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Cheng W, Lin K, Wang L, Wang X, Feng Y, Gu Z, Liu H. Clinical features of magnetically controlled capsule endoscopy in children: A large, retrospective cohort study. J Pediatr Gastroenterol Nutr 2025; 80:733-741. [PMID: 39916493 DOI: 10.1002/jpn3.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 12/24/2024] [Accepted: 01/08/2025] [Indexed: 04/02/2025]
Abstract
OBJECTIVE This study aimed to assess the utility of magnetically controlled capsule endoscopy (MCE) in the diagnosis of pediatric gastrointestinal diseases. METHODS A retrospective cohort study was conducted, which collected data from 1040 children (546 males and 494 females; mean age: 11.0 ± 2.6 years) who underwent MCE at Shanghai Children's Hospital between June 2017 and February 2023. Information on gastric visualization, cleanliness, examination times, lesion detection rates, and other parameters were recorded. A 2-week follow-up monitored capsule excretion and adverse reactions. RESULTS Of the 1055 patients, 78 had difficulty swallowing the capsule, and 15 could not swallow even with assistance, which led to their exclusion. The small intestine was successfully examined in 94.5% (206 out of 218) of the 218 children who were able to proceed with the procedure. The remaining 822 underwent esophagus and stomach examinations. The average transit time of the endoscopy capsule in the esophagus, stomach, and small intestine was 5 (3, 9) s, 57.0 (29.0, 102.0) min, and 306.0 (234.0, 500.0) min. In the examined cases, complete small bowel visualization was achieved in 94.5% of the patients. The most common symptoms reported by the patients were abdominal pain (77.9%) and nausea with vomiting (13.5%). Lesion detection rates were 38.8% in the stomach, 21.1% in the duodenum, and 43.1% in the jejunoileum. No complications, such as capsule retention or intestinal obstruction, were observed. CONCLUSION MCE is a feasible and safe method for examining the gastric cavity and small bowel in pediatric patients.
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Affiliation(s)
- Weiwei Cheng
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kai Lin
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Wang
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xing Wang
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuling Feng
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhujun Gu
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haifeng Liu
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Meng K, Li Y, Yan B, Pan F, Yan J, Zhou G, Chen H, Zhang X. Feasibility and Safety of a Novel Cable-Transmitted Magnetically Controlled Capsule Endoscopy System for Upper Gastrointestinal Examination. HEALTH CARE SCIENCE 2025; 4:94-102. [PMID: 40241979 PMCID: PMC11997460 DOI: 10.1002/hcs2.70010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 11/13/2024] [Accepted: 12/08/2024] [Indexed: 04/18/2025]
Abstract
Background To evaluate the feasibility and safety of a novel cable-transmitted magnetically controlled capsule endoscopy (CT-MCE) system for upper gastrointestinal examination. Methods Twenty-six participants (19 healthy volunteers and seven patients with gastrointestinal symptoms) willing to undergo upper gastrointestinal endoscopy were recruited. Each participant underwent CT-MCE followed by conventional gastroscopy within 24 h. Maneuverability and visibility of the CT-MCE capsule in the upper gastrointestinal tract, adverse events, and discomfort during the procedure were evaluated. The sensitivity and specificity of CT-MCE for diagnosing upper gastrointestinal lesions were evaluated using conventional gastroscopy findings as the standard. Results Maneuverability was graded as "good" for all segments of the esophagus. The percentage of participants in which maneuverability was good according to gastric region was as follows: cardia (100.00%), pylorus (96.15%), angulus (92.31%), antrum (88.46%), fundus (84.62%), and body (73.08%). In the duodenal bulb and descending duodenum, it was good in only 20.83% and 16.67% of participants, respectively. Visibility was graded as "excellent" or "good" in the esophagus, Z line, and duodenal bulb in all participants; excellent/good visibility was achieved in the stomach and descending duodenum in 96.15% and 79.17% of participants, respectively. Forty-one lesions were detected overall. The sensitivity and specificity of CT-MCE in diagnosing upper gastrointestinal lesions were 85.00% and 98.15%, respectively. The CT-MCE capsule was successfully removed through the mouth in all participants. No serious adverse events or capsule retention occurred. Conclusions CT-MCE showed good feasibility and safety for upper gastrointestinal examination. The system was effective in examining the esophagus and stomach with no risk of capsule retention.
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Affiliation(s)
- Ke Meng
- Department of Gastroenterology and HepatologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Yan Li
- Department of Gastroenterology and HepatologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Bin Yan
- Department of Gastroenterology and HepatologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Fei Pan
- Department of Gastroenterology and HepatologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | | | | | - Haixu Chen
- National Clinical Research Center of Geriatrics Disease, Institute of Geriatrics, Chinese PLA General HospitalBeijingChina
| | - Xiaomei Zhang
- Department of Gastroenterology and HepatologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
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Tian Y, Du S, Liu H, Yu H, Bai R, Su H, Guo X, He Y, Song Z, Chen Y, Li Q, Wang J, Huang W, Rong L. Prospective, multicenter, self-controlled clinical trial on the effectiveness and safety of a cable-transmission magnetically controlled capsule endoscopy system for the examination of upper GI diseases (with video). Gastrointest Endosc 2025; 101:804-817.e1. [PMID: 39111392 DOI: 10.1016/j.gie.2024.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/30/2024] [Accepted: 07/26/2024] [Indexed: 10/17/2024]
Abstract
BACKGROUND AND AIMS Many GI disorders and precancerous conditions often present asymptomatically, leading to delayed patient diagnoses and treatment interventions. In this study, we developed a novel cable-transmission magnetically controlled capsule endoscopy (CT-MCCE) system for detecting GI diseases and assessed its safety and feasibility through clinical trials. METHODS This prospective, multicenter trial compared CT-MCCE with conventional gastroscopy in patients aged 18 to 75 years with upper GI tract diseases between October 2022 and July 2023. The primary endpoints were the evaluation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the detection of focal lesions within the esophagus, stomach, and duodenal bulb using CT-MCCE. RESULTS One hundred eighty individuals (mean age, 43.1 years; 52.22% women) were recruited from 3 hospitals in China. CT-MCCE detected lesions in the esophagus with a sensitivity of 97.22%, specificity of 100%, PPV of 100%, NPV of 98.18%, and accuracy of 98.89%; detected gastric focal lesions in the entire stomach with a sensitivity of 96.81%, specificity of 98.84%, PPV of 98.91%, NPV of 96.59%, and accuracy of 97.78%; and detected lesions in the duodenal bulb with a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. There were no significant differences between CT-MCCE and EGD regarding the cleanliness of the upper GI tract and visibility of the upper GI mucosa. However, CT-MCCE was associated with a lower incidence of discomfort than EGD (P < .001). CONCLUSIONS The diagnostic performance of CT-MCCE is comparable with that of EGD in the completion of upper GI tract examinations and lesion detection. Furthermore, the improved tolerance of CT-MCCE in detecting upper GI diseases was noted without any observed adverse events. (Clinical trial registration number: ChiCTR2200063630.).
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Affiliation(s)
- Yuan Tian
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Shiyu Du
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing, China
| | - Hong Liu
- Gastroenterology Department, Capital Medical University affiliated Beijing Shijitan Hospital, Beijing, China
| | - Hang Yu
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Ruxue Bai
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing, China
| | - Hui Su
- Gastroenterology Department, Capital Medical University affiliated Beijing Shijitan Hospital, Beijing, China
| | - Xinyue Guo
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Yan He
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
| | - Zhenmei Song
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing, China
| | - Yanming Chen
- Gastroenterology Department, China-Japan Friendship Hospital, Beijing, China
| | - Qian Li
- Gastroenterology Department, Capital Medical University affiliated Beijing Shijitan Hospital, Beijing, China
| | - Jing Wang
- Gastroenterology Department, Capital Medical University affiliated Beijing Shijitan Hospital, Beijing, China
| | | | - Long Rong
- Department of Endoscopy Center, Peking University First Hospital, Beijing, China
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Sun Y, Sun B, Cui X, Li W, Zhang Y, He L, Nong S, Zhu Z, Wu J, Li D, Li X, Zhang S, Li X, Li M. Addressable and perceptible dynamic reprogram of ferromagnetic soft machines. Nat Commun 2025; 16:2267. [PMID: 40050263 PMCID: PMC11885537 DOI: 10.1038/s41467-025-57454-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 02/21/2025] [Indexed: 03/09/2025] Open
Abstract
Soft machines actuated by external magnetic fields have gained significant attention for their potential to interact with living organisms and complex environments. However, their adaptability and functionality are often limited by rigid magnetization during operation. In this work, we introduce dynamically reprogrammable magnetic soft machines with in situ reconfigurable magnetization profiles during operations, achieved through the synergy of various magnetic fields. A flexible resonant circuit is integrated into the machine body, enabling addressable and perceptible heating of specific regions via high-frequency fields of varying frequencies. The machine body is composed of microbeads made from a low-melting-point alloy and NdFeB microparticles. When heated, the alloy liquefies, allowing the rotation of NdFeB microparticles under a 40 mT pulsed programming field. Upon cooling, the new configuration is locked in place. This reprogramming process is equally effective for single or multiple machines, enabling versatile multi-pattern deformation of individual machines and cooperation of multiple ones. Furthermore, by incorporating addressable thermal actuation, we demonstrate in situ assembly of multiple robots. This work may enable a broad spectrum of magnetic soft machines with enhanced functionalities.
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Affiliation(s)
- Yuxuan Sun
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Boxi Sun
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Xiang Cui
- School of Computer Science and Technology, University of Science and Technology of China, 230026, Hefei, China
| | - Weihua Li
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Yue Zhang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230000, Hefei, Anhui, China
| | - Li He
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230000, Hefei, Anhui, China
| | - Shutong Nong
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Zhengqing Zhu
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Jiyang Wu
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Dongxiao Li
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Xingxiang Li
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China
| | - Shiwu Zhang
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China.
| | - Xiangyang Li
- School of Computer Science and Technology, University of Science and Technology of China, 230026, Hefei, China.
| | - Mujun Li
- Institute of Humanoid Robots, Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, 230026, Hefei, China.
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Tawheed A, Ismail A, Amer MS, Elnahas O, Mowafy T. Capsule endoscopy: Do we still need it after 24 years of clinical use? World J Gastroenterol 2025; 31:102692. [PMID: 39926220 PMCID: PMC11718605 DOI: 10.3748/wjg.v31.i5.102692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 11/20/2024] [Accepted: 12/02/2024] [Indexed: 12/30/2024] Open
Abstract
In this letter, we comment on a recent article published in the World Journal of Gastroenterology by Xiao et al, where the authors aimed to use a deep learning model to automatically detect gastrointestinal lesions during capsule endoscopy (CE). CE was first presented in 2000 and was approved by the Food and Drug Administration in 2001. The indications of CE overlap with those of regular diagnostic endoscopy. However, in clinical practice, CE is usually used to detect lesions in areas inaccessible to standard endoscopies or in cases of bleeding that might be missed during conventional endoscopy. Since the emergence of CE, many physiological and technical challenges have been faced and addressed. In this letter, we summarize the current challenges and briefly mention the proposed methods to overcome these challenges to answer a central question: Do we still need CE?
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Affiliation(s)
- Ahmed Tawheed
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11795, Egypt
| | - Alaa Ismail
- Faculty of Medicine, Helwan University, Cairo 11795, Egypt
| | - Mohab S Amer
- Faculty of Medicine, Helwan University, Cairo 11795, Egypt
- Department of Research, SMART Company for Research Services, Cairo 11795, Egypt
| | - Osama Elnahas
- Faculty of Medicine, Helwan University, Cairo 11795, Egypt
| | - Tawhid Mowafy
- Department of Internal Medicine, Gardenia Medical Center, Doha 0000, Qatar
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Wang L, Lin K, Cheng W, Wang X, Zhang Y, Feng Y, Gu Z, Liu H. Innovative nomogram approach to enhance the prediction of Helicobacter pylori infection in children via magnetic-controlled capsule endoscopy. Eur J Pediatr 2025; 184:139. [PMID: 39812900 DOI: 10.1007/s00431-024-05962-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 12/26/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025]
Abstract
Early detection and intervention are crucial in managing Helicobacter pylori (HP) infections, which are associated with various gastrointestinal diseases in children. The traditional Kyoto gastritis scoring system, though effective, requires adaptation for non-invasive techniques like magnetic-controlled capsule endoscopy to enhance early diagnosis and improve patient comfort. This retrospective study involved 474 pediatric patients who underwent magnetic-controlled capsule endoscopy coupled with a 13C urea breath test at the Children's Hospital affiliated with Shanghai Jiao Tong University School of Medicine from January to December 2023. Utilizing the Kyoto gastritis scoring system, adapted for magnetic-controlled capsule endoscopy, we evaluated its effectiveness in diagnosing HP infection. To enhance diagnostic precision, a nomogram was developed that integrates these gastritis scores with demographic and clinical variables, providing a comprehensive tool for assessing the risk of HP infection. Our findings indicate that a Kyoto gastritis score of ≥ 2 has a high predictive accuracy for HP infection, with an area under the curve (AUC) of 0.755 (95% CI 0.697-0.813). The study highlighted Kyoto gastritis score and white mucous as significant predictors of infection, with odds ratios of 5.94 (95% CI 3.40-10.49) and 2.78 (95% CI 1.65-4.71), respectively. A predictive model incorporating these factors alongside demographic and clinical variables demonstrated robust diagnostic potential. The nomogram, incorporating these factors, showed robust diagnostic potential and improved the predictive accuracy. CONCLUSIONS The adapted Kyoto gastritis scoring system for magnetic-controlled capsule endoscopy offers a promising approach for the early detection of HP infection in children. By integrating multiple diagnostic indicators from non-invasive magnetic-controlled capsule endoscopy, this model enhances early diagnostic accuracy and can significantly reduce discomfort and risks associated with traditional endoscopic procedures. WHAT IS KNOWN • The 13C urea breath test is used to screen children for Helicobacter pylori infection. Gastroendoscopy for the assessment of digestive diseases in children. WHAT IS NEW • Magnetic-controlled capsule endoscopy for the assessment of digestive diseases in children, combined with 13C urea breath test to improve the diagnosis of Helicobacter pylori in children.
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Affiliation(s)
- Ling Wang
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Kai Lin
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Weiwei Cheng
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Xing Wang
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Yong Zhang
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yuling Feng
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Zhujun Gu
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
| | - Haifeng Liu
- Department of Digestive Endoscopy Center, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
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Hoffmann SV, O'Shea JP, Galvin P, Jannin V, Griffin BT. State-of-the-art and future perspectives in ingestible remotely controlled smart capsules for drug delivery: A GENEGUT review. Eur J Pharm Sci 2024; 203:106911. [PMID: 39293502 DOI: 10.1016/j.ejps.2024.106911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 09/06/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
An emerging concern globally, particularly in developed countries, is the rising prevalence of Inflammatory Bowel Disease (IBD), such as Crohn's disease. Oral delivery technologies that can release the active therapeutic cargo specifically at selected sites of inflammation offer great promise to maximise treatment outcomes and minimise off-target effects. Therapeutic strategies for IBD have expanded in recent years, with an increasing focus on biologic and nucleic acid-based therapies. Reliable site-specific delivery in the gastrointestinal (GI) tract is particularly crucial for these therapeutics to ensure sufficient concentrations in the targeted cells. Ingestible smart capsules hold great potential for precise drug delivery. Despite previous unsuccessful endeavours to commercialise drug delivery smart capsules, the current rise in demand and recent advancements in component development, manufacturing, and miniaturisation have reignited interest in ingestible devices. Consequently, this review analyses the advancements in various mechanical and electrical components associated with ingestible smart drug delivery capsules. These components include modules for device localisation, actuation and retention within the GI tract, signal transmission, drug release, power supply, and payload storage. Challenges and constraints associated with previous capsule design functionality are presented, followed by a critical outlook on future design considerations to ensure efficient and reliable site-specific delivery for the local treatment of GI disorders.
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Affiliation(s)
- Sophia V Hoffmann
- School of Pharmacy, University College Cork, College Road, Cork, Ireland
| | - Joseph P O'Shea
- School of Pharmacy, University College Cork, College Road, Cork, Ireland
| | - Paul Galvin
- Tyndall National Institute, University College Cork, Cork T12R5CP, Ireland
| | | | - Brendan T Griffin
- School of Pharmacy, University College Cork, College Road, Cork, Ireland.
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Chang LJ, Liu HY, Ma XB, Gao T, Liu CX. Detection of early hidden carcinoma of cardia by reversely entering the esophagus with magnetically controlled capsule endoscopy: A case report. Arab J Gastroenterol 2024; 25:444-447. [PMID: 39289082 DOI: 10.1016/j.ajg.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 06/23/2024] [Accepted: 07/07/2024] [Indexed: 09/19/2024]
Abstract
Magnetically controlled capsule endoscopy (MCE) is a non-invasive method for gastropathy examination. However, due to the influence of gravity and lumen structure, the traditional capsule endoscopy rapidly passes through the cardia, leading to insufficient observation of the cardia mucosa. Case Summary. The patient, a 53-year-old male, had a history of subarachnoid hemorrhage for 5 years, and it has been 5 years since the aneurysm embolization.Computed Tomography Angiography (CTA) indicated the presence of an anterior cruciate aneurysm. Given the risks associated with traditional intubated gastroscopy, magnetic controlled capsule gastroscopy was chosen for gastric examination. Following the standard operating procedure, routine magnetic controlled capsule endoscopy was performed, and no lesions were detected.We combined magnetic force and patient posture adjustment to guide the capsule to pass through the cardia slowly and return to the esophagus, successfully detecting a concealed cardia lesion.Afterwards, the lesions of the cardia were treated with a magnifying gastroscope and endoscopic submucosal dissection (ESD).Pathological findings showed that adenocarcinoma was confined to the mucosa membrane, and in the postoperative pathological study, no tumor remnants or metastasis were discovered. This paper reports a case of a patient undergoing a physical examination, but no lesion was found during a routine examination using the magnetically controlled capsule gastroscope. However, we discovered a case of hidden early cardia cancer after guiding the capsule gastroscope back into the esophagus under magnetic control.
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Affiliation(s)
- Lu-Jie Chang
- Gastrointestinal Endoscopy Centre, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Hai-Yan Liu
- Gastrointestinal Endoscopy Centre, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Xing-Bin Ma
- Gastrointestinal Endoscopy Centre, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Tao Gao
- Gastrointestinal Endoscopy Centre, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Cheng-Xia Liu
- Gastrointestinal Endoscopy Centre, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China.
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9
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Chang L, Ma H, Li K, Gao T, Zeng J, Li Y, Luo Y, Chen Y, Liu C, Shi N. A novel method of cardia visualization and comfort level enhancement during magnetic capsule gastroscopy via sugar-glued tether-assisted technique: a randomized pilot study inspired by a Chinese snack-making process (with video). Surg Endosc 2024; 38:6948-6955. [PMID: 39361135 DOI: 10.1007/s00464-024-11218-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/19/2024] [Indexed: 11/01/2024]
Abstract
BACKGROUND Magnetic capsule gastroscopy (MCG) is a non-invasive diagnostic method for the digestive tract. However, its efficiency in visualizing the gastric cardia is often compromised due to the capsule's rapid passage. This study introduces a novel sugar-glued tether-assisted technique inspired by a traditional Chinese snack-making process to enhance cardia visualization and patient comfort during MCG. METHODS This pilot, open-label, single-center, randomized controlled, non-inferiority study was conducted at Binzhou Medical University Hospital. Seventy-eight patients were enrolled and divided into three groups: conventional MCG, suction cup tether-assisted MCG, and sugar-glued tether-assisted MCG. The primary outcomes included safety, comfort level, and gastric cardia visualization quality. Secondary outcomes assessed technique-associated performance and clinical factors. RESULTS The sugar-glued tether-assisted MCG demonstrated comparable cardia visualization quality to the suction cup method, with significantly better results than conventional MCG. Comfort levels were significantly higher in the sugar-glued group compared to the suction cup group. The number of swallow attempts was significantly lower in the sugar-glued group, with no adverse events reported. Secondary outcomes showed no significant differences in MCG assembly time and ingestion-to-detachment period between the suction cup and sugar-glued groups. CONCLUSION The sugar-glued tether-assisted MCG is a feasible and safe modification that enhances gastric cardia visualization while improving patient comfort. This technique provides a cost-effective alternative to the suction cup method, warranting further investigation in larger, multi-center studies.
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Affiliation(s)
- Lujie Chang
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Huaiyuan Ma
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China
- Institute of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Kun Li
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China
- Institute of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Tao Gao
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Jinbei Zeng
- Binzhou Medical University, Binzhou, Shandong, China
| | - Yiying Li
- Binzhou Medical University, Binzhou, Shandong, China
| | - Yuwen Luo
- Binzhou Medical University, Binzhou, Shandong, China
| | - Yan Chen
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China
- Binzhou Medical University, Binzhou, Shandong, China
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China
- Institute of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Chengxia Liu
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China.
- Binzhou Medical University, Binzhou, Shandong, China.
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China.
- Institute of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Ning Shi
- Department of Gastroenterology and Hepatology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, 256603, Shandong, China.
- Binzhou Medical University, Binzhou, Shandong, China.
- Endosocpy Center, Binzhou Medical University Hospital, Binzhou, Shandong, China.
- Institute of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
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Xu T, Li YY, Huang F, Gao M, Cai C, He S, Wu ZX. A Multi-task Neural Network for Image Recognition in Magnetically Controlled Capsule Endoscopy. Dig Dis Sci 2024; 69:4231-4239. [PMID: 39407081 DOI: 10.1007/s10620-024-08681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 10/04/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND AND AIMS Physicians are required to spend a significant amount of reading time of magnetically controlled capsule endoscopy. However, current deep learning models are limited to completing a single recognition task and cannot replicate the diagnostic process of a physician. This study aims to construct a multi-task model that can simultaneously recognize gastric anatomical sites and gastric lesions. METHODS A multi-task recognition model named Mul-Recog-Model was established. The capsule endoscopy image data from 886 patients were selected to construct a training set and a test set for training and testing the model. Based on the same test set, the model in this study was compared with the current single-task recognition model with good performance. RESULTS The sensitivity and specificity of the model for recognizing gastric anatomical sites were 99.8% (95% confidence intervals: 99.7-99.8) and 98.5% (95% confidence intervals: 98.3-98.7), and for gastric lesions were 98.8% (95% confidence intervals: 98.3-99.2) and 99.4% (95% confidence intervals: 99.1-99.7). Moreover, the positive predictive value, negative predictive value, and accuracy of the model were more than 95% in recognizing gastric anatomical sites and gastric lesions. Compared with the current single-task recognition model, our model showed comparable sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (p < 0.01, except for the negative predictive value of ResNet, p > 0.05). The Areas Under Curve of our model were 0.985 and 0.989 in recognizing gastric anatomical sites and gastric lesions. Furthermore, the model had 49.1 M parameters and 38.1G Float calculations. The model took 15.5 ms to recognize an image, which was less than the superposition of multiple single models (p < 0.01). CONCLUSIONS The Mul-Recog-Model exhibited high sensitivity, specificity, PPV, NPV, and accuracy. The model demonstrated excellent performance in terms of parameters quantity, Float computation, and computing time. The utilization of the model for recognizing gastric images can improve the efficiency of physicians' reports and meet complex diagnostic requirements.
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Affiliation(s)
- Ting Xu
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, China
| | - Yuan-Yi Li
- The Bioengineering College of Chongqing University, Chongqing, China
| | - Fang Huang
- Chongqing Jinshan Technology (Group) Co., Ltd., Chongqing, China
| | - Min Gao
- Chongqing Jinshan Technology (Group) Co., Ltd., Chongqing, China
| | - Can Cai
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, China
| | - Song He
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, China
| | - Zhi-Xuan Wu
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, China.
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Xu Y, Li S, Ye Z, Liang X, Zhang W, He H, Li J, Liu N, Cai X, Chen K. Application of small-sized magnetically controlled capsule gastroscopy in upper gastrointestinal diseases screening in asymptomatic individuals. Surg Endosc 2024:10.1007/s00464-024-11350-4. [PMID: 39443377 DOI: 10.1007/s00464-024-11350-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 10/09/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVE To explore the application of small-sized magnetically controlled capsule gastroscopy (MCCG) in upper gastrointestinal diseases screening in asymptomatic individuals. METHODS A retrospective analysis of the clinical data of 2163 asymptomatic individuals who underwent small-sized MCCG at our center from September 2022 to December 2023. The detection of submucosal tumors, polyps and ulcers in the upper gastrointestinal tract, the tolerance and safety of the subjects were statistically analyzed. RESULTS Suspected submucosal tumors in the upper gastrointestinal tract were detected in 34 (1.57%) of 2136 subjects, with a higher incidence in females and no observed age difference. Polyps were detected in 328 subjects (15.16%), with a higher incidence in females and an increased detection rate with increasing age. Ulcers were detected in 27 subjects (1.25%), with a higher incidence in males and no observed age difference. There was no significant discomfort in all subjects, and no adverse event or capsule retention occurred. CONCLUSION Small-sized MCCG can be used for focal lesion screening in the upper gastrointestinal tract and is comfortable and safe, making it a safe and efficient method for examining upper gastrointestinal diseases in the physical examination population.
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Affiliation(s)
- Yan Xu
- Department of Gastroenterology, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, Guangzhou, Guangdong, China
| | - Siquan Li
- Department of Gastroenterology, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, Guangzhou, Guangdong, China
| | - Zhanhui Ye
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiue Liang
- Department of Gastroenterology, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, Guangzhou, Guangdong, China
| | - Weizheng Zhang
- Clinical Laboratory, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, 109 Changling Road, Guangzhou, 510530, Guangdong, China
| | - Hongzhen He
- Department of Gastroenterology, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, Guangzhou, Guangdong, China
| | - Jun Li
- Department of Gastroenterology, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, Guangzhou, Guangdong, China
| | - Na Liu
- Department of Administration, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, 109 Changling Road, Guangzhou, 510530, Guangdong, China.
| | - Xiangsheng Cai
- Clinical Laboratory, Guangzhou Cadre and Talent Health Management Center, Guangzhou Eleventh People's Hospital, 109 Changling Road, Guangzhou, 510530, Guangdong, China.
| | - Kequan Chen
- Department of Gastroenterology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China.
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12
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Li J, Ren M, Ren L, Luo Y, Sun H, Zhang Z, He S, Lu G. The standardized training and assessment system for magnetically controlled capsule gastroscopy (with video). Scand J Gastroenterol 2024; 59:989-995. [PMID: 38742832 DOI: 10.1080/00365521.2024.2354424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND AIM To explore the feasibility of a standardized training and assessment system for magnetically controlled capsule gastroscopy (MCCG). METHODS The results of 90 trainees who underwent the standardized training and assessment system of the MCCG at the First Affiliated Hospital of Xi'an Jiaotong University from May 2020 to November 2023 was retrospectively analyzed. The trainees were divided into three groups according to their medical backgrounds: doctor, nurse, and non-medical groups. The training and assessment system adopted the '7 + 2' mode, seven days of training plus two days of theoretical and operational assessment. The passing rates of theoretical, operational, and total assessment were the primary outcomes. Satisfaction and mastery of the MCCG was checked. RESULTS Ninety trainees were assessed; theoretical assessment's passing rates in the three groups were 100%. The operational and total assessment passing rates were 100% (25/25), 97.92% (47/48), and 94.12% (16/17), for the doctor, nurse, and non-doctor groups respectively, with no significant difference (χ2 = 1.741, p = 0.419). No bleeding or perforation occurred during the procedure. Approximately, 96.00% (24/25), 95.83% (46/48), and 94.12% (16/17) of the doctor, nurse and non-medical groups anonymously expressed great satisfaction, respectively, without statistically significant difference (χ2 = 0.565, p = 1.000). The average follow-up time was 4-36 months, and 87 trainees (96.67%) had mastered the operation of the MCCG in daily work. CONCLUSIONS Standardized training and assessment of magnetically controlled capsule endoscopists is effective and feasible. Additionally, a strict assessment system and long-term communication and learning can improve teaching effects.
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Affiliation(s)
- Jing Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Mudan Ren
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Li Ren
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Yumei Luo
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Huanhuan Sun
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Zhiyong Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Shuixiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
| | - Guifang Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Shannxi Clinical Research Center of Digestive Disease (Cancer Devision), Xi'an, Shaanxi, China
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Cao Q, Deng R, Pan Y, Liu R, Chen Y, Gong G, Zou J, Yang H, Han D. Robotic wireless capsule endoscopy: recent advances and upcoming technologies. Nat Commun 2024; 15:4597. [PMID: 38816464 PMCID: PMC11139981 DOI: 10.1038/s41467-024-49019-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
Wireless capsule endoscopy (WCE) offers a non-invasive evaluation of the digestive system, eliminating the need for sedation and the risks associated with conventional endoscopic procedures. Its significance lies in diagnosing gastrointestinal tissue irregularities, especially in the small intestine. However, existing commercial WCE devices face limitations, such as the absence of autonomous lesion detection and treatment capabilities. Recent advancements in micro-electromechanical fabrication and computational methods have led to extensive research in sophisticated technology integration into commercial capsule endoscopes, intending to supersede wired endoscopes. This Review discusses the future requirements for intelligent capsule robots, providing a comparative evaluation of various methods' merits and disadvantages, and highlighting recent developments in six technologies relevant to WCE. These include near-field wireless power transmission, magnetic field active drive, ultra-wideband/intrabody communication, hybrid localization, AI-based autonomous lesion detection, and magnetic-controlled diagnosis and treatment. Moreover, we explore the feasibility for future "capsule surgeons".
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Affiliation(s)
- Qing Cao
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Runyi Deng
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yue Pan
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Ruijie Liu
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yicheng Chen
- Sir Run-Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016, China
| | - Guofang Gong
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Jun Zou
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Huayong Yang
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Dong Han
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, 310027, China.
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China.
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Xu Y, Zhang P, Wang L, Li Y, Luo B, Yu Y, Chen R. Performance evaluation and future prospects of capsule robot localization technology. GEO-SPATIAL INFORMATION SCIENCE 2024:1-31. [DOI: 10.1080/10095020.2024.2354239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 05/07/2024] [Indexed: 01/04/2025]
Affiliation(s)
- Yan Xu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Peng Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
- Institute of Medical Informatics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lei Wang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - You Li
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
- Institute of Medical Informatics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bin Luo
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
- Institute of Medical Informatics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yue Yu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Ruizhi Chen
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
- Institute of Medical Informatics, Renmin Hospital of Wuhan University, Wuhan, China
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15
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Oh DJ, Lee YJ, Kim SH, Chung J, Lee HS, Nam JH, Lim YJ. Efficacy and safety of three-dimensional magnetically assisted capsule endoscopy for upper gastrointestinal and small bowel examination. PLoS One 2024; 19:e0295774. [PMID: 38713694 DOI: 10.1371/journal.pone.0295774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/27/2023] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Magnetically assisted capsule endoscopy (MACE) showed the feasibility for upper gastrointestinal examination. To further enhance the performance of conventional MACE, it is necessary to provide quality-improved and three-dimensional images. The aim of this clinical study was to determine the efficacy and safety of novel three-dimensional MACE (3D MACE) for upper gastrointestinal and small bowel examination at once. METHODS This was a prospective, single-center, non-randomized, and sequential examination study (KCT0007114) at Dongguk University Ilsan Hospital. Adult patients who visited for upper endoscopy were included. The study protocol was conducted in two stages. First, upper gastrointestinal examination was performed using 3D MACE, and a continuous small bowel examination was performed by conventional method of capsule endoscopy. Two hours later, an upper endoscopy was performed for comparison with 3D MACE examination. The primary outcome was confirmation of major gastric structures (esophagogastric junction, cardia/fundus, body, angle, antrum, and pylorus). Secondary outcomes were confirmation of esophagus and duodenal bulb, accuracy for gastric lesions, completion of small bowel examination, 3D image reconstruction of gastric lesion, and safety. RESULTS Fifty-five patients were finally enrolled. The examination time of 3D MACE was 14.84 ± 3.02 minutes and upper endoscopy was 5.22 ± 2.39 minutes. The confirmation rate of the six major gastric structures was 98.6% in 3D MACE and 100% in upper endoscopy. Gastric lesions were identified in 43 patients during 3D MACE, and 40 patients during upper endoscopy (Sensitivity 0.97). 3D reconstructed images were acquired for all lesions inspected by 3D MACE. The continuous small bowel examination by 3D MACE was completed in 94.5%. 3D MACE showed better overall satisfaction (3D MACE 9.55 ± 0.79 and upper endoscopy 7.75 ± 2.34, p<0.0001). There were no aspiration or significant adverse event or capsule retention in the 3D MACE examination. CONCLUSIONS Novel 3D MACE system is more advanced diagnostic modality than the conventional MACE. And it is possible to perform serial upper gastrointestinal and small bowel examination as a non-invasive and one-step test. It would be also served as a bridge to pan-endoscopy.
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Affiliation(s)
- Dong Jun Oh
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Yea Je Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Sang Hoon Kim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Joowon Chung
- Department of Internal Medicine, Nowon Eulji Medical Center, Seoul, Republic of Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ji Hyung Nam
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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Fakhr Abdollahi A, Shaheed MH, Thaha MA, Vepa R. A review of modeling and control of remote-controlled capsule endoscopes. Expert Rev Med Devices 2024; 21:293-306. [PMID: 38573192 DOI: 10.1080/17434440.2024.2336135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION The significance of this review lies in addressing the limitations of passive locomotion in capsule endoscopes, hindering their widespread use in medical applications. The research focuses on evaluating existing miniature in vivo remote-controlled capsule endoscopes, examining their locomotion designs, and working theories to pave the way for overcoming challenges and enhancing their applicability in diagnostic and treatment settings. AREAS COVERED This paper explores control methods and dynamic system modeling in the context of self-propelled remote-controlled capsule endoscopes with a two-mass arrangement. The literature search, conducted at Queen Mary University of London Library from 2000 to 2022, utilized a systematic approach starting with the broad keyword 'Capsule Endoscope' and progressively narrowing down to specific aspects such as 'Capsule Endoscope Control' and 'Self-propelled Capsule Endoscope' using various criteria. EXPERT OPINION Efficiently driving and controlling remote-controlled capsule endoscopes have the potential to overcome the current limitations in medical technology, offering a viable solution for diagnosing and treating gastrointestinal diseases. Successful control of the remote-controlled capsule endoscope, as demonstrated in this review paper, will lead to a step change in medical engineering, establishing the remote-controlled capsule endoscope as a swift standard in the field.
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Affiliation(s)
- Afsoon Fakhr Abdollahi
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Mohammad Hasan Shaheed
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Mohamed Adhnan Thaha
- Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Department of Colorectal Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ranjan Vepa
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
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Xu R, Xu Q. A Survey of Recent Developments in Magnetic Microrobots for Micro-/Nano-Manipulation. MICROMACHINES 2024; 15:468. [PMID: 38675279 PMCID: PMC11052276 DOI: 10.3390/mi15040468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
Magnetically actuated microrobots have become a research hotspot in recent years due to their tiny size, untethered control, and rapid response capability. Moreover, an increasing number of researchers are applying them for micro-/nano-manipulation in the biomedical field. This survey provides a comprehensive overview of the recent developments in magnetic microrobots, focusing on materials, propulsion mechanisms, design strategies, fabrication techniques, and diverse micro-/nano-manipulation applications. The exploration of magnetic materials, biosafety considerations, and propulsion methods serves as a foundation for the diverse designs discussed in this review. The paper delves into the design categories, encompassing helical, surface, ciliary, scaffold, and biohybrid microrobots, with each demonstrating unique capabilities. Furthermore, various fabrication techniques, including direct laser writing, glancing angle deposition, biotemplating synthesis, template-assisted electrochemical deposition, and magnetic self-assembly, are examined owing to their contributions to the realization of magnetic microrobots. The potential impact of magnetic microrobots across multidisciplinary domains is presented through various application areas, such as drug delivery, minimally invasive surgery, cell manipulation, and environmental remediation. This review highlights a comprehensive summary of the current challenges, hurdles to overcome, and future directions in magnetic microrobot research across different fields.
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Affiliation(s)
| | - Qingsong Xu
- Department of Electromechanical Engineering, Faculty of Science and Technology, University of Macau, Avenida da Universidade, Taipa, Macau, China;
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Yang YL, Qin HW, Chen ZY, Fan HN, Yu Y, Da W, Zhu JS, Zhang J. Detachable string magnetically controlled capsule endoscopy for the noninvasive diagnosis of esophageal diseases: A prospective, blind clinical study. World J Gastroenterol 2024; 30:1121-1131. [PMID: 38577194 PMCID: PMC10989486 DOI: 10.3748/wjg.v30.i9.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Traditional esophagogastroduodenoscopy (EGD), an invasive examination method, can cause discomfort and pain in patients. In contrast, magnetically controlled capsule endoscopy (MCE), a noninvasive method, is being applied for the detection of stomach and small intestinal diseases, but its application in treating esophageal diseases is not widespread. AIM To evaluate the safety and efficacy of detachable string MCE (ds-MCE) for the diagnosis of esophageal diseases. METHODS Fifty patients who had been diagnosed with esophageal diseases were prospectively recruited for this clinical study and underwent ds-MCE and conventional EGD. The primary endpoints included the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ds-MCE for patients with esophageal diseases. The secondary endpoints consisted of visualizing the esophageal and dentate lines, as well as the subjects' tolerance of the procedure. RESULTS Using EGD as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%, 86.21%, 81.82%, 89.29%, and 86%, respectively. ds-MCE was more comfortable and convenient than EGD was, with 80% of patients feeling that ds-MCE examination was very comfortable or comfortable and 50% of patients believing that detachable string v examination was very convenient. CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD, providing a novel noninvasive method for treating esophageal diseases.
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Affiliation(s)
- Yan-Ling Yang
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Huang-Wen Qin
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Zhao-Yu Chen
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Hui-Ning Fan
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yi Yu
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Wei Da
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Jin-Shui Zhu
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Jing Zhang
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
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Jiang X, Pan J, Xu Q, Song YH, Sun HH, Peng C, Qi XL, Qian YY, Zou WB, Yang Y, Jin SQ, Duan BS, Wu S, Chu Y, Xiao DH, Hu LJ, Cao JZ, Dai JF, Liu X, Xia T, Zhou W, Chen T, Zhou CH, Wu W, Liu SJ, Yang ZY, Wang F, Zhang L, Li CZ, Xu H, Wang JX, Wei B, Lin Y, Deng X, Qu LH, Shen YQ, Wang H, Huang YF, Bao HB, Zhang S, Li L, Shi YH, Wang XY, Zou DW, Wan XJ, Xu MD, Mao H, He CH, Li Z, Zuo XL, He SX, Xie XP, Liu J, Yang CQ, Spada C, Li ZS, Liao Z. Diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis: prospective multicentre study. BMJ 2024; 384:e078581. [PMID: 38443074 PMCID: PMC10912951 DOI: 10.1136/bmj-2023-078581] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy and safety of using magnetically guided capsule endoscopy with a detachable string (ds-MCE) for detecting and grading oesophagogastric varices in adults with cirrhosis. DESIGN Prospective multicentre diagnostic accuracy study. SETTING 14 medical centres in China. PARTICIPANTS 607 adults (>18 years) with cirrhosis recruited between 7 January 2021 and 25 August 2022. Participants underwent ds-MCE (index test), followed by oesophagogastroduodenoscopy (OGD, reference test) within 48 hours. The participants were divided into development and validation cohorts in a ratio of 2:1. MAIN OUTCOME MEASURES The primary outcomes were the sensitivity and specificity of ds-MCE in detecting oesophagogastric varices compared with OGD. Secondary outcomes included the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices and the diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices. RESULTS ds-MCE and OGD examinations were completed in 582 (95.9%) of the 607 participants. Using OGD as the reference standard, ds-MCE had a sensitivity of 97.5% (95% confidence interval 95.5% to 98.7%) and specificity of 97.8% (94.4% to 99.1%) for detecting oesophagogastric varices (both P<0.001 compared with a prespecified 85% threshold). When using the optimal 18% threshold for luminal circumference of the oesophagus derived from the development cohort (n=393), the sensitivity and specificity of ds-MCE for detecting high risk oesophageal varices in the validation cohort (n=189) were 95.8% (89.7% to 98.4%) and 94.7% (88.2% to 97.7%), respectively. The diagnostic accuracy of ds-MCE for detecting high risk oesophagogastric varices, oesophageal varices, and gastric varices was 96.3% (92.6% to 98.2%), 96.9% (95.2% to 98.0%), and 96.7% (95.0% to 97.9%), respectively. Two serious adverse events occurred with OGD but none with ds-MCE. CONCLUSION The findings of this study suggest that ds-MCE is a highly accurate and safe diagnostic tool for detecting and grading oesophagogastric varices and is a promising alternative to OGD for screening and surveillance of oesophagogastric varices in patients with cirrhosis. TRIAL REGISTRATION ClinicalTrials.gov NCT03748563.
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Affiliation(s)
- Xi Jiang
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Jun Pan
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Qing Xu
- Department of Gastroenterology and Hepatology, Tongji Hospital of Tongji University School of Medicine, Shanghai, China
| | - Yu-Hu Song
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan-Huan Sun
- Department of Gastroenterology, Shanxi Clinical Research Centre of Digestive Disease (cancer division), the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Cheng Peng
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiao-Long Qi
- CHESS Centre, Department of Radiology, Basic Medicine Research and Innovation Centre of Ministry of Education, Zhongda Hospital, Medical School, Southeast University, Nurturing Centre of Jiangsu Province for State Laboratory of AI Imaging and Interventional Radiology, Nanjing, China
| | - Yang-Yang Qian
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Wen-Bin Zou
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Yang Yang
- Department of Gastroenterology and Endoscopy, The Fifth affiliated Zhuhai Hospital of Zunyi Medical University, Zhuhai, China
| | - Shao-Qin Jin
- Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ben-Song Duan
- Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shan Wu
- Department of Endoscopy, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ye Chu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ding-Hua Xiao
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Li-Juan Hu
- Department of Gastroenterology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Jun-Zhi Cao
- Department of Gastroenterology, Yangpu Hospital, Tongji University, Shanghai, China
| | - Jin-Feng Dai
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Liu
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Tian Xia
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Wei Zhou
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Tao Chen
- Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun-Hua Zhou
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Wu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shao-Jun Liu
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhen-Yu Yang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fen Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lu Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Cheng-Zhong Li
- Department of Infectious Diseases, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Hao Xu
- Department of Infectious Diseases, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jun-Xue Wang
- Department of Infection, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Bo Wei
- Department of Infection, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yong Lin
- Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xing Deng
- Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Li-Hong Qu
- Department of Infectious Diseases, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ying-Qiu Shen
- Department of Infectious Diseases, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui Wang
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Fei Huang
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hai-Biao Bao
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuo Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang Chinese University, Hangzhou, China
| | - Li Li
- Department of Gastroenterology, Yangpu Hospital, Tongji University, Shanghai, China
| | - Yi-Hai Shi
- Department of Gastroenterology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Xiao-Yan Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Duo-Wu Zou
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin-Jian Wan
- Department of Endoscopy, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mei-Dong Xu
- Department of Gastroenterology, Endoscopy Centre, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua Mao
- Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chao-Hui He
- Department of Gastroenterology and Endoscopy, The Fifth affiliated Zhuhai Hospital of Zunyi Medical University, Zhuhai, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shui-Xiang He
- Department of Gastroenterology, Shanxi Clinical Research Centre of Digestive Disease (cancer division), the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiao-Ping Xie
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Liu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang-Qing Yang
- Department of Gastroenterology and Hepatology, Tongji Hospital of Tongji University School of Medicine, Shanghai, China
| | - Cristiano Spada
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Zhao-Shen Li
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Zhuan Liao
- Department of Gastroenterology, Changhai Clinical Research Unit, National Clinical Research Centre for Digestive Diseases, National Key Laboratory of Immunity and Inflammation, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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20
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Sun Y, Zhang W, Gu J, Xia L, Cao Y, Zhu X, Wen H, Ouyang S, Liu R, Li J, Jiang Z, Cheng D, Lv Y, Han X, Qiu W, Cai K, Song E, Cao Q, Li L. Magnetically driven capsules with multimodal response and multifunctionality for biomedical applications. Nat Commun 2024; 15:1839. [PMID: 38424039 PMCID: PMC10904804 DOI: 10.1038/s41467-024-46046-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
Untethered capsules hold clinical potential for the diagnosis and treatment of gastrointestinal diseases. Although considerable progress has been achieved recently in this field, the constraints imposed by the narrow spatial structure of the capsule and complex gastrointestinal tract environment cause many open-ended problems, such as poor active motion and limited medical functions. In this work, we describe the development of small-scale magnetically driven capsules with a distinct magnetic soft valve made of dual-layer ferromagnetic soft composite films. A core technological advancement achieved is the flexible opening and closing of the magnetic soft valve by using the competitive interactions between magnetic gradient force and magnetic torque, laying the foundation for the functional integration of both drug release and sampling. Meanwhile, we propose a magnetic actuation strategy based on multi-frequency response control and demonstrate that it can achieve effective decoupled regulation of the capsule's global motion and local responses. Finally, through a comprehensive approach encompassing ideal models, animal ex vivo models, and in vivo assessment, we demonstrate the versatility of the developed magnetic capsules and their multiple potential applications in the biomedical field, such as targeted drug delivery and sampling, selective dual-drug release, and light/thermal-assisted therapy.
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Affiliation(s)
- Yuxuan Sun
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Wang Zhang
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Junnan Gu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Liangyu Xia
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Yinghao Cao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xinhui Zhu
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Hao Wen
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Shaowei Ouyang
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Ruiqi Liu
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Jialong Li
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Zhenxing Jiang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Denglong Cheng
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yiliang Lv
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Xiaotao Han
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Wu Qiu
- School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Kailin Cai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Enmin Song
- School of Computer and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Quanliang Cao
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China.
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
| | - Liang Li
- Wuhan National High Magnetic Field Center, Huazhong University of Science and Technology, Wuhan, 430074, China.
- State Key Laboratory of Advanced Electromagnetic Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
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21
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Thwaites PA, Yao CK, Halmos EP, Muir JG, Burgell RE, Berean KJ, Kalantar‐zadeh K, Gibson PR. Review article: Current status and future directions of ingestible electronic devices in gastroenterology. Aliment Pharmacol Ther 2024; 59:459-474. [PMID: 38168738 PMCID: PMC10952964 DOI: 10.1111/apt.17844] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/15/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Advances in microelectronics have greatly expanded the capabilities and clinical potential of ingestible electronic devices. AIM To provide an overview of the structure and potential impact of ingestible devices in development that are relevant to the gastrointestinal tract. METHODS We performed a detailed literature search to inform this narrative review. RESULTS Technical success of ingestible electronic devices relies on the ability to miniaturise the microelectronic circuits, sensors and components for interventional functions while being sufficiently powered to fulfil the intended function. These devices offer the advantages of being convenient and minimally invasive, with real-time assessment often possible and with minimal interference to normal physiology. Safety has not been a limitation, but defining and controlling device location in the gastrointestinal tract remains challenging. The success of capsule endoscopy has buoyed enthusiasm for the concepts, but few ingestible devices have reached clinical practice to date, partly due to the novelty of the information they provide and also due to the challenges of adding this novel technology to established clinical paradigms. Nonetheless, with ongoing technological advancement and as understanding of their potential impact emerges, acceptance of such technology will grow. These devices have the capacity to provide unique insight into gastrointestinal physiology and pathophysiology. Interventional functions, such as sampling of tissue or luminal contents and delivery of therapies, may further enhance their ability to sharpen gastroenterological diagnoses, monitoring and treatment. CONCLUSIONS The development of miniaturised ingestible microelectronic-based devices offers exciting prospects for enhancing gastroenterological research and the delivery of personalised, point-of-care medicine.
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Affiliation(s)
- Phoebe A. Thwaites
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Chu K. Yao
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Emma P. Halmos
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Jane G. Muir
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Rebecca E. Burgell
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Kyle J. Berean
- Atmo BiosciencesMelbourneVictoriaAustralia
- School of Engineering, RMIT UniversityMelbourneVictoriaAustralia
| | - Kourosh Kalantar‐zadeh
- Faculty of Engineering, School of Chemical and Biomolecular EngineeringThe University of SydneyCamperdownNew South WalesAustralia
| | - Peter R. Gibson
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
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22
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Li M, Liu R, Wu Y. Randomised controlled trial of early magnetically controlled capsule endoscopy for the prevention of gastrointestinal bleeding in patients at high bleeding risk scheduled for percutaneous coronary intervention: MACE-GPS study protocol. BMJ Open 2024; 14:e077852. [PMID: 38262638 PMCID: PMC10806601 DOI: 10.1136/bmjopen-2023-077852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Limited data are available regarding the decision-making process for preventing gastrointestinal bleeding in patients at high risk of bleeding scheduled for percutaneous coronary intervention (HBPCI), especially due to the lack of a simple, accurate and sensitive methods for gastrointestinal injury detection. This randomised trial aims to assess the effects of early magnetically controlled capsule endoscopy (MCE) in patients with HBPCI for the prevention of gastrointestinal bleeding compared with conventional management. METHODS AND ANALYSIS The Magnetic-Assisted Capsule Endoscopy Gastrointestinal bleeding Protection Strategy (MACE-GPS) is a multicentre, open-label, randomised controlled trial. Patients admitted for HBPCI will be randomised and placed into two study groups. In the early MCE group, 1228 patients will undergo MCE following admission to the hospital. If necessary, these patients may further undergo a multidisciplinary approach to determine treatment based on the MCE findings. A total of 1228 patients in the control group will undergo conventional treatment based on the attending cardiologist's interpretation of their clinical presentations. The primary end point is the incidence of gastrointestinal bleeding within 12 months of enrolment. ETHICS AND DISSEMINATION The MACE-GPS trial has been approved by the ethics committees of all participating sites. Participant recruitment began in April 2023 and will be completed in April 2025, and the 1-year follow-up will be completed in April 2026. The study results will be disseminated through conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER ChiCTR2300070025.
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Affiliation(s)
- Minghui Li
- Department of Cardiology, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Rong Liu
- Department of Cardiology, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yongjian Wu
- Department of Cardiology, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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23
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Zhou J, Li M, Li N, Zhou Y, Wang J, Jiao N. System integration of magnetic medical microrobots: from design to control. Front Robot AI 2023; 10:1330960. [PMID: 38169802 PMCID: PMC10758462 DOI: 10.3389/frobt.2023.1330960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Magnetic microrobots are ideal for medical applications owing to their deep tissue penetration, precise control, and flexible movement. After decades of development, various magnetic microrobots have been used to achieve medical functions such as targeted delivery, cell manipulation, and minimally invasive surgery. This review introduces the research status and latest progress in the design and control systems of magnetic medical microrobots from a system integration perspective and summarizes the advantages and limitations of the research to provide a reference for developers. Finally, the future development direction of magnetic medical microrobot design and control systems are discussed.
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Affiliation(s)
- Junjian Zhou
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Mengyue Li
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Na Li
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuting Zhou
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jingyi Wang
- College of Information and Electrical Engineering, Shenyang Agricultural University, Shenyang, China
| | - Niandong Jiao
- State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Sciences, Shenyang, China
- Institutes for Robotics and Intelligent Manufacturing, Chinese Academy of Sciences, Shenyang, China
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24
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Mascarenhas M, Martins M, Afonso J, Ribeiro T, Cardoso P, Mendes F, Andrade P, Cardoso H, Ferreira J, Macedo G. The Future of Minimally Invasive Capsule Panendoscopy: Robotic Precision, Wireless Imaging and AI-Driven Insights. Cancers (Basel) 2023; 15:5861. [PMID: 38136403 PMCID: PMC10742312 DOI: 10.3390/cancers15245861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
In the early 2000s, the introduction of single-camera wireless capsule endoscopy (CE) redefined small bowel study. Progress continued with the development of double-camera devices, first for the colon and rectum, and then, for panenteric assessment. Advancements continued with magnetic capsule endoscopy (MCE), particularly when assisted by a robotic arm, designed to enhance gastric evaluation. Indeed, as CE provides full visualization of the entire gastrointestinal (GI) tract, a minimally invasive capsule panendoscopy (CPE) could be a feasible alternative, despite its time-consuming nature and learning curve, assuming appropriate bowel cleansing has been carried out. Recent progress in artificial intelligence (AI), particularly in the development of convolutional neural networks (CNN) for CE auxiliary reading (detecting and diagnosing), may provide the missing link in fulfilling the goal of establishing the use of panendoscopy, although prospective studies are still needed to validate these models in actual clinical scenarios. Recent CE advancements will be discussed, focusing on the current evidence on CNN developments, and their real-life implementation potential and associated ethical challenges.
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Affiliation(s)
- Miguel Mascarenhas
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - Miguel Martins
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
| | - João Afonso
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - Tiago Ribeiro
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - Pedro Cardoso
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - Francisco Mendes
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
| | - Patrícia Andrade
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - Helder Cardoso
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
| | - João Ferreira
- Department of Mechanic Engineering, Faculty of Engineering, University of Porto, 4200-065 Porto, Portugal;
- DigestAID—Digestive Artificial Intelligence Development, 455/461, 4200-135 Porto, Portugal
| | - Guilherme Macedo
- Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, 4200-427 Porto, Portugal; (M.M.); (J.A.); (T.R.); (P.C.); (F.M.); (P.A.); (H.C.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-047 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-427 Porto, Portugal
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Yu Y, Liao Z, Jiang X, Pan J, Zhou W, Lau JYW. The use of magnet-controlled capsule endoscopy as the initial diagnostic tool in patients with acute upper gastrointestinal bleeding. J Gastroenterol Hepatol 2023; 38:2027-2034. [PMID: 37534802 DOI: 10.1111/jgh.16310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/20/2023] [Accepted: 07/08/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND The latest magnet-controlled capsule endoscopy (MCCE) system can examine the water-distended stomach, duodenum, and the small bowel. We assessed the use of MCCE as the first diagnostic tool in patients with acute upper gastrointestinal bleeding (AUGIB). METHODS This was a prospective cohort study that enrolled patients admitted with AUGIB from two teaching hospitals. Patients underwent MCCE as the initial diagnostic modality. Our primary endpoint was the diagnostic yield of MCCE. The subsequent care of these patients was guided by MCCE findings. RESULTS Of 100 enrolled patients, 99 (mean age 54 years, 70.7% men) with a median Glasgow-Blatchford score of 6 (IQR 3-9) underwent MCCE. In three patients, MCCE found active bleeding (two duodenal ulcers and Dieulafoy's lesion). The overall diagnostic yield of MCCE was 95.8% (92 lesions in 96 patients); five in the esophagus (Mallory Weiss tears 2, varices 1, and esophagitis 2), 51 in the stomach (gastric erosions 26, gastric ulcers 14, cancer 3, GIST 3, gastric polyps 3, antral vascular ectasia 1,angiodysplasia 1), 32 in the duodenum (ulcers 28, erosions 3, polyp 1), and four in the small bowel (ulcers 2, an erosion with a nonbleeding vessel 1, Meckel's diverticulum 1). Fifty-two (52.5%) patients were discharged without endoscopy. Forty-five (45.5%) patients underwent inpatient esophagogastroduodenoscopy (EGD), which found an antral ulcer and six duodenal ulcers in addition. CONCLUSIONS In stable patients with AUGIB, MCCE can be used as a diagnostic tool. EGD should follow in patients with an inadequate view of the duodenum.
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Affiliation(s)
- Yuanyuan Yu
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
| | - Zhuan Liao
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xi Jiang
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jun Pan
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Wei Zhou
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - James Y W Lau
- Department of Surgery, Prince of Wales Hospital, Hong Kong, China
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Wang X, Hu X, Xu Y, Yong J, Li X, Zhang K, Gan T, Yang J, Rao N. A systematic review on diagnosis and treatment of gastrointestinal diseases by magnetically controlled capsule endoscopy and artificial intelligence. Therap Adv Gastroenterol 2023; 16:17562848231206991. [PMID: 37900007 PMCID: PMC10612444 DOI: 10.1177/17562848231206991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023] Open
Abstract
Background Magnetically controlled capsule endoscopy (MCCE) is a non-invasive, painless, comfortable, and safe equipment to diagnose gastrointestinal diseases (GID), partially overcoming the shortcomings of conventional endoscopy and wireless capsule endoscopy (WCE). With advancements in technology, the main technical parameters of MCCE have continuously been improved, and MCCE has become more intelligent. Objectives The aim of this systematic review was to summarize the research progress of MCCE and artificial intelligence (AI) in the diagnosis and treatment of GID. Data Sources and Methods We conducted a systematic search of PubMed and EMBASE for published studies on GID detection of MCCE, physical factors related to MCCE imaging quality, the application of AI in aiding MCCE, and its additional functions. We synergistically reviewed the included studies, extracted relevant data, and made comparisons. Results MCCE was confirmed to have the same performance as conventional gastroscopy and WCE in detecting common GID, while it lacks research in detecting early gastric cancer (EGC). The body position and cleanliness of the gastrointestinal tract are the main factors affecting imaging quality. The applications of AI in screening intestinal diseases have been comprehensive, while in the detection of common gastric diseases such as ulcers, it has been developed. MCCE can perform some additional functions, such as observations of drug behavior in the stomach and drug damage to the gastric mucosa. Furthermore, it can be improved to perform a biopsy. Conclusion This comprehensive review showed that the MCCE technology has made great progress, but studies on GID detection and treatment by MCCE are in the primary stage. Further studies are required to confirm the performance of MCCE.
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Affiliation(s)
- Xiaotong Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoming Hu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongxue Xu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiahao Yong
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiang Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Kaixuan Zhang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Gan
- Digestive Endoscopic Center of West China Hospital, Sichuan University, Chengdu, China
| | - Jinlin Yang
- Digestive Endoscopic Center of West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Chengdu, Sichuan Province 610017, China
| | - Nini Rao
- School of Life Science and Technology, University of Electronic Science and Technology of China, No. 4, Section Two, Jianshe North Road, Chengdu 610054, China
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Wu TT, Zhang MY, Tan ND, Chen SF, Zhuang QJ, Luo Y, Xiao YL. Patients at risk for further examination with conventional gastroscopy after undergoing magnetically controlled capsule endoscopy. J Dig Dis 2023; 24:522-529. [PMID: 37681236 DOI: 10.1111/1751-2980.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE In this study we aimed to compare the need for further examination with conventional gastroscopy within 1 year after magnetically assisted capsule endoscopy (MCCE) examination between patients with gastrointestinal (GI) symptoms and asymptomatic individuals. METHODS After propensity score matching analysis, 372 patients with GI symptoms and 372 asymptomatic individuals who had undergone MCCE at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2019 to December 30, 2020 were retrospectively enrolled. Demographic and clinical characteristics of the participants and their MCCE and gastroscopic findings (performed within 1 year after MCCE) were analyzed. RESULTS Fifty-one (6.85%) patients underwent further examination with conventional gastroscopy within 1 year after MCCE. Those with GI symptoms were more likely to undergo conventional gastroscopy than those without (9.95% vs 3.76%, P < 0.001). Polyps were the most common finding of MCCE. The rate of conventional gastroscopy in patients with focal lesions was significantly higher than that in those without focal lesions (P < 0.05). However, such rate did not differ in the different age groups (P = 0.106). CONCLUSIONS MCCE is an optimal alternative for gastric examination, especially for large-scale screening of asymptomatic individuals. Patients with GI symptoms or focal lesions detected by MCCE are more likely to seek further examination with conventional gastroscopy for biopsy or endoscopic treatment than those without.
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Affiliation(s)
- Ting Ting Wu
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Meng Yu Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Nian Di Tan
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Song Feng Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qian Jun Zhuang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yu Luo
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Ying Lian Xiao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
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Kong QZ, Peng C, Li Z, Tian BL, Li YY, Chen FX, Zuo XL, Li YQ. Inadequate gastric preparation and its associated factors for magnetically controlled capsule endoscopy. Front Pharmacol 2023; 14:1184754. [PMID: 37701026 PMCID: PMC10493275 DOI: 10.3389/fphar.2023.1184754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
Goals: To explore factors associated with inadequate gastric preparation for MCE. Background: Factors associated with inadequate gastric preparation for magnetically controlled capsule endoscopy (MCE) remains unclear. Study: Data of patients who underwent MCE from June 2021 to July 2022 were prospectively collected. The gastric cleanliness score (GCS) of the six stomach regions (gastric cardia, fundus, body, angulus, antrum, and pylorus) was recorded. Patients with GCS score ≥18 were defined as the adequate preparation. Factors related to inadequate gastric preparation were analyzed using a logistic regression model with estimated odds ratios (OR). Results: The mean GCS score of 211 patients was 17.01 ± 2.82. In the multivariable analysis, proton pump inhibitor (PPI) use (OR 3.57; 95% CI 1.69-7.95; p < 0.01) and premedication time after administering simethicone <30 min (OR 2.86; 95% CI 1.10-7.39; p = 0.03) were independent risk factors for inadequate gastric preparation. Comparing the gastric cleanliness of different locations, the median GCS of the lower stomach [10.00, IQR (9.50, 11.00)] was significantly higher than that of the upper stomach [7.00, IQR (6.00, 8.00)] (p <0.001). Conclusion: PPI use and inadequate premedication time (<30 min) may reduce the quality of gastric preparation for MCE. The type, dose, duration of medication, and discontinuation time of PPIs was well worth further exploration. Appropriate control of the type and time of premedication may be the key to improving overall gastric cleanliness.
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Affiliation(s)
- Qing-Zhou Kong
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Cheng Peng
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Bao-Ling Tian
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yue-Yue Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Fei-Xue Chen
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, Shandong, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, Shandong, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yan-Qing Li
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, Shandong, China
- Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital, Shandong University, Jinan, Shandong, China
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Li J, Li L, Li Y, Chen L, Liang R, Liu M, Jiao H. Magnetic-controlled capsule endoscopy performance in aging patients. BMC Gastroenterol 2023; 23:277. [PMID: 37568133 PMCID: PMC10422704 DOI: 10.1186/s12876-023-02914-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The increasing elderly population and wide use of magnetic capsule endoscopy (MCE) have led to more attention to elderly patients. AIM The aim of this study was to assess the performance (including transit time, cleanliness score, positive findings and safety) of MCE in aging patients (≥ 60 years), especially patients over 80 years old. METHODS Consecutive patients of ≥ 60 years undergoing MCE at our center from August 2017 to August 2022 were classified into the oldest (≥ 80 years) and the older (60-79 years) groups. Esophageal transit time (ETT), gastric examination time (GET), small bowel transit time (SITT), and the quality of gastric preparation were compared. Information on examination indications, subjective discomforts, adverse events, and MCE outcomes were compared. RESULTS Of 293 enrolled patients, 128 patients were in the oldest group and 165 patients were in the older group. ETT and GET were longer in the oldest group, whereas SITT was slightly longer in the oldest patients. Visualization scores were significantly lower in the body and antrum in the oldest patients. The total visualization score was lower in the older group compared with the oldest group; however, the difference was not significant. Cleanliness scores at the fundus and antrum and total cleanliness scores were lower in the oldest patients compared with the older patients. Positive findings and ulcers and erosions in the small intestine were more common in the oldest group. One patient had nausea during the gastric examination. Capsule retention in the cecum occurred in one case. CONCLUSION MCE was feasible and safe for aging patients. ETT and GET were markedly longer and gastric cleanliness and visualization were worse, while overall small intestine-positive findings were higher in the oldest patients compared with the older patients.
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Affiliation(s)
- Jiaxin Li
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Li Li
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Yueyuan Li
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Long Chen
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Rongyue Liang
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Meilin Liu
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China
| | - Hongmei Jiao
- Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
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Gao Y, Cai MX, Tian B, Lin H, Jiang ZY, Yang XC, Lu L, Li L, Shi LH, Liu XY, Wang YL, Li ZS, Xin L, Wang LW. Setting 6-Minute Minimal Examination Time Improves the Detection of Focal Upper Gastrointestinal Tract Lesions During Endoscopy: A Multicenter Prospective Study. Clin Transl Gastroenterol 2023; 14:e00612. [PMID: 37307142 PMCID: PMC10461959 DOI: 10.14309/ctg.0000000000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Positive correlation between examination time and neoplasm detection using esophagogastroduodenoscopy (EGD) has been described by observational studies, but the effect of setting minimal examination time still requires investigation. METHODS This prospective, 2-stage, interventional study was conducted in 7 tertiary hospitals in China, enrolling consecutive patients undergoing intravenously sedated diagnostic EGDs. In stage I, the baseline examination time was collected without informing the endoscopists. In stage II, the minimal examination time was set for the same endoscopist according to the median examination time of normal EGDs in stage I. The primary outcome was the focal lesion detection rate (FDR), defined as the proportion of subjects with at least one focal lesion among all subjects. RESULTS A total of 847 and 1,079 EGDs performed by 21 endoscopists were included in stages I and II, respectively. In stage II, the minimal examination time was set as 6 minutes, and the median time for normal EGD increased from 5.8 to 6.3 minutes ( P < 0.001). Between the 2 stages, the FDR was significantly improved (33.6% vs 39.3%, P = 0.011), and the effect of the intervention was significant (odds ratio, 1.25; 95% confidence interval, 1.03-1.52; P = 0.022) even after adjusting for subjects' age, smoking status, endoscopists' baseline examination time, and working experience. The detection rate of high-risk lesions (neoplastic lesions and advanced atrophic gastritis) was also significantly higher in stage II (3.3% vs 5.4%, P = 0.029). In the endoscopist-level analysis, all practitioners reached a median examination time of 6 minutes, and the coefficients of variation of FDR (36.9%-26.2%) and examination time (19.6%-6.9%) decreased in stage II. DISCUSSION Setting a 6-minute minimal examination time significantly improved the detection of focal lesions during EGDs and has the potential to be implemented for quality improvement.
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Affiliation(s)
- Ye Gao
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Meng-Xi Cai
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Bo Tian
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Han Lin
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zhen-Yu Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Xiao-Cui Yang
- Department of Gastroenterology, Ankang Central Hospital, Ankang, Shaanxi, China
| | - Lin Lu
- Department of Gastroenterology, Linyi People's Hospital, Linyi, Shandong, China
| | - Li Li
- Digestive Endoscopy Center, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Li-Hong Shi
- Department of Gastroenterology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiao-Yu Liu
- Department of Gastroenterology, Yulin No. 2 hospital, Yulin, Shaanxi, China
| | - Yi-Lin Wang
- Georgetown Preparatory School, North Bethesda, MD, USA
| | - Zhao-Shen Li
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Lei Xin
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Luo-Wei Wang
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
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Meltzer AC, Kumar A, Kallus SJ, Schueler SA, Mattu N, Ma Y, He Y, Fleischer DE, Cave DR. Magnetically controlled capsule for assessment of the gastric mucosa in symptomatic patients: a prospective, single-arm, single-center, comparative study. IGIE 2023; 2:139-147. [DOI: 10.1016/j.igie.2023.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Gao JX, Liu HF. [Recent research on the application of defoamers in children undergoing digestive endoscopy]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:541-545. [PMID: 37272183 DOI: 10.7499/j.issn.1008-8830.2301074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Endoscopy is a common tool for the diagnosis and treatment of gastrointestinal disorders in children. The presence of bubbles in the gastrointestinal tract is one of the important factors affecting the clarity of endoscopic visual field, and the application of defoamers can significantly reduce bubbles in the gastrointestinal tract, improve the quality of gastrointestinal preparation, and further increase disease detection rate. Various studies have been conducted on gastrointestinal preparation before endoscopy in children, but there still lacks a uniform protocol for the application of defoamers. This article summarizes the use of defoamers in children before digestive endoscopy and related research advances and points out that existing studies on defoamers have a small sample size and that there are still controversies over the selection and timing of administration, so as to provide a reference for in-depth research on defoamers in the future.
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Affiliation(s)
- Jie-Xia Gao
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
| | - Hai-Feng Liu
- Department of Digestive Endoscopy Center, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
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Di Nardo G, Micheli F, Cozzi DA, Mercantini P, Parisi P, Baccini F, Mennini M, Raucci U, Marasco G. Magnetic-Assisted Capsule Endoscopy in Children With Crohn Disease: Feasibility and Impact on Gastric Transit Time. J Pediatr Gastroenterol Nutr 2023; 76:646-651. [PMID: 36763990 DOI: 10.1097/mpg.0000000000003733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVES Standard capsule endoscopy (CE) is ineffective for upper gastrointestinal (GI) tract examination because it does not allow operator-controlled navigation of the capsule. Magnetically assisted capsule endoscopy (MACE) may offer a solution to these problems. This pilot study is aimed to evaluate the feasibility of MACE system in pediatric Crohn disease (CD) and if magnetic steering could enhance capsule gastric emptying when compared with standard CE. METHODS Pediatric CD patients already studied by standard small bowel CE were enrolled. All participants swallowed a magnetically assisted CE and an external magnetic field navigator was used to guide the capsule through the upper GI tract. Maneuverability, completeness of the MACE examination, differences in the esophageal transit time (ETT), gastric transit time (GTT), and pyloric transit time (PTT) between standard CE and MACE were assessed. RESULTS Ten patients [mean age 11.4 years (range 6-15); 60% male] were enrolled. Maneuverability was defined as good and fair in 60% and 40% of participants, respectively. Completeness of MACE examination was 95%, 65%, and 92.5% in the esophagus, proximal, and distal stomach, respectively. Transpyloric passage of the capsule under magnetic control was successfully performed in 80% of patients. Magnetic intervention significantly increased ETT ( P < 0.001) and reduced GTT and PTT ( P = 0.002). No significant adverse events occurred. CONCLUSIONS MACE is a safe and feasible technique in children. Magnetic steering enhances capsule gastric emptying and facilitates capsule transpyloric passage when compared with standard CE.
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Affiliation(s)
- Giovanni Di Nardo
- From the NESMOS Department, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Federica Micheli
- the Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Denis A Cozzi
- the Pediatric Surgery Unit, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy
| | - Paolo Mercantini
- the Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Pasquale Parisi
- From the NESMOS Department, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Flavia Baccini
- the Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Mennini
- Translational Research in Pediatric Specialities Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Umberto Raucci
- the Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Marasco
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- the Department of Medical and Surgical Sciences, University of Bologna, Italy
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Hong SM, Baek DH. A Review of Colonoscopy in Intestinal Diseases. Diagnostics (Basel) 2023; 13:diagnostics13071262. [PMID: 37046479 PMCID: PMC10093393 DOI: 10.3390/diagnostics13071262] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
Since the development of the fiberoptic colonoscope in the late 1960s, colonoscopy has been a useful tool to diagnose and treat various intestinal diseases. This article reviews the clinical use of colonoscopy for various intestinal diseases based on present and future perspectives. Intestinal diseases include infectious diseases, inflammatory bowel disease (IBD), neoplasms, functional bowel disorders, and others. In cases of infectious diseases, colonoscopy is helpful in making the differential diagnosis, revealing endoscopic gross findings, and obtaining the specimens for pathology. Additionally, colonoscopy provides clues for distinguishing between infectious disease and IBD, and aids in the post-treatment monitoring of IBD. Colonoscopy is essential for the diagnosis of neoplasms that are diagnosed through only pathological confirmation. At present, malignant tumors are commonly being treated using endoscopy because of the advancement of endoscopic resection procedures. Moreover, the characteristics of tumors can be described in more detail by image-enhanced endoscopy and magnifying endoscopy. Colonoscopy can be helpful for the endoscopic decompression of colonic volvulus in large bowel obstruction, balloon dilatation as a treatment for benign stricture, and colon stenting as a treatment for malignant obstruction. In the diagnosis of functional bowel disorder, colonoscopy is used to investigate other organic causes of the symptom.
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Jiang B, Qian YY, Wang YC, Pan J, Jiang X, Zhu JH, Qiu XO, Zhou W, Li ZS, Liao Z. A novel capsule endoscopy for upper and mid-GI tract: the UMGI capsule. BMC Gastroenterol 2023; 23:76. [PMID: 36927462 PMCID: PMC10019395 DOI: 10.1186/s12876-023-02696-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUNDS AND AIMS Complete and consecutive observation of the gastrointestinal (GI) tract continues to present challenges for current endoscopy systems. We developed a novel upper and mid gastrointestinal (UMGI) capsule endoscopy using the modified detachable string magnetically controlled capsule endoscopy (DS-MCE) and inspection method and aimed to assess the clinical application. METHODS Patients were recruited to undergo UMGI capsule endoscopy followed by esophagogastroduodenoscopy. All capsule procedures in the upper gastrointestinal (UGI) tract were conducted under the control of magnet and string. The main outcome was technical success, and the secondary outcomes included visualization of the UMGI tract, examination time, diagnostic yield, compliance, and safety evaluation. RESULTS Thirty patients were enrolled and all UMGI capsule procedures realized repeated observation of the esophagus and duodenum with detection rates of 100.0%, 80.0%, and 86.7% of Z-line, duodenal papilla, and reverse side of pylorus, respectively. String detachment was succeeded in 29 patients (96.7%) and the complete examination rate of UMGI tract was 95.45% (21/22). All UMGI capsule procedures were well tolerated with low discomfort score, and had a good diagnostic yield with per-lesion sensitivity of 96.2% in UGI diseases. No adverse events occurred. CONCLUSIONS This new capsule endoscopy system provides an alternative screening modality for the UMGI tract, and might be indicated in cases of suspected upper and small bowel GI bleeding. Trial registration DS-MCE-UGI and SB, NCT04329468. Registered 27 March 2020, https://clinicaltrials.gov/ct2/results?cond=&term=NCT04329468 .
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Affiliation(s)
- Bin Jiang
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
- Department of Gastroenterology, The First Naval Hospital of Southern Theater Command, Zhanjiang, 524005, Guangdong, China
| | - Yang-Yang Qian
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Yuan-Chen Wang
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Jun Pan
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Xi Jiang
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Jia-Hui Zhu
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Xiao-Ou Qiu
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Wei Zhou
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Zhao-Shen Li
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China
| | - Zhuan Liao
- Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital, Shanghai, 200433, China.
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Sun H, Liu J, Wang Q. Magnetic Actuation Systems and Magnetic Robots for Gastrointestinal Examination and Treatment. CHINESE JOURNAL OF ELECTRICAL ENGINEERING 2023; 9:3-28. [DOI: 10.23919/cjee.2023.000009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Affiliation(s)
- Hongbo Sun
- Institute of Electrical Engineering, Chinese Academy of Sciences,Beijing,China,100190
| | - Jianhua Liu
- Institute of Electrical Engineering, Chinese Academy of Sciences,Beijing,China,100190
| | - Qiuliang Wang
- Institute of Electrical Engineering, Chinese Academy of Sciences,Beijing,China,100190
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Jiang B, Pan J, Qian YY, He C, Xia J, He SX, Sha WH, Feng ZJ, Wan J, Wang SS, Zhong L, Xu SC, Li XL, Huang XJ, Zou DW, Song DD, Zhang J, Ding WQ, Chen JY, Chu Y, Zhang HJ, Yu WF, Xu Y, He XQ, Tang JH, He L, Fan YH, Chen FL, Zhou YB, Zhang YY, Yu Y, Wang HH, Ge KK, Jin GH, Xiao YL, Fang J, Yan XM, Ye J, Yang CM, Li Z, Song Y, Wen MY, Zong Y, Han X, Wu LL, Ma JJ, Xie XP, Yu WH, You Y, Lu XH, Song YL, Ma XQ, Li SD, Zeng B, Gao YJ, Ma RJ, Ni XG, He CH, Liu YP, Wu JS, Liu J, Li AM, Chen BL, Cheng CS, Sun XM, Ge ZZ, Feng Y, Tang YJ, Li ZS, Linghu EQ, Liao Z. Clinical guideline on magnetically controlled capsule gastroscopy (2021 edition). J Dig Dis 2023; 24:70-84. [PMID: 37220999 DOI: 10.1111/1751-2980.13173] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023]
Abstract
With the development and generalization of endoscopic technology and screening, clinical application of magnetically controlled capsule gastroscopy (MCCG) has been increasing. In recent years, various types of MCCG are used globally. Therefore, establishing relevant guidelines on MCCG is of great significance. The current guidelines containing 23 statements were established based on clinical evidence and expert opinions, mainly focus on aspects including definition and diagnostic accuracy, application population, technical optimization, inspection process, and quality control of MCCG. The level of evidence and strength of recommendations were evaluated. The guidelines are expected to guide the standardized application and scientific innovation of MCCG for the reference of clinicians.
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Affiliation(s)
- Bin Jiang
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- Department of Gastroenterology, The First Naval Hospital of Southern Theater Command, Zhanjiang, Guangdong Province, China
| | - Jun Pan
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yang Yang Qian
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chen He
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ji Xia
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- Department of Gastroenterology, The 926th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kaiyuan, Yunnan Province, China
| | - Shui Xiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wei Hong Sha
- Department of Gastroenterology, Guangdong Provincial Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Zhi Jie Feng
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Jun Wan
- Department of Gastroenterology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Sha Sha Wang
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Liang Zhong
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu Chang Xu
- Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai, China
| | - Xiu Ling Li
- Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - Xiao Jun Huang
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
| | - Duo Wu Zou
- Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dan Dan Song
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Zhang
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Qun Ding
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia Yu Chen
- Department of Gastroenterology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
| | - Ye Chu
- Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Jing Zhang
- Department of Digestive Endoscopy, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Wei Fang Yu
- Department of Gastroenterology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Yan Xu
- Department of Gastroenterology, Guangzhou Cadre Health Management Center, Guangzhou, Guangdong Province, China
| | - Xue Qiang He
- Department of Gastroenterology and Respiration, The 924th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Guilin, Guangxi Zhuang Autonomous Region, China
| | - Jian Hua Tang
- Department of Gastroenterology, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, China
| | - Ling He
- Department of Gastroenterology II, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, China
| | - Yi Hong Fan
- Department of Gastroenterology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, China
| | - Feng Lin Chen
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Yu Bao Zhou
- Department of Gastroenterology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yi Yang Zhang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Yong Yu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hai Hong Wang
- Department of Gastroenterology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ku Ku Ge
- Department of Gastroenterology, Xi'an Children's Hospital, Xi'an, Shaanxi Province, China
| | - Guo Hua Jin
- Department of Gastroenterology, The First Bethune Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ying Lian Xiao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jun Fang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Xue Min Yan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Ye
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Chong Mei Yang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Yan Song
- Digestive Endoscopy Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
| | - Mao Yao Wen
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ye Zong
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao Han
- Department of Gastroenterology, General Hospital of the Northern Theater Command, Shenyang, Liaoning Province, China
| | - Lan Lan Wu
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Jing Ma
- Department of Gastroenterology, Jiangsu Provincial Hospital, Nanjing, Jiangsu Province, China
| | - Xiao Ping Xie
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wei Hua Yu
- Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Yu You
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Xiao Hong Lu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Yu Lin Song
- Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xue Qin Ma
- Department of Gastroenterology, Qinghai University Affiliated Hospital, Xining, Qinghai Province, China
| | - Shu Dan Li
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Bin Zeng
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Yun Jie Gao
- Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Jun Ma
- Department of Gastroenterology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
| | - Xiao Guang Ni
- Department of Digestive Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Hui He
- Department of Gastroenterology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, Guangdong Province, China
| | - Yi Pin Liu
- Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong Province, China
| | - Jian Sheng Wu
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jing Liu
- Department of Gastroenterology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ai Min Li
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Bai Li Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Chun Sheng Cheng
- Department of Gastroenterology, Nanshan Hospital, Guangdong Medical University, Shenzhen, Guangdong Province, China
| | - Xiao Mei Sun
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang Province, China
| | - Zhi Zheng Ge
- Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Feng
- Editorial Office of Chinese Journal of Digestion, Shanghai, China
| | - Yong Jin Tang
- Editorial Office of Chinese Journal of Digestive Endoscopy, Nanjing, Jiangsu Province, China
| | - Zhao Shen Li
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - En Qiang Linghu
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhuan Liao
- National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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Shi H, Pang S, Ming F, Yangdai T, Tian S, Lin R. A novel intelligent chromo capsule endoscope for the diagnosis of neoplastic lesions in the gastrointestinal tract. Gastroenterol Rep (Oxf) 2023; 11:goad021. [PMID: 37091502 PMCID: PMC10118998 DOI: 10.1093/gastro/goad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/25/2023] Open
Abstract
Background Chromoendoscopy has not been fully integrated into capsule endoscopy. This study aimded to develop and validate a novel intelligent chromo capsule endoscope (ICCE). Methods The ICCE has two modes: a white-light imaging (WLI) mode and an intelligent chromo imaging (ICI) mode. The performance of the ICCE in observing colors, animal tissues, and early gastrointestinal (GI) neoplastic lesions in humans was evaluated. Images captured by the ICCE were analysed using variance of Laplacian (VoL) values or image contrast evaluation. Results For color observation, conventional narrow-band imaging endoscopes and the ICI mode of the ICCE have similar spectral distributions. Compared with the WLI mode, the ICI mode had significantly higher VoL values for animal tissues (2.154 ± 1.044 vs 3.800 ± 1.491, P = 0.003), gastric precancerous lesions and early gastric cancers (2.242 ± 0.162 vs 6.642 ± 0.919, P < 0.001), and colon tumors (3.896 ± 1.430 vs 11.882 ± 7.663, P < 0.001), and significantly higher contrast for differentiating tumor and non-tumor areas (0.069 ± 0.046 vs 0.144 ± 0.076, P = 0.005). More importantly, the sensitivity, specificity, and accuracy of the ICI mode for early GI tumors were 95.83%, 91.67%, and 94.64%, respectively, which were significantly higher than the values of the WLI mode (78.33% [P < 0.001], 77.08% [P = 0.01], and 77.98% [P < 0.001], respectively). Conclusions We successfully integrated ICI into the capsule endoscope. The ICCE is an innovative and useful tool for differential diagnosis based on contrast-enhanced images and thus has great potential as a superior diagnostic tool for early GI tumor detection.
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Affiliation(s)
| | | | - Fanhua Ming
- Ankon Technologies Co., Ltd, Wuhan, Hubei, P. R. China
| | | | - Shuxin Tian
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
- Department of Gastroenterology, The First Affiliated Hospital of Medical College, Shihezi University, Shihezi, Xinjiang, P. R. China
| | - Rong Lin
- Corresponding author. Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, P. R. China. Tel: +86-27-85726085;
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Jiang X, Qiu XO, Li Z, Pan J, Peng C, Zuo XL, Liao Z, Li ZS. Small-sized versus standard magnetic capsule endoscopy in adults: a two-center, double-blinded randomized controlled trial. Endoscopy 2023; 55:52-57. [PMID: 35820437 DOI: 10.1055/a-1881-4369] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND : Certain patients experience difficulty swallowing a video capsule endoscopy (VCE) device owing to its relatively large size. The newly developed small-sized magnetically controlled capsule endoscopy (MCE) device is the smallest VCE device ever reported. We aimed to evaluate the performance of the small-sized MCE device in terms of ingestion and examination efficacy. METHODS : Patients in two centers were prospectively enrolled and randomized to the small-sized or standard MCE groups. Differences in capsule ingestion difficulties, visualization of the gastrointestinal tract, and capsule transit times were compared. RESULTS : 96 patients were enrolled (48 in each group). In the small-sized MCE group, the mean (SD) difficulty score and time to swallow the capsule, and success rate for swallowing the capsule at the first attempt were 0.6 (1.0), 3.4 (1.3) seconds, and 89.6 %, which was significant better compared with the standard MCE group with 3.1 (1.7), 12.0 (14.3) seconds and 60.4 %, respectively (all P < 0.001). Visualization of the esophagus, stomach, and small bowel were comparable between the two groups. The small-sized MCE group had a significantly shorter gastric transit time (49.4 minutes vs. 66.2 minutes; P = 0.04) and longer small-bowel transit time (5.8 hours vs. 5.0 hours; P = 0.045). CONCLUSIONS : The small-sized MCE device is feasible and safe for gastrointestinal examination, alleviating difficulties in capsule ingestion, improving gastric emptying under magnetic control, and prolonging the small-bowel transit time.
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Affiliation(s)
- Xi Jiang
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xiao-Ou Qiu
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jun Pan
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Cheng Peng
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhuan Liao
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhao-Shen Li
- National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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He C, Wang Q, Jiang X, Jiang B, Qian YY, Pan J, Liao Z. Magnetic capsule endoscopy: concept and application of artificial intelligence. ARTIFICIAL INTELLIGENCE IN CAPSULE ENDOSCOPY 2023:217-241. [DOI: 10.1016/b978-0-323-99647-1.00009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Xi S, Jing L, Lili W, Tingting L, Jun L, Ming W, Zhiqiang W, Peng J. Magnetic controlled capsule endoscope (MCCE)'s diagnostic performance for H. pylori infection status based on the Kyoto classification of gastritis. BMC Gastroenterol 2022; 22:502. [PMID: 36474169 PMCID: PMC9724339 DOI: 10.1186/s12876-022-02589-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have shown that the Kyoto classification of gastritis can accurately predict H. pylori infection status on conventional gastroscopy. The aim of this study was to test whether the Kyoto classification of gastritis applies well to magnetic controlled capsule endoscopy (MCCE). METHODS We consecutively recruited 227 participants who underwent both MCCE and urea breath tests (UBTs). Two physicians who were blinded to the UBT results independently made the diagnosis of H. pylori infection status according to 10 findings listed in the Kyoto classification of gastritis after reviewing MCCE images. We also developed 2 predictive models to assess H. pylori infection status by combining these 10 findings. RESULTS The MCCE's overall diagnostic accuracy for H. pylori infection status was 80.2%. The sensitivity, specificity and diagnostic odds ratio (DOR) for current infection were 89.4%, 90.1% and 77.1, respectively. Major specific findings were mucosal swelling and spotty redness for current infection, regular arrangement of collecting venules (RAC), streak redness, fundic gland polyp (FGP) for noninfection, and map-like redness for past-infection. In the two prediction models, the area under the curve (AUC) values for predicting noninfection and current infection were 84.7 and 84.9, respectively. CONCLUSIONS The Kyoto classification of gastritis applied well to MCCE. H. pylori infection status could be accurately assessed on MCCE according to the Kyoto classification of gastritis.
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Affiliation(s)
- Sun Xi
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Liu Jing
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wu Lili
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Li Tingting
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Li Jun
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wang Ming
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wang Zhiqiang
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Jin Peng
- grid.414252.40000 0004 1761 8894Department of Gastroenterology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
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Zhang Y, Qu L, Gou Y, Hao J, Pan Y, Huang X. In vitro and in vivo evaluation of a novel wired transmission magnetically controlled capsule endoscopy system for upper gastrointestinal examination. Surg Endosc 2022; 36:9454-9461. [PMID: 36112221 DOI: 10.1007/s00464-022-09603-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/25/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Magnetically controlled capsule endoscopy (MCCE) has recently increasingly been used for gastric examination. However, the image quality and esophageal observation is suboptimal. We developed a novel wired transmission magnetically controlled capsule endoscopy (WT-MCCE) system and evaluated its feasibility through in vitro and in vivo experiments. METHODS A plastic stomach model and a pathological upper gastrointestinal model were used to evaluate the performance of WT-MCCE in vitro experiments. Twice of examination in the two in vitro models by WT-MCCE were performed by 5 endoscopists who were experienced in performing wireless capsule endoscopy. The examination of traditional gastroscopy (Olympus, GIF-HQ290) in the pathological upper gastrointestinal model was set as the control. In vivo experiments were performed in a live canine model by 3 endoscopists, in which WT-MCCE was inserted with the assistance of gastroscopy. Measurements included maneuverability, examination time, visualization of gastric mucosa, image quality and diagnostic accuracy. RESULTS WT-MCCE showed good performance in both in vitro and in vivo experiments with excellent visualization of mucosa (75-100%). The mean operation time is 17.6 ± 2.7 min, 22.3 ± 1.9 min and 29.3 ± 3.4 min in three models, respectively. In pathological upper gastrointestinal model, all lesions, including esophageal varices, one polyp, one foreign body, two gastric ulcers and one duodenal ulcer, were detected by both WT-MCCE and traditional gastroscopy by all endoscopists. For the observation of esophagus and stomach in the canine model, WT-MCCE also showed excellent maneuverability and good image quality. CONCLUSIONS The novel WT-MCCE system performed well in evaluating upper gastrointestinal landmarks and lesions in two in vitro models, and showed good performance in a canine model. WT-MCCE may be potentially useful for diagnosis of esophageal and gastric diseases.
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Affiliation(s)
- Yaoping Zhang
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
- Gansu Provincial Digestive Endoscopy Engineering Research Center, Lanzhou, Gansu Province, China
| | - Lina Qu
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
- Gansu Provincial Digestive Endoscopy Engineering Research Center, Lanzhou, Gansu Province, China
| | - Yani Gou
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
- Gansu Provincial Digestive Endoscopy Engineering Research Center, Lanzhou, Gansu Province, China
| | - Jinyong Hao
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China
- Gansu Provincial Digestive Endoscopy Engineering Research Center, Lanzhou, Gansu Province, China
| | - Yanglin Pan
- Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, Shaanxi, China.
| | - Xiaojun Huang
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China.
- Gansu Provincial Digestive Endoscopy Engineering Research Center, Lanzhou, Gansu Province, China.
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Wang Z, Han W, Xue F, Zhao Y, Wu P, Chen Y, Yang C, Gu W, Jiang J. Nationwide gastric cancer prevention in China, 2021-2035: a decision analysis on effect, affordability and cost-effectiveness optimisation. Gut 2022; 71:2391-2400. [PMID: 35902213 DOI: 10.1136/gutjnl-2021-325948] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 07/08/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To project future trajectories of the gastric cancer (GC) burden in China under different scenarios of GC prevention and identify strategies to improve affordability and cost-effectiveness. DESIGN Using a cohort of Chinese men and women born during 1951-1980, we assumed that different prevention strategies were conducted, including eradication of Helicobacter pylori (Hp) and endoscopy screening (one-time, annual, biennial, triennial or stratified according to personal risk). We performed a literature search to identify up-to-date data and populate a Markov model to project the number of new GC cases and deaths during 2021-2035, as well as resource requirements and quality-adjusted life-years (QALYs). We examined the impacts of general (among the whole population) and targeted (high-risk population) prevention. RESULTS During 2021-2035, 10.0 million new GC cases and 5.6 million GC deaths would occur, with 7.6%-35.5% and 6.9%-44.5%, respectively, being avoidable through various prevention strategies. Relative to the status quo, Hp eradication was a cost-saving strategy. General annual screening dominated other screening strategies, but cost more than CNY 70 000 per QALY gained (willingness-to-pay) compared with Hp eradication. Among endoscopy strategies, targeted screening resulted in 44%-49% lower cost per QALY gained over the status quo than general screening. Among high-risk population, tailoring the screening frequency according to personal risk could reduce endoscopy-related resources by 22% compared with biennial screening and by 55% compared with annual screening, CONCLUSION: Our findings provide important input for future decision-making and investment, highlighting the need and feasibility for China to include GC prevention in its national health plans.
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Affiliation(s)
- Zixing Wang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Yujie Zhao
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Peng Wu
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Yali Chen
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Cuihong Yang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Wentao Gu
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medical Sciences, Beijing, China
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Zhang T, Chen Y, Jiang X, He C, Pan J, Zhou W, Hu J, Liao Z, Li Z. 5G-based remote magnetically controlled capsule endoscopy for examination of the stomach and small bowel. United European Gastroenterol J 2022; 11:42-50. [PMID: 36416805 PMCID: PMC9892422 DOI: 10.1002/ueg2.12339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIMS Remote endoscopy can improve diagnostic efficiency of gastrointestinal (GI) diseases for patients in remote areas. A novel remote magnetically controlled capsule endoscopy (MCE) system based on a 5G network was developed for real-time remote GI examinations. We aimed to evaluate the feasibility and safety of the 5G-based remote MCE for examination of the stomach and small bowel. METHODS This was a prospective, nonrandomized, comparative study. Consecutive participants enrolled in the First People's Hospital of Yinchuan underwent remote MCE examinations performed by an endoscopist located in Changhai Hospital. Consecutive participants enrolled in Changhai Hospital underwent conventional MCE examinations performed by the same endoscopist. The main outcomes included the complete visualization rate of the stomach and small bowel, safety assessment and network latency time of remote MCE examinations. RESULTS From March 2021 to June 2021, 20 participants in each group were enrolled. The complete visualization rate of the stomach and small bowel was 100% in both groups (p > 0.999) without any adverse event. The median network latency time of remote MCE group was 19.948 ms. Gastric examination time (8.96 vs. 8.92 min, p = 0.234), maneuverability (15.00 vs. 15.00, p = 0.317), image quality (1.00 vs. 1.00, p > 0.999) and diagnostic yields in the stomach and small bowel (55% vs. 30%, 5% vs. 0%, both p > 0.05) were comparable between remote and conventional MCE groups. All participants in remote MCE group considered remote MCE acceptable and necessary. CONCLUSIONS 5G-based remote MCE was a feasible and safe method for viewing the stomach and small bowel.
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Affiliation(s)
- Ting Zhang
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Yi‐Zhi Chen
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Xi Jiang
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Chen He
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Jun Pan
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Wei Zhou
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Jian‐Ping Hu
- Department of GastroenterologyThe First People's Hospital of YinchuanYinchuanNingxiaChina
| | - Zhuan Liao
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
| | - Zhao‐Shen Li
- National Clinical Research Center for Digestive DiseasesDepartment of GastroenterologyChanghai HospitalNaval Medical UniversityShanghaiChina
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Tai FWD, Healy A, Thokala P, Chetcuti Zammit S, Sidhu R, McAlindon M. Cost comparison of oral, transnasal and magnet assisted capsule endoscopy in the examination of the upper gastrointestinal tract in patients with dyspepsia. Frontline Gastroenterol 2022; 14:300-305. [PMID: 37409341 PMCID: PMC11138180 DOI: 10.1136/flgastro-2022-102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Conventional oral upper gastrointestinal (GI) endoscopy can obe uncomfortable. By comparison, transnasal endoscopy (TNE) and magnet assisted capsule endoscopy (MACE) have superior tolerability. A cost comparison of competing upper GI endoscopic modalities have yet to be performed. Methods We performed a cost comparison study of oral, TNE and MACE by a combination of activity-based costing and averaging of fixed costs over 24 481 upper GI endoscopies performed for dyspepsia over a 10-year period. Results On average, 9.4 procedures were performed daily. TNE was cheapest at €125.90 per procedure, costing 30% less than oral endoscopy at €184.10 and threefold cheaper than MACE at €407.10. Flexible endoscope reprocessing cost €53.80. TNE was cheaper than oral endoscopy as sedation was not required. Oral endoscopies have a further rate of infectious complications, estimated to cost €16.20 per oral procedure in inpatient admissions. Oral and TNE equipment are more expensive to purchase and maintain than MACE costing €79 330 and €81 819, respectively compared with MACE at €15 420 per annum. However, capsule endoscopes cost significantly more per procedure at €369.00 than the consumables for flexible endoscopy (per oral €12.30, TNE €5.30). Conclusions TNE cost less to perform than conventional per oral endoscopy. The cost of capsule endoscopes will need to be reduced significantly if routine use is to be expected.
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Affiliation(s)
- Foong Way David Tai
- Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield, UK
| | - Ailish Healy
- Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield, UK
| | - Praveen Thokala
- Health Economics and Decision Science, The University of Sheffield School of Health and Related Research, Sheffield, UK
| | | | - Reena Sidhu
- Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield, UK
| | - Mark McAlindon
- Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield, UK
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Li Y, Yan JS, Yan B, Meng K. Feasibility and safety of a novel string magnetically controlled capsule endoscopy for esophageal and gastric examination in a porcine model. Shijie Huaren Xiaohua Zazhi 2022; 30:795-802. [DOI: 10.11569/wcjd.v30.i18.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Currently used magnetically controlled capsule gastroscope has many shortcomings, such as low resolution and frame rate, incomplete examination of the esophagus due to rapid passage, and risk of capsule retention. A novel string magnetically controlled capsule endoscopy with high frame rate and resolution can examine the esophagus comprehensively, and has no risk of capsule retention.
AIM To verify the feasibility and safety of a novel string magnetically controlled capsule endoscopy for esophageal and gastric examination by animal experiments.
METHODS Magnetically controlled capsule endoscopy (MCE) and traditional gastroscopy were performed on three Bama minipigs successively. The examination time for the esophagus and stomach was recorded. The MCE maneuverability and mucosal visualization in each part of the esophagus and stomach (upper, middle, and lower part of the esophagus, Z-line, and gastric cardia, fundus, body, angulus, antrum, and pylorus). Routine blood and biochemistry parameters of experimental animals before and after examination were analyzed, and adverse reactions occurring during the experiment were recorded.
RESULTS Compared with traditional gastroscopy, MCE showed no significant difference in esophageal examination time (104.67 s ± 7.02 s vs 88.33 s ± 3.51 s, P = 0.093). The gastric examination time of MCE was longer than that of traditional gastroscopy (25.67 min ± 5.69 min vs 6.00 min ± 1.00 min, P = 0.019). The MCE maneuverability and mucosal visualization were better in the esophagus, Z-line, and gastric body, antrum, and pylorus than in the gastric cardia and fundus. No obvious adverse reactions occurred in experimental animals.
CONCLUSION The novel string magnetically controlled capsule endoscopy has satisfactory feasibility and safety for esophageal and gastric examination in the porcine model.
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Affiliation(s)
- Yan Li
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jing-Shuang Yan
- School of Medicine, Nankai University, Tianjin 300071, China
| | - Bin Yan
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Ke Meng
- Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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A Robust Deep Model for Classification of Peptic Ulcer and Other Digestive Tract Disorders Using Endoscopic Images. Biomedicines 2022; 10:biomedicines10092195. [PMID: 36140296 PMCID: PMC9496137 DOI: 10.3390/biomedicines10092195] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Accurate patient disease classification and detection through deep-learning (DL) models are increasingly contributing to the area of biomedical imaging. The most frequent gastrointestinal (GI) tract ailments are peptic ulcers and stomach cancer. Conventional endoscopy is a painful and hectic procedure for the patient while Wireless Capsule Endoscopy (WCE) is a useful technology for diagnosing GI problems and doing painless gut imaging. However, there is still a challenge to investigate thousands of images captured during the WCE procedure accurately and efficiently because existing deep models are not scored with significant accuracy on WCE image analysis. So, to prevent emergency conditions among patients, we need an efficient and accurate DL model for real-time analysis. In this study, we propose a reliable and efficient approach for classifying GI tract abnormalities using WCE images by applying a deep Convolutional Neural Network (CNN). For this purpose, we propose a custom CNN architecture named GI Disease-Detection Network (GIDD-Net) that is designed from scratch with relatively few parameters to detect GI tract disorders more accurately and efficiently at a low computational cost. Moreover, our model successfully distinguishes GI disorders by visualizing class activation patterns in the stomach bowls as a heat map. The Kvasir-Capsule image dataset has a significant class imbalance problem, we exploited a synthetic oversampling technique BORDERLINE SMOTE (BL-SMOTE) to evenly distribute the image among the classes to prevent the problem of class imbalance. The proposed model is evaluated against various metrics and achieved the following values for evaluation metrics: 98.9%, 99.8%, 98.9%, 98.9%, 98.8%, and 0.0474 for accuracy, AUC, F1-score, precision, recall, and loss, respectively. From the simulation results, it is noted that the proposed model outperforms other state-of-the-art models in all the evaluation metrics.
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Endoscopic methods for the detection and treatment of gastric cancer. Curr Opin Gastroenterol 2022; 38:436-442. [PMID: 35881962 DOI: 10.1097/mog.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
PURPOSE OF REVIEW The intent of this review is to describe new advances in endoscopic approaches to surveillance and management of gastric cancer. RECENT FINDINGS There are new endoscopic techniques and approaches that have improved the detection of gastric cancer, including narrow band imaging, confocal laser endocytomicroscopy and magnetically controlled capsule endoscopy. This article highlights the role of endoscopic submucosal dissection in the treatment of focal and diffuse gastric dysplasia and early gastric cancer with a discussion of indications, complications and outcomes. We review several recent guidelines addressing the surveillance strategies for individuals at high-risk for developing gastric cancer, such as those with atrophic gastritis and intestinal metaplasia, how gastric dysplasia and early gastric cancer can be endoscopically managed, and recommended surveillance after endoscopic intervention. SUMMARY Endoscopic approaches are evolving rapidly that will improve detection of dysplasia and early gastric cancer in high-risk individuals. Surveillance guidelines from various international societies reflect differences in local experience and prevalence of gastric cancer. Endoscopic submucosal dissection is now widely accepted as a first-line approach to early gastric cancers that can be resected en-bloc .
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Zhang X. Clinical Observation of the Effect of Nasal Breathing on Nonanalgesic and Sedative Gastroscopy. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8603625. [PMID: 36101798 PMCID: PMC9439884 DOI: 10.1155/2022/8603625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to investigate the safety, tolerance, and comfort of the subjects in gastroscopy by observing and comparing the effect of gastroscopy under two different breathing modes: nasal breathing and nasal inspiration and oral expiration. A total of 60 subjects who underwent routine gastroscopy in the hospital from January 2021 to June 2021 were selected as the research subjects. According to the willingness of the subjects, they were divided into a nasal breathing group and a nasal inspiration and oral expiration group. The differences in vital signs, adverse reactions, and visual analog scale (VAS) scores were compared between the two groups. There were no significant differences in mean arterial pressure, heart rate, and blood oxygen saturation between the two groups before, during, and after the examination (P > 0.05). The nasal breathing group had fewer adverse reactions such as nausea, cough, belching, and restlessness than the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). VAS score of the nasal breathing group was lower than that of the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). Subjects are more tolerant to nasal breathing mode, which causes fewer adverse reactions, less pain, and more comfort and is more worthy to be popularized in primary hospitals.
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Affiliation(s)
- Xuzhen Zhang
- Digestive Endoscopy Center, Beijing Jingmei Group General Hospital, Mentougou, Beijing 102399, China
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Sun X, Wang F, Liu J, Wu L, Wang Z, Chen X, Wang M, Zeng Q. Risk factors for small-intestinal mucosal breaks beyond aspirin. J Gastroenterol Hepatol 2022; 37:1596-1602. [PMID: 35642270 DOI: 10.1111/jgh.15892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM There remains lots of unknowns for small intestinal mucosal breaks (SIMBs). The application of magnetic controlled capsule endoscope (MCCE) may provide a better understanding of SIMBs. The aim of our study was to investigate the prevalence and characteristics of SIMBs in the general population as well as risk factors for SIMBs other than aspirin. METHODS Clinical data on individuals who visited our institute between January 2019 and February 2021 for MCCE examination as a health check were collected and analyzed retrospectively. All study participants must have completed the small bowel inspection. Multivariate analysis was employed to reveal the independent risk factors for SIMBs. RESULTS A total of 1599 participants, 103 of whom were aspirin users, were finally included. The prevalence of SIMBs was 8.3% (132/1599) in all participants, with 36.9% (38/103) in aspirin users and 6.3% (94/1496) in non-aspirin users. The multivariate analysis showed that in addition to aspirin (OR: 6.17, 95% CI: 3.25-11.58), obesity (OR: 2.30, 95% CI: 1.38-3.92) and smoking (OR: 1.85, 95% CI: 1.56-3.20) were also independent risk factors for SIMBs. Jejunum involvement was more common in aspirin users (20/38, 52.6%), while ilium involvement was more common in non-aspirin users (58/94, 61.7%). Moderate SIMBs (erosions) were more common in aspirin users (17/38, 44.7%), while severe SIMBs (large erosions/ulcers) were more common in non-aspirin users (17/94, 18.1%). CONCLUSIONS The risk factors for SIMBs include aspirin as well as smoking and obesity, and the severity and distributive features of SIMBs differ between aspirin users and non-aspirin users.
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Affiliation(s)
- Xi Sun
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Fei Wang
- Department of Health Management Institution, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Liu
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lili Wu
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Zhiqiang Wang
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiao Chen
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ming Wang
- Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qang Zeng
- Department of Health Management Institution, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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