David S. Holder
Tomographic imaging of circuit activity in brain and nerve with fast neural Electrical Impedance Tomography (fnEIT)
David Holder has had a joint training in Clinical Medicine and Biophysics. As a medical student, X-ray CT was just being developed. He became interested in adapting inverse tomographic imaging methods for imaging fast electrical neural activity in the brain or nerve. In 1982, he interrupted his medical career to plan this and undertook a Master’s degree in Biophysics at the University of California Berkeley, USA. He came up with the idea of achieving this with the then new technique of EIT. Since then, he has been working on this at University College London where he is consultant in Clinical Neurophysiology undertaking EMG and EEG which provides a secure platform to undertake the challenging and high risk goal of developing neural EIT in an interdisciplinary group in Bioengineering and Neurophysiology in Medical Physics.
His keynote talk will be an overview of fast neural Electrical Impedance Tomography for imaging fast electrical activity over milliseconds in the brain or in peripheral nerve. The original vision was that it could be undertaken non-invasively in humans with EEG-type scalp electrodes but this is not currently possible because the resistive skull diverts current so the signal-to-noise ratio is too small. He will review completed work showing it can produce validated fast neural images of activity over milliseconds in brain and nerve, at the expense of needing intracranial or nerve cuff electrodes. He will then present current studies which aim to improve coverage in brain EIT with depth electrode adapted for impedance measurement, to obviate the need for intracranial electrodes by recording with atomic magnetometers, achieve absolute EIT with time-of-flight recording, and image localised fascicular activity in the cervical vagus nerve to allow targeted vagal nerve stimulation and so avoid unwanted side-effects.
Atsuko Shono
The use of EIT monitoring in critically ill patients - seeking answers to diverse clinical questions
Atsuko Shono is a Japanese intensivist at Shimane university hospital in Izumo, Shimane, Japan. She has been working in the intensive care unit for about two decades after specialization in Anesthesiology. Her work focuses specifically on the respiratory management and clinical research using EIT in ICU. Atsuko Shono spent 2 years (2013-2015) in Rotterdam for studying EIT research, since then she kept researching EIT in Japan. Recently, she is actively working in introducing EIT monitoring in seminars and congresses held in Japan to spread its use in ICU. Her working place, Izumo city, is located at west part in Japan facing Japan Sea and famous as a historical place. It is mentioned in historical record of ancient matters that all the Gods in Japan come together once a year and discuss about the future of Japan at big shrine called “Izumo Oyashiro”.
Nowadays not only in research field but also in clinical practice, the application of EIT become more common. In Japan, EIT use in clinical practice was approved by PMDA eventually last year and many intensivists show interests in using EIT for the respiratory management. The next challenge is whether EIT can contribute to the better patient outcome. Atsuko Shono’s keynote talk will focus on how EIT can provide useful information leading to a better choice of therapeutic strategy. The background of critically ill patients vary patient by patient and their clinical conditions change day by day. The intensivists are facing diverse clinical questions which are unpredictable and needed to be addressed in real-time without delay. She would like to introduce the utilization of EIT trying to seek answers for decision-making through some clinical cases in this lecture.
Introduction by: Inéz Frerichs.
Thomas Muders
Recent Advances on Lung Perfusion Imaging using EIT
Dr. Thomas Muders graduated from medical school at the Rheinische-Friedrich-Wilhelms-Universität Bonn in 2003. In the same year, he became a research associate and assistant physician at the Department of Anesthesiology and Intensive Care Medicine at Bonn University Hospital. In 2008 he received his doctorate and became a specialist in anesthesiology. He then continued his clinical and experimental research as a postdoctoral researcher. Since 2012, he has been working there as a senior attending in intensive care medicine.
His experimental research involves different animal models of lung injury and ARDS, functional imaging of the lung using computed tomography (CT), single-photon emission computed tomography (SPECT), and electrical impedance tomography (EIT) for individual optimization of mechanical ventilation, examination of regional lung mechanics, regional ventilation and perfusion distribution, and pulmonary gas exchange. Muders authored and co-authored over 80 scientific works including book chapters, journal papers and conference contributions. His full publication record can be accessed at Orcid, Google Scholar, and Web of Science. He is active in various scientifc societies, such as the Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) and the Deutsche Interdisziplinäre Vereinigung für Intensivmedizin (DIVI).
Muders’s keynote talk at EIT 2023 will cover the topic of “Recent Advances on Lung Perfusion Imaging using EIT”. He will show how EIT can be used for bedside monitoring of regional lung perfusion and gas exchange in critically ill patients. He will present different algorithmic approaches how to extract lung perfusion from pulsatile- and bolus-related EIT-signals and methodological validation studies in animals comparing EIT, CT, and SPECT. In addition, the technical challenges that arise when transferring findings from animal experiments to clinical application are outlined.
Introduction by: Steffen Leonhardt.