Improvements in Bioimpedance SpectroscopyData Analysis : Artefact Correction, ColeParameters, and Body Fluid Estimation

Abstract: The estimation of body fluids is a useful and common practice in the status assessment of diseasemechanisms and treatments. Electrical bioimpedance spectroscopy (EBIS) methods are non-invasive,inexpensive, and efficient alternatives for the estimation of body fluids. However, these methods areindirect, and their robustness and validity are unclear.Regarding the recording of measurements, a controversy developed regarding a spectrum deviationin the impedance plane, which is caused by capacitive leakage. This deviation is frequentlycompensated for by the extended Cole model, which lacks a theoretical basis; however, there is nomethod published to estimate the parameters. In this thesis, a simplified model to correct thedeviation was proposed and tested. The model consists of an equivalent capacitance in parallel withthe load.Subsequently, two other measurement artefacts were considered. Both artefacts were frequentlydisregarded with regard to total body and segmental EBIS measurements as their influence isinsignificant with suitable skin-electrode contact. However, this case is not always valid, particularlyfrom a textile-enabled measurement system perspective. In the estimation of body fluids, EBIS dataare fitted to a model to obtain resistances at low and high frequencies. These resistances can berelated to body fluid volumes. In order to minimise the influence of all three artefacts on theestimation of body fluids and improve the robustness and suitability of the model fitting the differentdomains of immittance were used and tested. The conductance in a reduced frequency spectrum wasproposed as the most robust domain against the artefacts considered.The robustness and accuracy of the method did not increase, even though resistances at low and highfrequencies can be robustly estimated against measurement artefacts. Thus, there is likely error in therelation between the resistances and volumes. Based on a theoretical analysis, state of the artmethods were reviewed and their limitations were identified. New methods were also proposed. Allmethods were tested using a clinical database of patients involved in growth hormone replacementtherapy. The results indicated EBIS are accurate methods to estimate body fluids, however they haverobustness limits. It is hypothesized that those limits in extra-cellular fluid are primarily due toanisotropy, in total body fluid they are primarily due to the uncertainty ρi, and errors in intra-cellularfluid are primarily due to the addition of errors in extracellular and total body fluid. Currently, theseerrors cannot be prevented or minimised. Thus, the limitations for robustness must be predicted priorto applying EBIS to estimate body fluids.