Effects of Anatomical Variations of the Stomach on Body-Surface Gastric Mapping Investigated Using a Large Population-Based Multiscale Simulation Approach

Body-surface gastric mapping (BSGM) measures the resultant body-surface potentials of gastric slow waves using an array of cutaneous electrodes. However, there is no established protocol to guide the placement of the mapping array and to account for the effects of biodiversity on the interpretation of BSGM data. This study aims to quantify the effect of anatomical variation of the stomach on body surface potentials. To this end, 93 subject specific models of the stomach and torso were developed, based on data obtained from the Cancer Imaging Archive. For each subject a set of points were created to model general anatomy the stomach and the torso, using a finite element mesh. A bidomain model was used to simulate the gastric slow waves in the antegrade wave (AW) direction and formation of colliding waves (CW). A forward modeling approach was employed to simulate body-surface potentials from the equivaelent dipoles. Simulated data were sampled from a 5 × 5 array of electrodes from the body-surface and compared between AW and CW cases. Anatomical parameters such as the Euclidean distance from the xiphoid process (8.6 ± 2.2 cm), orientation relative to the axial plane (195 ± 20.0°) were quantified. Electrophysiological simulations of AW and CW were both correlated to specific metrics derived from BSGM signals. In general, the maximum amplitude ( ∆ ϕ) and orientation ( θ) of the signals provided consistent separation of AW and CW. The findings of this study will aid gastric BSGM electrode array design and placement protocol in clinical practices.