Introduction There are several ventilator modes that are used for maintenance mechanical ventilation but no conclusive evidence that one mode of ventilation is better than another. Vibration response imaging is a novel bedside imaging technique that displays vibration energy of lung sounds generated during the respiratory cycle as a real-time structural and functional image of the respiration process. In this study, we objectively evaluated the differences in regional lung vibration during different modes of mechanical ventilation by means of this new technology.

The animal study showed that electrical impedance measurements reflect morphological changes related to the growth of a cancerous skin lesion. These findings are in agreement with a preliminary clinical study. Electrical Impedance Scanning can therefore be considered as an objective and non-invasive tool for differentiation between benign and malignant skin lesions.

A validation study proved the value of electrical impedance scanning as a noninvasive technique for detection of melanoma lesions of the trunk and extremities, specifically, of in situ and thin type. In addition, image analysis was shown to be a valuable, complementary procedure. New parameters should be designed to optimize the performance of electrical impedance scanning for melanomas of the head and neck.

A new postprocessing algorithm was developed for the diagnosis of breast cancer using electrical impedance scanning. This algorithm automatically recognizes bright focal spots in the conductivity map of the breast. Moreover, this algorithm discriminates between malignant and benign/normal tissues using two main predictors: phase at 5 kHz and crossover frequency, the frequency at which the imaginary part of the admittance is at its maximum. The thresholds for these predictors were adjusted using a learning group consisting of 83 carcinomas and 378 benign cases. In addition, the algorithm was verified on an independent test group including 87 carcinomas, 153 benign cases and 356 asymptomatic cases. Biopsy was used as gold standard for determining pathology in the symptomatic cases. A sensitivity of 84% and a specificity of 52% were obtained for the test group.

Introduction Automated mapping of lung sound distribution is a novel area of interest currently investigated in mechanically ventilated, critically ill patients. The objective of the present study was to assess changes in thoracic sound distribution resulting from changes in positive end-expiratory pressure (PEEP). Repeatability of automated lung sound measurements was also evaluated.

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Background: Complementary bedside lung monitoring modalities are often sought in order to assist in the differentiation between several lung opacities in the intensive care unit (ICU). Objectives: To evaluate the use of computerized lung acoustic monitoring as a complementary approach in the differentiation between various chest radiographic densities in critically ill patients. Methods: Lung vibration intensity was assessed in 82 intensive care patients using vibration response imaging. Patients were classified according to their primary findings on chest radiography (CXR): consolidation (n = 35), congestion (n = 10), pleural effusion (n = 15), atelectasis/hypoinflation (n = 10) and normal findings (n = 12). Sixty patients were mechanically ventilated and 22 patients were spontaneously breathing. Results: Significantly elevated vibration intensity was detected in patients with consolidation, as opposed to pleural effusion, atelectasis and normal CXR (p < 0.01, Mann-Whitney U test). Vibration intensity was also increased for congestion, but this increase was not significant. The positive predictive value of CXR lung opacity in combination with increased vibration intensity to detect consolidations and/or congestions was 95% (20/21). Furthermore, vibration intensity was significantly higher in mechanically ventilated patients compared to spontaneously breathing patients (p = 0.001, Mann-Whitney U test). Differences related to gender, age and body position were not significant. Conclusions: Computerized lung acoustic monitoring at the bedside was found to be a useful, readily available, noninvasive, adjunctive tool in the differentiation between various CXR densities in critically ill patients.

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