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Electrical impedance tomography (EIT), which can assess regional lung ventilation at the bedside, has never been compared with positron-emission tomography (PET), a gold-standard to quantify regional ventilation. This experiment systematically compared both techniques in injured and non-injured lungs.    Methods  The study was performed in six mechanically ventilated female piglets. In normal lungs, tidal volume (V T ) was randomly changed to 6, 8, 10 and 15 ml/kg on zero end-expiratory pressure (ZEEP), then, at V T  10 ml/kg, positive end-expiratory pressure (PEEP) was randomly changed to 5, 10 and 15 cmH 2 O. Afterwards, acute lung injury (ALI) was subsequently created in three animals by injecting 3 ml/kg hydrochloric acid into the trachea. Then at PEEP 5 cmH 2 O, V T  was randomly changed to 8 and 12 ml/kg and PEEP of 10 and 15 cmH 2 O applied at V T  10 ml/kg. EIT and PET examinations were performed simultaneously. EIT ventilation (V TEIT ) and lung volume (V L ) were measured in the anterior and posterior area of each lung. On the same regions of interest, ventilation (V PET ) and aerated lung volume (VA atten ) were determined with PET.    Results  On ZEEP, V TEIT  and V PET  significantly correlated for global (V TEIT  = VPET - 2E-13, R 2  = 0.95,  P  < 0.001) and regional (V TEIT  = 0.81V PET +7.65, R 2  = 0.63,  P  < 0.001) ventilation over both conditions. For ALI condition, corresponding R 2  were 0.91 and 0.73 ( P  < 0.01). Bias was = 0 and limits of agreement were -37.42 and +37.42 ml/min for global ventilation over both conditions. These values were 0.04 and -29.01 and +29.08 ml/min, respectively, for regional ventilation. Significant correlations were also found between V L  and VA atten  for global (V L  = VA atten +1E-12, R 2  = 0.93,  P  < 0.0001) and regional (V L  = 0.99VA atten +0.92, R 2  = 0.65,  P  < 0.001) volume. For ALI condition, corresponding R 2  were 0.94 ( P  < 0.001) and 0.54 ( P  < 0.05). Bias was = 0 and limits of agreement ranged -38.16 and +38.16 ml for global ventilation over both conditions. These values were -0.24 and -31.96 to +31.48 ml, respectively, for regional ventilation.    Conclusions  Regional lung ventilation and volume were accurately measured with EIT in healthy and injured lungs and validated by simultaneous PET imaging.

Electrical impedance tomography compared to positron emission tomography for the measurement of regional lung ventilation: an experimental study