A direct image reconstruction method of electrical impedance tomography (EIT) is evaluated using three-dimensional (3-D) finite element models of cylindrical and torso-shaped volume conductors. The cylindrical model is used to examine the effect of electrode configurations and the sensitivity to off-plane objects and to noise in the measured data. It is also used to validate the modeling procedures by comparison with experimental data acquired from a similar cylindrical tank filled with saline. Simulation results show only minor differences in performance between the various electrode configurations. In the second part, a realistic human thorax model constructed from CT images is used to evaluate monitoring of pulmonary edema by EIT. The conductivity, volume, and vertical position of an abnormal region in the lungs are varied to simulate the progress of edema. Dynamic EIT images are reconstructed from data computed for the inhomogeneous thorax (heart and lungs) as the reference set and a realistic amount of noise is added to reproduce the conditions in which the technique would be used in practice. Simulation results show that a 10 ml edema region with a conductivity equal to that of blood can be detected at a 40 dB signal-to-noise ratio (SNR). Detection of a smaller volume, in the order of 2 ml, should be possible by improving either the instrumentation to achieve 60 dB SNR or the performance of reconstruction algorithms.