Torso-Tank Validation of High-Resolution Electrogastrography (EGG): Forward Modelling, Methodology and Results

Electrogastrography (EGG) is a non-invasive method for measuring gastric electrical activity. Recent simulation studies have attempted to extend the current clinical utility of the EGG, in particular by providing a theoretical framework for distinguishing specific gastric slow wave dysrhythmias. In this paper we implement an experimental setup called a ‘torso-tank’ with the aim of expanding and experimentally validating these previous simulations. The torso-tank was developed using an adult male torso phantom with 190 electrodes embedded throughout the torso. The gastric slow waves were reproduced using an artificial current source capable of producing 3D electrical fields. Multiple gastric dysrhythmias were reproduced based on high-resolution mapping data from cases of human gastric dysfunction (gastric re-entry, conduction blocks and ectopic pacemakers) in addition to normal test data. Each case was recorded and compared to the previously-presented simulated results. Qualitative and quantitative analyses were performed to define the accuracy showing $$\sim $$∼ 1.8% difference, $$\sim $$∼ 0.99 correlation, and $$\sim $$∼ 0.04 normalised RMS error between experimental and simulated findings. These results reaffirm previous findings and these methods in unison therefore present a promising morphological-based methodology for advancing the understanding and clinical applications of EGG.

[1]  P. Pasricha,et al.  Origins and Patterns of Spontaneous and Drug-Induced Canine Gastric Myoelectrical Dysrhythmia , 2003, Digestive Diseases and Sciences.

[2]  Andrew J. Pullan,et al.  Abnormal initiation and conduction of slow-wave activity in gastroparesis, defined by high-resolution electrical mapping. , 2012, Gastroenterology.

[3]  W. Lammers,et al.  Gut peristalsis is governed by a multitude of cooperating mechanisms. , 2009, American journal of physiology. Gastrointestinal and liver physiology.

[4]  L J Van Schelven,et al.  Pitfalls in the analysis of electrogastrographic recordings. , 1999, Gastroenterology.

[5]  Leo K. Cheng,et al.  Loss of Interstitial Cells of Cajal and Patterns of Gastric Dysrhythmia in Patients With Chronic Unexplained Nausea and Vomiting. , 2015, Gastroenterology.

[6]  T. Westfall,et al.  Modulation of intracellular calcium transients and dopamine release by neuropeptide Y in PC-12 cells. , 1994, The American journal of physiology.

[7]  T. Abell,et al.  The impact of surgical excisions on human gastric slow wave conduction, defined by high‐resolution electrical mapping and in silico modeling , 2015, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[8]  Rob S. MacLeod,et al.  Verification of a defibrillation simulation using internal electric fields in a human shaped phantom , 2014, Computing in Cardiology 2014.

[9]  B. N. Cuffin,et al.  Studies of the Electrocardiogram Using Realistic Cardiac and Torso Models , 1977, IEEE Transactions on Biomedical Engineering.

[10]  J. Huizinga,et al.  Interstitial cells of Cajal, from structure to function , 2013, Front. Neurosci..

[11]  Jerry Zeyu Gao,et al.  A simplified biophysical cell model for gastric slow wave entrainment simulation , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[12]  Leo K. Cheng,et al.  A multiscale model of the electrophysiological basis of the human electrogastrogram. , 2010, Biophysical journal.

[13]  Leo K. Cheng,et al.  A theoretical study of the initiation, maintenance and termination of gastric slow wave re-entry. , 2014, Mathematical medicine and biology : a journal of the IMA.

[14]  Y Nagata The influence of the inhomogeneities of electrical conductivity within the torso on the electrocardiogram as evaluated from the view point of the transfer impedance vector. , 1970, Japanese heart journal.

[15]  M. Bortolotti ELECTROGASTROGRAPHY: A SEDUCTIVE PROMISE, ONLY PARTIALLY KEPT , 1998, American Journal of Gastroenterology.

[16]  G O'Grady,et al.  Rapid high‐amplitude circumferential slow wave propagation during normal gastric pacemaking and dysrhythmias , 2012, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[17]  D. Narmoneva,et al.  Modulation of cell function by electric field: a high-resolution analysis , 2015, Journal of The Royal Society Interface.

[18]  J D Chen,et al.  Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis. , 1994, The American journal of physiology.

[20]  Leo K. Cheng,et al.  High-resolution entrainment mapping of gastric pacing: a new analytical tool. , 2010, American journal of physiology. Gastrointestinal and liver physiology.

[21]  R. Macleod,et al.  Effects of heart position on the body-surface electrocardiogram. , 2000, Journal of electrocardiology.

[22]  R. Fisher,et al.  Multichannel Electrogastrography (EGG) in Symptomatic Patients: A Single Center Study , 2004, American Journal of Gastroenterology.

[23]  W E Bolch,et al.  Individual variations in mucosa and total wall thickness in the stomach and rectum assessed via endoscopic ultrasound. , 2003, Physiological measurement.

[24]  Todd P. Coleman,et al.  High-Resolution Electrogastrogram: A Novel, Noninvasive Method for Determining Gastric Slow-Wave Direction and Speed , 2017, IEEE Transactions on Biomedical Engineering.

[25]  H. Parkman,et al.  Electrogastrography: a document prepared by the gastric section of the American Motility Society Clinical GI Motility Testing Task Force , 2003, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[26]  J. Haueisen,et al.  The localization of focal heart activity via body surface potential measurements: tests in a heterogeneous torso phantom , 2009, Physics in medicine and biology.

[27]  Jens Haueisen,et al.  Influence of anisotropic compartments on magnetic field and electric potential distributions generated by artificial current dipoles inside a torso phantom , 2008, Physics in medicine and biology.

[28]  R. Lux,et al.  Epicardial Potential Mapping: Effects of Conducting Media on Isopotential and Isochrone Distributions , 1991, Circulation.

[29]  T. Abell,et al.  Glucagon-evoked gastric dysrhythmias in humans shown by an improved electrogastrographic technique. , 1985, Gastroenterology.

[30]  Andrew J. Pullan,et al.  Mathematically Modelling the Electrical Activity of the Heart: From Cell to Body Surface and Back Again , 2005 .

[31]  W. C. Alvarez,et al.  The electrogastrogram and what it shows , 1922 .

[32]  R. Macleod,et al.  Electrocardiographic mapping in a realistic torso tank preparation , 1995, Proceedings of 17th International Conference of the Engineering in Medicine and Biology Society.

[33]  W. Hasler,et al.  Directed endoscopic mucosal mapping of normal and dysrhythmic gastric slow waves in healthy humans , 2004, Neurogastroenterology and Motility.

[34]  R. Mårvik,et al.  Gastrin stimulates histamine release from the isolated pig stomach. , 1997, Scandinavian journal of gastroenterology.

[35]  J. C. Erickson,et al.  Diabetic gastroparesis alters the biomagnetic signature of the gastric slow wave , 2016, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[36]  G. Farrugia Interstitial cells of Cajal in health and disease , 2008, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[37]  Leo K. Cheng,et al.  Origin and propagation of human gastric slow-wave activity defined by high-resolution mapping. , 2010, American journal of physiology. Gastrointestinal and liver physiology.

[38]  F. Chang,et al.  Electrogastrography: Basic knowledge, recording, processing and its clinical applications , 2005, Journal of gastroenterology and hepatology.

[39]  A. J. Pullan,et al.  Mathematical models and numerical methods for the forward problem in cardiac electrophysiology , 2002 .