT examination is then performed with a portable system with a EIT data acquisition console and a 16-electrode belt. The data acquisition console used in this example consists of a power management module, with a current generator providing alternating current at frequencies ranging from 10 KHz to 1 MHz (other frequency ranges, e.g., in the order of GHz, are also envisaged), a data acquisition module for potential difference measurement, and a control and output module for module coordination, data processing and cloud-server communication. The position of the electrode belt (hence the electrodes on it) targets the upper abdominal region, as indicated by the bottom boundary of the ribcage.
The conductivity is reconstructed using a custom version of the pyEIT python library. The changes in conductivity between two pairs of frequency (28.75 kHz-20.00 kHz) and (28.75 kHz-25.00 kHz) are computed by averaging the conductivity map of the difference over the region of interest (ROI) covering the whole liver. Both the prior and region of interest are extracted from a CT scan image.
In this example, a method to extract more information from the frequency-difference curve is provided. This method is based on that if the change in conductivity with respect to frequency is small, then the shape of the measured voltage over frequency is given by a linear combination of the shape of the conductivity changes over frequency. For example, approximate the conductivity change over frequency by its Taylor expansion:
The measured potential is equal to Vmes(ω)=F(σ(ω)), which is approximated by the discrete operator Vmes(ω)≈{tilde over (F)}(σ(xN,ω)), where xN is vector of points that discretizes the domain. The difference of potential can be approximated as follows
and the derivatives can be identified as
It should be noted that the relationship between
is the same as the relationship between ΔV and Δσ. Thus, the exact same methods used to reconstruct Δσ can be used to reconstruct
It is assumed that the parts of the body that cause first order and second order change are different, and thus isolating them would provide more specific information. Note that this method example has been presented with an expansion up to two orders. However, it can be extended to higher orders, provided the conductivity changes have enough derivatives. It can also be extended to any functional basis/free family decomposition. Assume that M tissue types are contributing to the conductivity change and they each have a conductivity variation of Δσi(ω), then, under the linearity assumption (2), the following can be obtained:
where ΔV(ω) is the electric potential difference data sets (except the reference set), αi is the parameter indicative of impact caused by tissue type i, Δσi(ω) is predetermined spectrum specific to tissue type i, M is the total number of tissue types, ∈ is an error term. The Δσi(ω) can be obtained by tabulated values and the coefficient can be estimated by classic linear mixed model methods (Table I).
Once the model for the controlled attenuation parameter is constructed, more EIT data is acquired (without measuring the vibration-controlled transient elastography controlled attenuation parameter) to minimize the variance of the prediction. For each frequency acquisition, the duration of the acquisition and the number of repetitions can be freely chosen. Assume that the data acquired at the frame i for the repetition j provides an observation of the controlled attenuation parameter of
where CAP is the true value of the controlled attenuation parameter, ∈F,i,j is the measurement error (i.e., due to sensor noise) and ∈R,j is the repetition error (the patient does not repeat exactly the same pattern). Denote by NF the number of frames acquired per repetition and by NR the number of repetitions; to estimate the controlled attenuation parameter, the Monte-Carlo average is used over all the frames
Assuming that the ∈F,i,j, ∈R,j are independent random variables and the errors ∈F,i,j (resp. ∈R,j) share the same finite variance σF2 (resp. σR2), by the central limit theorem, the following can be obtained:
when NR and NF are large enough. In this example duration of one acquisition is modelled by the product of the number of frames NF and the duration of the acquisition of one frame tF plus a setup time tS. The total duration of all the acquisitions is then T=NR (NFtF+tS).
By fixing the total time T=T0 and the previous equations, the total variance can be decomposed into the part due to measurement noise and the part due to repetition (
Finally, the values are chosen by rounding off the obtained real values. For a setup time of tS=5 s and a total acquisition time of T0=30 s per frequency, the optimal number of repetitions is NR=3 and the acquisition time is NFtF=5 second.
3.1 Linear Regression with Simple Difference
In this example, the controlled attenuation parameter is predicted by a linear regression using as features the spatial average of the change in conductivity dC28.75kHz-22kHz, dC28.75kHz-25kHz and the anthropometric variable WoH (waist circumference over height). All the variables are significant under a student t-test at level 0.05%. The coefficient of determination is 0.932 and the adjusted one is 0.919 (Table II). The predicted controlled attenuation parameter seems to be able to classify the liver state based on the FibroScan controlled attenuation parameter, (sensitivity=0.75 and a specificity=0.71, the subject being incorrectly classified being mostly close to the threshold,
From Table III, it can be seen that including both conductivity and WoH improves greatly the quality of the regression, compared to using solely one or the other. The coefficients of the linear regression using normalized data being of the same order of magnitude, it can be determined that they have the same importance in the prediction.
3.2 Linear Regression with Unmixed Polynomial Coefficients
As explained above, the first order and second order variation of V with respect to ω are used to reconstruct the conductivity. For each patient or subject the α and β are estimated using least-squares verifying Vmes (ω)−Vmes(ω0)≈α(ω−ω0)+β(ω−ω0)2 and are then used to reconstruct an image. The average conductivity in the liver area dCα and dCβ are computer and used as regressors. This polynomial model provides a good approximation of the change in potential between 10 kHz and 35 kHz (MAPE of 4%). Their performances in the predicted cap are similar to the simple difference, with an adjusted R-squared of 0.914 with WoH (
The data in this example suggests a strong correlation between the difference of conductivity across two frequency pairs and the controlled attenuation parameter measured by vibration-controlled transient elastography, in addition to the already observed correlation with the waist circumference over height (WoH). This correlation can be explained by the conductivity change with respect to the fat content in liver tissue, and is captured by EIT. A shape prior is used to focus on the liver region. Furthermore, the use of a self-administrable EIT device instead of a vibration-controlled transient elastography permits to have a more affordable measure with a real-time result, without requiring the help of a trained professional for acquisition.
The spectral unmixing method in one embodiment provides results similar to classic fd-EIT (adj. R-squared of 0.914), confirming the validity of the approach. Due to its reasonable assumptions, this approach can be applied to other organs (e.g. kidney).
In summary, this embodiment shows that multi-spectral electrical impedance tomography can predict clinical-standard controlled attenuation parameter in patients with or without nonalcoholic fatty liver disease using waist over height (WoH) anthropometric as complementary information. This embodiment also provides a spectral unmixing method to estimate controlled attenuation parameter from multi-spectral EIT by matching the coefficient of a functional decomposition. This spectral unmixing method can be applied for processing other EIT data for diagnosing different diseases (other than liver disease). This embodiment also provides an algorithm to determine the optimal number of repetitions (NR=3) and acquisition time (NFtS=5 s) that minimizes the error and maximizes the accuracy under a constraint of time. In one example, these aspects are all independent from each other (i.e., implemented separately). In another example, two or more of these aspects are implemented at the same time.
Example 2 can be considered as a specific example implementation of the methods 100-300 in
This example relates to EIT based systems and methods for assessing health state or condition of the liver of a subject (e.g., whether the subject has non-alcoholic fatty liver disease (NAFLD)).
64 human subjects are included in the experiment of this example. These subjects range from 21 years old to 84 years old, with waist circumferences from 65 cm to 127 cm and BMI from 18.9 to 43.3. The subject's body measure information including gender, BMI, age, waist circumference, height and prior medical history are collected (
Data are first automatically filtered based on EIT quality (
In this example the CAP prediction (CAP prediction using EIT data) model is a linear regression model with the above 3 features, and subject's waist-over-height ratio (WtHt), height, weight, age, and gender with train/development/test split. The model is built using the scikit-learn library in python in this example.
The scatterplot of all the (EIT-based) predicted CAP against true CAP values is shown in
The 3 features used in this example uncover more information about the status of the liver. In this example, for constant reference EIT, 50 kHz is chosen as the target frequency while conventional time-difference EIT is modified with the reference constant reference EIT. As the mean of all available healthy classified by CAP is chosen as the reference conductivity data, the unique characteristics of each subject can be captured in the feature.
For group source separation, grouping all the combinations of fd-EIT ideally maximize the signal difference between fat and liver tissue, thus highlighted properties can be unmixed to produce a feature correlating to fat tissue.
For fd-EIT, the frequency 160 kHz and the reference frequency 80 kHz are chosen.
To demonstrate clinical screening performance, a self-assessment score disclosed in Y.-ho Lee, et al., PLoS ONE, vol. 9, no. 9, 2014 is compared with the EIT-based predicted CAP.
As shown in
To predict the model's performance in this example, additional data points are simulated based on the variance of existing model to match the population distribution from the National Health and Nutrition Examination Survey Data (NHANES) database using ADAPT library.
It is predicted that sensitivity and specificity stay at around 77% while the AUC of ROC is maintained at 0.80(N=1264), as shown in
Overall, this example demonstrates that EIT can predict clinical standard VCTE FibroScan CAP with anthropometric measures and conductivity features. This example has also demonstrated a cost-effective and self-administrable alternative for home- and community-based NAFLD widespread diagnostic screening and monitoring.
Example 3 can be considered as a specific example implementation of the methods 100-300 in
In this example: a data processing pipeline to extract the kidney signals from in vivo EIT data is provided, and a regression model to estimate the eGFR of CKD patients using EIT features and the age only is provided. The regression result is used to classify the CKD stage of the patient.
21 healthy individuals (controls) and 54 clinical diagnosed CKD patients are tested in this example. Corresponding demographics and physical characteristics, including gender, age, weight, height, and waist circumference for the subjects are collected. In this example, the subjects have undergone both eGFR measurement and EIT-kidney assessment.
All EIT experiments in this example are conducted using a PVC electrode belt connected to a palm sized portable EIT console through an HDMI cable. The EIT console is connected to a computer with specialized software to collect, visualize and save the collected raw EIT data and system information for further data processing and analysis. The electrode belt consists of 16 modular electrode holders, each containing a printed circuit board that can be connected to 1 gel electrode. The electrode belt is placed circumferentially on the abdominal (upper abdominal) region. Throughout the whole EIT data acquisition process, the subjects are asked to breathe normally and to stay still.
In total, there are 208 (16 injection pairs×13 measurement pairs per injection pair) stimulation-measurement at each frequency. Each measurement is measured at a frame rate of 33 fps. 24 frequencies, in the range of 28 kHz to 300 kHz, are used in the EIT measurement and analysis process.
To acquire ground truth eGFRs, blood serum and urine samples are collected from each subject. Creatinine level, evaluated using the blood serum samples, is then used to derive the eGFR score of the subject with the known equation:
eGFR=141×min(SCr/κ,1)α×max(SCr/κ,1)−1.209×0.993Age×1.018[if female]×1.159[if Black]
where eGFR is the estimated glomerular filtration rate (mL/min/1.73 m2), SCr is the standardized serum creatinine (mg/dL), κ=0.7 for females or κ=0.9 for males, α=−0.329 for females or α=−0.411 for males, min indicates the minimum of SCr/κ or 1, max indicates the maximum of SCr/κ or 1, Age represents age of subject in years.
CKD stages are classified according to the value of eGFRs extracted from blood serum samples with the following criteria: Stage 1 CKD: (eGFR>90); Stage 2 CKD: (eGFR: 60-89); Stage 3 CKD: (eGFR: 30-60); Stage 4 CKD: (eGFR: 15-30); Stage 5 CKD: (eGFR: <15). The CKD stages are also grouped in terms of severity according to the following scheme: normal to mild (Stage 1-2), moderate (Stage 3) severe (Stage 4-5).
EIT reconstruction is conducted in Python using the library pyEIT and customized functions. Frequency difference EIT is used in this example, with reference frequency at 30 kHz and the other 23 frequencies ranging from 28 kHz to 300 kHz used for frequency difference reconstruction.
To ensure the quality of data for the purpose of further analysis, a measurement quality classifier and a reconstruction algorithm for arbitrary stimulation-measurement patterns are developed. For each frame, the classifier filters data to remove undesired effects due to uncontrollable events such as faulty measurements due to subject movements.
For each subject and each frequency, the mean of all frames is taken, all electrodes that are corrupted in any one of the frames are labelled and the corresponding stimulation-measurements are removed after taking the mean across frames. Since a reconstruction algorithm for arbitrary stimulation-measurement patterns is developed, we are able to reconstruct the conductivity images after the electrodes involved in faulty measurements are removed.
Group source separation (
After isolating the signals sources, the source of the kidney signal is determined from the group separation result. From this group result, the individual kidney source is extracted. After the group source separation, the signal from the kidneys is the strongest amongst all other signals in the extracted kidney image component. The region of interest (ROI), i.e., the kidneys, is then extracted from the individual source.
After the kidney signal and the ROIs are extracted, EIT related features are generated, including but not limited to the mean conductivity within, outside the ROIs and the ratio between them. The data are split into train set and test set with 60 and 15 data points respectively in a stratified manner. A linear regression model is trained with the train set is evaluated using 5-fold cross validation.
Statistical comparisons are performed on CKD stages and severity classification using one-way ANOVA followed by multiple comparisons Bonferroni post-hoc tests (*p<0.05, **p<0.01, ***p<0.001).
The principle and operation of the group source separation has been described with reference to
It is found that the eGFR is correlated with mean conductivity of the group kidney source, the individual kidney source, and the kidney ROI with linear correlation coefficients of −0.4, 0.59 and −0.4. In addition to the EIT features, it is also found that the age is linear correlated to the eGFR with a coefficient of −0.68. It is found that the mean conductivity within the kidney ROIs is negatively linearly correlated to the mean conductivity of the individual kidney signal image with coefficient of −0.79. Please see
In this example the EIT features are fitted together with the age using a Lasso algorithm. The age has the highest relative importance of 0.45 among all the features, while the mean conductivity in the individual kidney source, in the group source, and in the ROI are 0.40, 0.10 and 0.05, respectively (
The CKD stages are obtained from the eGFR predicted from the regression model by the following criteria: Stage 1 CKD: (eGFR>90); Stage 2 CKD: (eGFR: 60-89); Stage 3 CKD: (eGFR: 30-60); Stage 4 CKD: (eGFR: 15-30); Stage 5 CKD: (eGFR: <15). Considering Stage 1 CKD as healthy and Stages 3, 4 and 5 CKD as non-healthy, a specificity of >99.9% and sensitivity of 87.5% in obtained (
This example demonstrates an eGFR estimation model and a CKD stage classification scheme using a portable, self-administrative EIT device. The operation of this device does not require dedicated professionally trained staff and clinical environment. Furthermore, this imaging device is non-invasive, ionizing-radiation-free and is cost-effective. This device can be used for medical screenings, for early chronic kidney disease diagnosis and longitudinal renal function monitoring without the need of public health services. Therefore, the device can enhance the quality and extend the area of application of telemedicine to renal function monitoring and chronic kidney diseases. Further, due to the portability and user-friendliness, the device can provide community-based CKD screening for individuals in locations that could be missed by public healthcare system.
In this example it is found that the mean conductivity in the individual extracted signal has a very negative linear correlation with the mean conductivity in ROI while having a relative importance of 0.4 in the Lasso model and a linear correlation coefficient of 0.59 with the eGFR. This suggests that the mean conductivity in the individual extracted signal is dominated by signals related to kidney functions.
The evaluation of classification specificity and sensitivity is based on 21 healthy subjects. A simulation based on the prediction error and a population eGFR distribution of the existing Lasso model is generated. Data from NHANES are used as the population eGFR distribution.
An ROC curve with AUC=0.82 is obtained (
In summary, in this example, clinical data and EIT data of 54 CKD patients and 21 healthy subjects are obtained with a portable EIT device. This example provides a data processing pipeline with a group source separation algorithm that isolates the kidney signals from raw EIT data. There is found significant correlations between standard eGFR and eGFR predicted from a linear model using EIT features and the age. CKD stages are classified from the estimated eGFR using the proposed model and 87.5% sensitivity and >99.9% specificity are obtained. This renal function assessment example demonstrates the feasibility of EIT to be used in the field of telemedicine as a non-invasive approach for early CKD diagnosis and potential for longitudinal CKD monitoring.
Although not required, the embodiments described with reference to the Figures can be implemented as an application programming interface (API) or as a series of libraries for use by a developer or can be included within another software application, such as a terminal or computer operating system or a portable computing device operating system. Generally, as program modules include routines, programs, objects, components and data files assisting in the performance of particular functions, the skilled person will understand that the functionality of the software application may be distributed across a number of routines, objects and/or components to achieve the same functionality desired herein.
It will also be appreciated that where the methods and systems of the invention are either wholly implemented by computing system or partly implemented by computing systems then any appropriate computing system architecture may be utilized. This will include stand-alone computers, network computers, dedicated or non-dedicated hardware devices. Where the terms “computing system” and “computing device” are used, these terms are intended to include (but not limited to) any appropriate arrangement of computer or information processing hardware capable of implementing the function described.
It will be appreciated by a person skilled in the art that variations and/or modifications may be made to the described and/or illustrated embodiments of the invention to provide other embodiments of the invention. The described/or illustrated embodiments of the invention should therefore be considered in all respects as illustrative, not restrictive. Example optional features of the invention are provided in the summary and the description. Some embodiments of the invention may include one or more of these optional features (some of which are not specifically illustrated in the drawings). Some embodiments of the invention may lack one or more of these optional features (some of which are not specifically illustrated in the drawings). For example, the method embodiments of the invention are not limited for use in humans but can be use in other animals. The method can be applied for determining health state or condition of different tissues or organs of different subjects. The EIT data acquisition need not be performed using a portable EIT device such as the ones illustrated—the EIT data can be obtained using other EIT devices. The data processing methods of the invention can be implemented on any suitable device or devices (including one or more of server, computer, phone, the EIT console (portable or not), etc.). For example, the method of the invention can be used for diagnosis for different diseases associated with different tissues or organs of interest.
Number | Date | Country | Kind |
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32022046981.3 | Jan 2022 | HK | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2023/073608 | 1/28/2023 | WO |