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Lei II, Koulaouzidis A, Baatrup G, Samaan M, Parisi I, McAlindon M, Toth E, Shaukat A, Valentiner U, Dabos KJ, Fernandez I, Robertson A, Schelde-Olesen B, Parsons N, Arasaradnam RP. Rationalizing polyp matching criteria in colon capsule endoscopy: an international expert consensus through RAND (modified DELPHI) process. Therap Adv Gastroenterol 2024; 17:17562848241242681. [PMID: 38883159 PMCID: PMC11179528 DOI: 10.1177/17562848241242681] [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: 01/09/2024] [Accepted: 03/08/2024] [Indexed: 06/18/2024] Open
Abstract
Background Colon capsule endoscopy (CCE) has gained momentum as an alternative modality for the investigation of the lower gastrointestinal tract. Of the few challenges that remain, the comparison and - eventually - matching of polyps at different timestamps leads to the potential for double reporting and can contribute to false-positive findings and inaccuracies. With the impending artificial intelligence integration, the risk of double reporting the same polyp due to the lack of information on spatial orientation underscores the necessity for establishing criteria for polyp matching. Objectives This RAND/University of California, Los Angeles (modified Delphi) process aims to identify the key factors or components used to match polyps within a CCE video. This involves exploring the attributes of each factor to create comprehensive polyp-matching criteria based on international expert consensus. Design A systematic qualitative study using surveys. Methods A panel of 11 international CCE experts convened to assess a survey comprised of 60 statements. Participants anonymously rated statement appropriateness on a 1-9 scale (1-3: inappropriate, 4-6: uncertain and 7-9: appropriate). Following a virtual group discussion of the Round 1 results, a Round 2 survey was developed and completed before the final analysis. Results The factors that were agreed to be essential for polyp matching include (1) timestamp, (2) polyp localization, (3) polyp vascular pattern, (4) polyp size, (5) time interval of the polyp appearance between the green and yellow camera, (6) surrounding tissue, (7) polyp morphology and (8) polyp surface and contour. When five or more factors are satisfied, it was agreed that the comparing polyps are likely the same polyp. Conclusion This study has established the first complete criteria for polyp matching in CCE. While it might not provide a definitive solution for matching difficult, small and common polyps, these criteria serve as a framework to guide and facilitate the process of polyp-matching.
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Affiliation(s)
- Ian Io Lei
- Institute of Precision Diagnostics and Translational Medicine, University Hospital of Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Anastasios Koulaouzidis
- Surgical Research Unit, Odense University Hospital, Svendborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Social Medicine and Public Health, Pomeranian Medical University, Szczecin, Poland
- Department of Medicine, OUH Svendborg Sygehus, Svendborg, Denmark
| | - Gunnar Baatrup
- Surgical Research Unit, Odense University Hospital, Svendborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mark Samaan
- Inflammatory Bowel Disease Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ioanna Parisi
- Department of Gastroenterology, University College Hospital, London, UK
| | - Mark McAlindon
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ervin Toth
- Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Aasma Shaukat
- Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, New York City, NY, USA
| | - Ursula Valentiner
- Corporate Health International, Inverness, UK
- Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Alexander Robertson
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Nicholas Parsons
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Ramesh P Arasaradnam
- Institute of Precision Diagnostics and Translational Medicine, University Hospital of Coventry and Warwickshire, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Leicester Cancer Centre, University of Leicester, Leicester, UK
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2
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Yao L, Khan SR, Dolmans G, Romme J, Mitra S. High Accuracy Localization for Miniature Ingestible Devices Using Mutual Inductance. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2024; 18:662-678. [PMID: 38306262 DOI: 10.1109/tbcas.2024.3361045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
This article demonstrates an inductively coupled high-accuracy localization system for miniature ingestible devices. It utilizes an inductance double capacitances-series capacitance (LCC-S) compensation architecture that enables mutual inductance measurement at primary side that is positioned outside the human body and less constrained by power budget and size than the miniature ingestible. Depending on the secondary circuit architecture, only limited and simple cooperative measurements are needed from the ingestible secondary side, which saves power and area in the miniature device. The errors in the system are modeled thoroughly, providing insights about system require-ments for a particular localization accuracy target for efficient design and to identify key building blocks with large influence on overall performance. The model shows that sub-centimeter localization root-mean-square error (RMSE) can be achieved with a modest external ADC (18bit) using three primary coils and three secondary coils. The localization is verified along a complete small intestine tract with realistic dimensions. The proposed model is verified by simulation and experiment showing that at the selected frequency range up to 5 MHz the body has no influence on the accuracy. The use of 0.9% saline as phantom is proposed which guarantees the analysis validity for all body types.
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Sun T, Chen J, Zhang J, Zhao Z, Zhao Y, Sun J, Chang H. Application of micro/nanorobot in medicine. Front Bioeng Biotechnol 2024; 12:1347312. [PMID: 38333078 PMCID: PMC10850249 DOI: 10.3389/fbioe.2024.1347312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/02/2024] [Indexed: 02/10/2024] Open
Abstract
The development of micro/nanorobots and their application in medical treatment holds the promise of revolutionizing disease diagnosis and treatment. In comparison to conventional diagnostic and treatment methods, micro/nanorobots exhibit immense potential due to their small size and the ability to penetrate deep tissues. However, the transition of this technology from the laboratory to clinical applications presents significant challenges. This paper provides a comprehensive review of the research progress in micro/nanorobotics, encompassing biosensors, diagnostics, targeted drug delivery, and minimally invasive surgery. It also addresses the key issues and challenges facing this technology. The fusion of micro/nanorobots with medical treatments is poised to have a profound impact on the future of medicine.
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Affiliation(s)
- Tianhao Sun
- Department of Thoracic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyu Chen
- Department of Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiayang Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhihong Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yiming Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingxue Sun
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hao Chang
- Department of Thoracic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Rehan M, Al-Bahadly I, Thomas DG, Young W, Cheng LK, Avci E. Smart capsules for sensing and sampling the gut: status, challenges and prospects. Gut 2023; 73:186-202. [PMID: 37734912 PMCID: PMC10715516 DOI: 10.1136/gutjnl-2023-329614] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 08/26/2023] [Indexed: 09/23/2023]
Abstract
Smart capsules are developing at a tremendous pace with a promise to become effective clinical tools for the diagnosis and monitoring of gut health. This field emerged in the early 2000s with a successful translation of an endoscopic capsule from laboratory prototype to a commercially viable clinical device. Recently, this field has accelerated and expanded into various domains beyond imaging, including the measurement of gut physiological parameters such as temperature, pH, pressure and gas sensing, and the development of sampling devices for better insight into gut health. In this review, the status of smart capsules for sensing gut parameters is presented to provide a broad picture of these state-of-the-art devices while focusing on the technical and clinical challenges the devices need to overcome to realise their value in clinical settings. Smart capsules are developed to perform sensing operations throughout the length of the gut to better understand the body's response under various conditions. Furthermore, the prospects of such sensing devices are discussed that might help readers, especially health practitioners, to adapt to this inevitable transformation in healthcare. As a compliment to gut sensing smart capsules, significant amount of effort has been put into the development of robotic capsules to collect tissue biopsy and gut microbiota samples to perform in-depth analysis after capsule retrieval which will be a game changer for gut health diagnosis, and this advancement is also covered in this review. The expansion of smart capsules to robotic capsules for gut microbiota collection has opened new avenues for research with a great promise to revolutionise human health diagnosis, monitoring and intervention.
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Affiliation(s)
- Muhammad Rehan
- Department of Electronic Engineering, Sir Syed University of Engineering & Technology, Karachi, Pakistan
| | - Ibrahim Al-Bahadly
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North, New Zealand
| | - David G Thomas
- School of Agriculture and Environment, Massey University, Palmerston North, New Zealand
| | - Wayne Young
- AgResearch Ltd, Palmerston North, New Zealand
| | - Leo K Cheng
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Ebubekir Avci
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North, New Zealand
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington, New Zealand
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5
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Luo MR, Cai TN, Lu JL, Liu ZH, Guo SJ, Liu ZW, Yao K, Qin ZK, Ye YL. Regular gastroscopy and colonoscopy during the evaluation of urachal cancer: do we really need them? BMC Cancer 2023; 23:1156. [PMID: 38012559 PMCID: PMC10683129 DOI: 10.1186/s12885-023-11531-9] [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: 01/11/2023] [Accepted: 10/16/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE Urachal cancer is similar to gastrointestinal adenocarcinoma in histology, and gastroscopy/colonoscopy is often administered during perioperative evaluation. However, gastroscopy and colonoscopy have corresponding disadvantages. This study discusses whether gastroscopy/colonoscopy is truly necessary for patients with urachal cancer. PATIENTS AND METHODS A total of 166 bladder adenocarcinoma cases diagnosed at Sun Yat-sen University Cancer Center were retrospectively reviewed and divided into two groups (urachal cancer and nonurachal cancer), and perioperative evaluations were retrieved. RESULTS There were 78 patients with urachal cancer, the median age was 48 years, and 59 were male. Perioperative gastroscopy/colonoscopy revealed 5 intestinal polyps and 1 adenoma during these evaluations, and no primary gastrointestinal cancer was found. Meanwhile, preoperative imaging evaluation did not detect significant gastrointestinal lesions. For 88 patients with nonurachal cancer, including primary bladder adenocarcinoma and metastatic tumors from gastrointestinal cancer, the median age was 56 years, and 64 were male. Preoperative imaging evaluation demonstrated 36 cases of gastrointestinal lesions, and 32 were confirmed by gastroscopy/colonoscopy; the other 4 were negative. Another 4 cases of colon cancer were detected by regular colonoscopy for suspected primary bladder adenocarcinoma. In all, 35 cases of colon cancer and 1 case of gastric cancer were identified by endoscopic examination. The diagnostic consistency of imaging and gastrointestinal endoscopy was favorable (P < 0.001), and the negative predictive value and diagnostic efficiency of imaging were 96.9% and 94.6%, respectively. CONCLUSIONS The vast majority of gastrointestinal cancer cases can be identified by assessment of the patient's clinical symptoms, meticulous physical examination, and imaging evaluation. We recommend that gastroscopy/colonoscopy only be applied to patients with urachal cancer when the above examinations are positive.
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Affiliation(s)
- Ming-Rui Luo
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Tao-Nong Cai
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Jiang-Li Lu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Zhen-Hua Liu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Sheng-Jie Guo
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Zhuo-Wei Liu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Kai Yao
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China
| | - Zi-Ke Qin
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China.
| | - Yun-Lin Ye
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P.R. China.
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Chen F, Chen L, Xu T, Ye H, Liao H, Zhang D. Precise angle estimation of capsule robot in ultrasound using heatmap guided two-stage network. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107605. [PMID: 37390795 DOI: 10.1016/j.cmpb.2023.107605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE A capsule robot can be controlled inside gastrointestinal (GI) tract by an external permanent magnet outside of human body for finishing non-invasive diagnosis and treatment. Locomotion control of capsule robot relies on the precise angle feedback that can be achieved by ultrasound imaging. However, ultrasound-based angle estimation of capsule robot is interfered by gastric wall tissue and the mixture of air, water, and digestive matter existing in the stomach. METHODS To tackle these issues, we introduce a heatmap guided two-stage network to detect the position and estimate the angle of the capsule robot in ultrasound images. Specifically, this network proposes the probability distribution module and skeleton extraction-based angle calculation to obtain accurate capsule robot position and angle estimation. RESULTS Extensive experiments were finished on the ultrasound image dataset of capsule robot within porcine stomach. Empirical results showed that our method obtained small position center error of 0.48 mm and high angle estimation accuracy of 96.32%. CONCLUSION Our method can provide precise angle feedback for locomotion control of capsule robot.
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Affiliation(s)
- Fang Chen
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China; College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China.
| | - Lingyu Chen
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China; College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Tianze Xu
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China; College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Haoran Ye
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China; College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, China
| | - Daoqiang Zhang
- Key Laboratory of Brain-Machine Intelligence Technology, Ministry of Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China; College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
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Yogev D, Goldberg T, Arami A, Tejman-Yarden S, Winkler TE, Maoz BM. Current state of the art and future directions for implantable sensors in medical technology: Clinical needs and engineering challenges. APL Bioeng 2023; 7:031506. [PMID: 37781727 PMCID: PMC10539032 DOI: 10.1063/5.0152290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Implantable sensors have revolutionized the way we monitor biophysical and biochemical parameters by enabling real-time closed-loop intervention or therapy. These technologies align with the new era of healthcare known as healthcare 5.0, which encompasses smart disease control and detection, virtual care, intelligent health management, smart monitoring, and decision-making. This review explores the diverse biomedical applications of implantable temperature, mechanical, electrophysiological, optical, and electrochemical sensors. We delve into the engineering principles that serve as the foundation for their development. We also address the challenges faced by researchers and designers in bridging the gap between implantable sensor research and their clinical adoption by emphasizing the importance of careful consideration of clinical requirements and engineering challenges. We highlight the need for future research to explore issues such as long-term performance, biocompatibility, and power sources, as well as the potential for implantable sensors to transform healthcare across multiple disciplines. It is evident that implantable sensors have immense potential in the field of medical technology. However, the gap between research and clinical adoption remains wide, and there are still major obstacles to overcome before they can become a widely adopted part of medical practice.
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Affiliation(s)
| | | | | | | | | | - Ben M. Maoz
- Authors to whom correspondence should be addressed: and
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8
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Liu Y, Wang Q, Qin Y, Guo H, Li J, Li Z, Wen H, Ma Z, Tang J, Liu J. Microwave target location method based on the diamond NV color center. APPLIED OPTICS 2023; 62:4275-4280. [PMID: 37706917 DOI: 10.1364/ao.493338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/05/2023] [Indexed: 09/15/2023]
Abstract
We propose a method for microwave target source localization based on the diamond nitrogen vacancy color center. We use coherent population oscillation effect and modulation and demodulation techniques to achieve the detection of microwave intensity of microwave target sources, with a minimum detection intensity of 0.59 µW. Positioning of the microwave source was achieved within 50×100c m 2 distance from the system 1 m away using the cubic spline interpolation algorithm and minimum mean squared error. The maximum positioning error was 3.5 cm. This method provides a new, to the best of our knowledge, idea for the passive localization of microwave targets.
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Drake CE, Cheng LK, Paskaranandavadivel N, Alighaleh S, Angeli-Gordon TR, Du P, Bradshaw LA, Avci R. Stomach Geometry Reconstruction Using Serosal Transmitting Coils and Magnetic Source Localization. IEEE Trans Biomed Eng 2023; 70:1036-1044. [PMID: 36121949 PMCID: PMC10069741 DOI: 10.1109/tbme.2022.3207770] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Bioelectric slow waves (SWs) are a key regulator of gastrointestinal motility, and disordered SW activity has been linked to motility disorders. There is currently a lack of practical options for the acquisition of the 3D stomach geometry during research studies when medical imaging is challenging. Accurately recording the geometry of the stomach and co-registering electrode and sensor positions would provide context for in-vivo studies and aid the development of non-invasive methods of gastric SW assessment. METHODS A stomach geometry reconstruction method based on the localization of transmitting coils placed on the gastric serosa was developed. The positions and orientations of the coils, which represented boundary points and surface-normal vectors, were estimated using a magnetic source localization algorithm. Coil localization results were then used to generate surface models. The reconstruction method was evaluated against four 3D-printed anatomically realistic human stomach models and applied in a proof of concept in-vivo pig study. RESULTS Over ten repeated reconstructions, average Hausdorff distance and average surface-normal vector error values were 4.7 ±0.2 mm and 18.7 ±0.7° for the whole stomach, and 3.6 ±0.2 mm and 14.6 ±0.6° for the corpus. Furthermore, mean intra-array localization error was 1.4 ±1.1 mm for the benchtop experiment and 1.7 ±1.6 mm in-vivo. CONCLUSION AND SIGNIFICANCE Results demonstrated that the proposed reconstruction method is accurate and feasible. The stomach models generated by this method, when co-registered with electrode and sensor positions, could enable the investigation and validation of novel inverse analysis techniques.
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Sharma S, Ramadi KB, Poole NH, Srinivasan SS, Ishida K, Kuosmanen J, Jenkins J, Aghlmand F, Swift MB, Shapiro MG, Traverso G, Emami A. Location-aware ingestible microdevices for wireless monitoring of gastrointestinal dynamics. NATURE ELECTRONICS 2023; 6:242-256. [PMID: 37745833 PMCID: PMC10516531 DOI: 10.1038/s41928-023-00916-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/04/2023] [Indexed: 09/26/2023]
Abstract
Localization and tracking of ingestible microdevices in the gastrointestinal (GI) tract is valuable for the diagnosis and treatment of GI disorders. Such systems require a large field-of-view of tracking, high spatiotemporal resolution, wirelessly operated microdevices and a non-obstructive field generator that is safe to use in practical settings. However, the capabilities of current systems remain limited. Here, we report three dimensional (3D) localization and tracking of wireless ingestible microdevices in the GI tract of large animals in real time and with millimetre-scale resolution. This is achieved by generating 3D magnetic field gradients in the GI field-of-view using high-efficiency planar electromagnetic coils that encode each spatial point with a distinct magnetic field magnitude. The field magnitude is measured and transmitted by the miniaturized, low-power and wireless microdevices to decode their location as they travel through the GI tract. This system could be useful for quantitative assessment of the GI transit-time, precision targeting of therapeutic interventions and minimally invasive procedures.
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Affiliation(s)
- Saransh Sharma
- Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA
- These authors contributed equally: Saransh Sharma, Khalil B. Ramadi
| | - Khalil B. Ramadi
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Engineering, New York University Abu Dhabi, Abu Dhabi, UAE
- Tandon School of Engineering, New York University, New York, NY, USA
- These authors contributed equally: Saransh Sharma, Khalil B. Ramadi
| | - Nikhil H. Poole
- Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Shriya S. Srinivasan
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Keiko Ishida
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Johannes Kuosmanen
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Josh Jenkins
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Fatemeh Aghlmand
- Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Margaret B. Swift
- Department of Chemical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Mikhail G. Shapiro
- Department of Chemical Engineering, California Institute of Technology, Pasadena, CA, USA
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA
- These authors jointly supervised this work: Mikhail G. Shapiro, Giovanni Traverso, Azita Emami
| | - Giovanni Traverso
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- These authors jointly supervised this work: Mikhail G. Shapiro, Giovanni Traverso, Azita Emami
| | - Azita Emami
- Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA
- These authors jointly supervised this work: Mikhail G. Shapiro, Giovanni Traverso, Azita Emami
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Chu Y, Huang F, Gao M, Zou DW, Zhong J, Wu W, Wang Q, Shen XN, Gong TT, Li YY, Wang LF. Convolutional neural network-based segmentation network applied to image recognition of angiodysplasias lesion under capsule endoscopy. World J Gastroenterol 2023; 29:879-889. [PMID: 36816625 PMCID: PMC9932427 DOI: 10.3748/wjg.v29.i5.879] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/26/2022] [Accepted: 01/12/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Small intestinal vascular malformations (angiodysplasias) are common causes of small intestinal bleeding. While capsule endoscopy has become the primary diagnostic method for angiodysplasia, manual reading of the entire gastrointestinal tract is time-consuming and requires a heavy workload, which affects the accuracy of diagnosis.
AIM To evaluate whether artificial intelligence can assist the diagnosis and increase the detection rate of angiodysplasias in the small intestine, achieve automatic disease detection, and shorten the capsule endoscopy (CE) reading time.
METHODS A convolutional neural network semantic segmentation model with a feature fusion method, which automatically recognizes the category of vascular dysplasia under CE and draws the lesion contour, thus improving the efficiency and accuracy of identifying small intestinal vascular malformation lesions, was proposed. Resnet-50 was used as the skeleton network to design the fusion mechanism, fuse the shallow and depth features, and classify the images at the pixel level to achieve the segmentation and recognition of vascular dysplasia. The training set and test set were constructed and compared with PSPNet, Deeplab3+, and UperNet.
RESULTS The test set constructed in the study achieved satisfactory results, where pixel accuracy was 99%, mean intersection over union was 0.69, negative predictive value was 98.74%, and positive predictive value was 94.27%. The model parameter was 46.38 M, the float calculation was 467.2 G, and the time length to segment and recognize a picture was 0.6 s.
CONCLUSION Constructing a segmentation network based on deep learning to segment and recognize angiodysplasias lesions is an effective and feasible method for diagnosing angiodysplasias lesions.
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Affiliation(s)
- Ye Chu
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Fang Huang
- Technology Platform Department, Jinshan Science & Technology (Group) Co., Ltd., Chongqing 401120, China
| | - Min Gao
- Technology Platform Department, Jinshan Science & Technology (Group) Co., Ltd., Chongqing 401120, China
| | - Duo-Wu Zou
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Jie Zhong
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Wei Wu
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Qi Wang
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Xiao-Nan Shen
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Ting-Ting Gong
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
| | - Yuan-Yi Li
- Technology Platform Department, Jinshan Science & Technology (Group) Co., Ltd., Chongqing 401120, China
| | - Li-Fu Wang
- Department of Gastroenterology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai 200025, China
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12
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Sun H, Liu J, Wang Q, Lai C, Chi W, Niu C, Wang L, Teng Z, Shi Y, Tian P. In vivo animal study of the magnetic navigation system for capsule endoscope manipulation within the esophagus, stomach, and colorectum. Med Phys 2022; 49:6813-6823. [PMID: 36087029 DOI: 10.1002/mp.15976] [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: 04/01/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSES Magnetic navigation capsule endoscopy (MNCE) is considered to be an important means to realize the controllable and precise examination of capsule endoscopy (CE) in the unstructured gastrointestinal (GI) tract. For the current magnetic navigation system (MNS), due to the limitation of workspace, driving force, and control method of the CE, only clinical application in the stomach has been realized, whereas the examination of other parts of the GI tract is still in the experimental stage. More preclinical studies are needed to achieve the multisite examination of the GI tract. METHODS Based on the MNS (Supiee) developed in the laboratory, an X-ray imaging system with magnetic shielding and a commercial CE are integrated to form the MNCE system. Then, in vivo GI tract experiments with a porcine model are performed to verify the clinical feasibility and safety of this system. Moreover, the effects of different control modes on the efficiency and effect of GI tract examination are studied. RESULTS Animal experiments demonstrate that with the MNCE system, it is convenient to achieve steering control in any direction and multiple reciprocating movements of CE in the GI tract. Benefiting from the flexibility of the three basic control modes, the achieved swing movement pattern of CE can effectively reduce the inspection time. It is demonstrated that the esophageal examination time can be reduced from 13.2 to 9.2 min with a maximum movement speed of 5 mm/s. CONCLUSION In this paper, the feasibility, safety, and efficacy of the MNCE system for a one-stop examination of the in vivo GI tract (esophagus, stomach, and colorectum) is first demonstrated. In addition, complex movement patterns of CE such as the swinging are proved to effectively improve examination efficiency and disease detection rates. This study is crucial for the clinical application of the MNCE system.
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Affiliation(s)
- Hongbo Sun
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jianhua Liu
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Qiuliang Wang
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chunxiao Lai
- Department of Gastroenterology, Baiyun Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenqiang Chi
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China
| | - Chaoqun Niu
- College of Information and Communication Engineering, Faculty of Information Technology, Beijing University of Technology, Beijing, China
| | - Lei Wang
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Zhifan Teng
- College of Electrical and Information Engineering, Hunan University, Changsha, China
| | - Yang Shi
- School of Mechanical and Electrical Engineering, Xi'an Technological University, Xi'an, China
| | - Peilong Tian
- School of Mechanical and Electrical Engineering, Xi'an Technological University, Xi'an, China
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13
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Wu L, Lu K. Experimental investigation of a new type of driving concept for capsule robot. INTEL SERV ROBOT 2022. [DOI: 10.1007/s11370-022-00443-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Winters C, Subramanian V, Valdastri P. Robotic, self-propelled, self-steerable, and disposable colonoscopes: Reality or pipe dream? A state of the art review. World J Gastroenterol 2022; 28:5093-5110. [PMID: 36188716 PMCID: PMC9516669 DOI: 10.3748/wjg.v28.i35.5093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/21/2022] [Accepted: 09/01/2022] [Indexed: 02/06/2023] Open
Abstract
Robotic colonoscopes could potentially provide a comfortable, less painful and safer alternative to standard colonoscopy. Recent exciting developments in this field are pushing the boundaries to what is possible in the future. This article provides a comprehensive review of the current work in robotic colonoscopes including self-propelled, steerable and disposable endoscopes that could be alternatives to standard colonoscopy. We discuss the advantages and disadvantages of these systems currently in development and highlight the technical readiness of each system to help the reader understand where and when such systems may be available for routine clinical use and get an idea of where and in which situation they can best be deployed.
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Affiliation(s)
- Conchubhair Winters
- Leeds Institute of Medical Research, University of Leeds, St. James’s University Hospital, Leeds LS9 7TF, United Kingdom
| | - Venkataraman Subramanian
- Leeds Institute of Medical Research, University of Leeds, St. James’s University Hospital, Leeds LS9 7TF, United Kingdom
| | - Pietro Valdastri
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
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15
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Mahmood S, Schostek S, Schurr MO, Bergsland J, Balasingham I, Fosse E. Robot-assisted magnetic capsule endoscopy; navigating colorectal inclinations. MINIM INVASIV THER 2022; 31:930-938. [DOI: 10.1080/13645706.2022.2032181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Marc O. Schurr
- Ovesco Endoscopy AG, Tuebingen, Germany
- IHCI-Institute, Steinbeis University Berlin, Tuebingen, Germany
| | - Jacob Bergsland
- Intervention Center, Oslo University Hospital, Oslo, Norway
- BH Heart Center, Tuzla, Bosnia and Herzegovina
| | - Ilangko Balasingham
- Intervention Center, Oslo University Hospital, Oslo, Norway
- Department of Electronic Systems, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik Fosse
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Intervention Center, Oslo University Hospital, Oslo, Norway
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16
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Li K, Xu Y, Zhao Z, Meng MQH. External and Internal Sensor Fusion Based Localization Strategy for 6-DOF Pose Estimation of a Magnetic Capsule Robot. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3178473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Keyu Li
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Yangxin Xu
- Yuanhua Robotics, Perception & AI Technologies Limited, Shenzhen, China
| | - Ziqi Zhao
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Max Q.-H. Meng
- Shenzhen Key Laboratory of Robotics Perception and Intelligence, and the Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
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17
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Tracking the Traveled Distance of Capsule Endoscopes along a Gastrointestinal-Tract Model Using Differential Static Magnetic Localization. Diagnostics (Basel) 2022; 12:diagnostics12061333. [PMID: 35741143 PMCID: PMC9221653 DOI: 10.3390/diagnostics12061333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/13/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022] Open
Abstract
The traveled distance and orientation of capsule endoscopes for each video frame are not available in commercial systems, but they would be highly relevant for physicians. Furthermore, scientific approaches lack precisely tracking the capsules along curved trajectories within the typical gastrointestinal tract. Recently, we showed that the differential static magnetic localisation method is suitable for the precise absolute localisation of permanent magnets assumed to be integrated into capsule endoscopes. Thus, in the present study, the differential method was employed to track permanent magnets in terms of traveled distance and orientation along a length trajectory of 487.5 mm, representing a model of the winding gastrointestinal tract. Permanent magnets with a diameter of 10 mm and different lengths were used to find a lower boundary for magnet size. Results reveal that the mean relative distance and orientation errors did not exceed 4.3 ± 3.3%, and 2 ± 0.6∘, respectively, when the magnet length was at least 5 mm. Thus, a 5 mm long magnet would be a good compromise between achievable tracking accuracy and magnet volume, which are essential for integration into small commercial capsules. Overall, the proposed tracking accuracy was better than that of the state of the art within a region covering the typical gastrointestinal-tract size.
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18
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Xu Y, Li K, Zhao Z, Meng MQH. Autonomous Magnetic Navigation Framework for Active Wireless Capsule Endoscopy Inspired by Conventional Colonoscopy Procedures. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3141378] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Micheal MM, Adel A, Kim CS, Park JO, Misra S, Khalil ISM. 2D Magnetic Actuation and Localization of a Surface Milli-Roller in Low Reynolds Numbers. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3148787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Sperry AJ, Christensen JJ, Abbott JJ. Six-Degree-of-Freedom Localization With a 3-Axis Accelerometer and a 2-Axis Magnetometer for Magnetic Capsule Endoscopy. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3143293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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21
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Huang HE, Yen SY, Chu CF, Suk FM, Lien GS, Liu CW. Autonomous navigation of a magnetic colonoscope using force sensing and a heuristic search algorithm. Sci Rep 2021; 11:16491. [PMID: 34389760 PMCID: PMC8363733 DOI: 10.1038/s41598-021-95760-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022] Open
Abstract
This paper presents an autonomous navigation system for cost-effective magnetic-assisted colonoscopy, employing force-based sensors, an actuator, a proportional-integrator controller and a real-time heuristic searching method. The force sensing system uses load cells installed between the robotic arm and external permanent magnets to derive attractive force data as the basis for real-time surgical safety monitoring and tracking information to navigate the disposable magnetic colonoscope. The average tracking accuracy on magnetic field navigator (MFN) platform in x-axis and y-axis are 1.14 ± 0.59 mm and 1.61 ± 0.45 mm, respectively, presented in mean error ± standard deviation. The average detectable radius of the tracking system is 15 cm. Three simulations of path planning algorithms are presented and the learning real-time A* (LRTA*) algorithm with our proposed directional heuristic evaluation design has the best performance. It takes 75 steps to complete the traveling in unknown synthetic colon map. By integrating the force-based sensing technology and LRTA* path planning algorithm, the average time required to complete autonomous navigation of a highly realistic colonoscopy training model on the MFN platform is 15 min 38 s and the intubation rate is 83.33%. All autonomous navigation experiments are completed without intervention by the operator.
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Affiliation(s)
- Hao-En Huang
- Department of Electrical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan (R.O.C.).
| | - Sheng-Yang Yen
- Department of Electrical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan (R.O.C.)
| | - Chia-Feng Chu
- Department of Electrical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan (R.O.C.)
| | - Fat-Moon Suk
- Division of Gastroenterology, Department of Internal Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (R.O.C.).,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (R.O.C.)
| | - Gi-Shih Lien
- Division of Gastroenterology, Department of Internal Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (R.O.C.).,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (R.O.C.)
| | - Chih-Wen Liu
- Department of Electrical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan (R.O.C.)
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22
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Capsule endoscopy with a 3-dimensional magnetic tracking system: a promising tool to locate intestinal lesions. Eur J Gastroenterol Hepatol 2021; 33:1129-1130. [PMID: 34213507 DOI: 10.1097/meg.0000000000002066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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23
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A Flavor of the Future of GI Endoscopy-New Solutions Shape the Field of Modern Gastrointestinal Care. Cancers (Basel) 2021; 13:cancers13123007. [PMID: 34208440 PMCID: PMC8235533 DOI: 10.3390/cancers13123007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/02/2022] Open
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24
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Alsunaydih FN, Yuce MR. Next-generation ingestible devices: sensing, locomotion and navigation. Physiol Meas 2021; 42. [PMID: 33706294 DOI: 10.1088/1361-6579/abedc0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022]
Abstract
There is significant interest in exploring the human body's internal activities and measuring important parameters to understand, treat and diagnose the digestive system environment and related diseases. Wireless capsule endoscopy (WCE) is widely used for gastrointestinal (GI) tract exploration due to its effectiveness as it provides no pain and is totally tolerated by the patient. Current ingestible sensing technology provides a valuable diagnostic tool to establish a platform for monitoring the physiological and biological activities inside the human body. It is also used for visualizing the GI tract to observe abnormalities by recording the internal cavity while moving. However, the capsule endoscopy is still passive, and there is no successful locomotion method to control its mobility through the whole GI tract. Drug delivery, localization of abnormalities, cost reduction and time consumption are improvements that can be gained from having active ingestible WCEs. In this article, the current technological developments of ingestible devices including sensing, locomotion and navigation are discussed and compared. The main features required to implement next-generation active WCEs are explored. The methods are evaluated in terms of the most important features such as safety, velocity, complexity of design, control, and power consumption.
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Affiliation(s)
- Fahad N Alsunaydih
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia.,Department of Electrical Engineering, Qassim University, Onizah, Qassim, Saudi Arabia
| | - Mehmet R Yuce
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
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25
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Systematic Performance Evaluation of a Novel Optimized Differential Localization Method for Capsule Endoscopes. SENSORS 2021; 21:s21093180. [PMID: 34063644 PMCID: PMC8125465 DOI: 10.3390/s21093180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/22/2022]
Abstract
Capsule endoscopy is a well-established diagnostic tool for the gastrointestinal tract. However, the reliable tracking of capsule endoscopes needs further investigation. Recently, the static magnetic differential method for the localization of capsule endoscopes has shown promising results. This method was experimentally validated by investigating the difference in the measured values of the geomagnetic flux density of a representative sensor pair. In the measurements, it was revealed that misalignment of the sensors and ferromagnetic material near the sensor pair had the most significant impact on the differential approach. Besides, a systematical simulation-based study was conducted. Herein, the position and alignment of all sensors of the localization system were randomly varied. Furthermore, root-mean-squared noise was added to the sensor measurements, and the influence of nearby ferromagnetic material was evaluated. Subsequently, non-idealities were applied simultaneously on the proposed localization system, and the entire system was rotated. The proposed method was significantly better than state-of-the-art geomagnetic compensation methods for the localization of capsule endoscopes with mean position and orientation errors of approximately 2 mm and 1°, respectively.
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26
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Camboni D, Massari L, Chiurazzi M, Calio R, Alcaide JO, D'Abbraccio J, Mazomenos E, Stoyanov D, Menciassi A, Carrozza MC, Dario P, Oddo CM, Ciuti G. Endoscopic Tactile Capsule for Non-Polypoid Colorectal Tumour Detection. ACTA ACUST UNITED AC 2021. [DOI: 10.1109/tmrb.2020.3037255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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27
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Herp J, Deding U, Buijs MM, Kroijer R, Baatrup G, Nadimi ES. Feature Point Tracking-Based Localization of Colon Capsule Endoscope. Diagnostics (Basel) 2021; 11:diagnostics11020193. [PMID: 33525715 PMCID: PMC7911448 DOI: 10.3390/diagnostics11020193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 01/10/2023] Open
Abstract
In large bowel investigations using endoscopic capsules and upon detection of significant findings, physicians require the location of those findings for a follow-up therapeutic colonoscopy. To cater to this need, we propose a model based on tracking feature points in consecutive frames of videos retrieved from colon capsule endoscopy investigations. By locally approximating the colon as a cylinder, we obtained both the displacement and the orientation of the capsule using geometrical assumptions and by setting priors on both physical properties of the intestine and the image sample frequency of the endoscopic capsule. Our proposed model tracks a colon capsule endoscope through the large intestine for different prior selections. A discussion on validating the findings in terms of intra and inter capsule and expert panel validation is provided. The performance of the model is evaluated based on the average difference in multiple reconstructed capsule’s paths through the large intestine. The path difference averaged over all videos was as low as 4±0.7 cm, with min and max error corresponding to 1.2 and 6.0 cm, respectively. The inter comparison addresses frame classification for the rectum, descending and sigmoid, splenic flexure, transverse, hepatic, and ascending, with an average accuracy of 86%.
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Affiliation(s)
- Jürgen Herp
- Faculty of Engineering, Applied Artificial Intelligence and Data Science, Maersk Mc-Kinney Moller Institute, University of Southern Denmark, 5230 Odense, Denmark;
- Correspondence:
| | - Ulrik Deding
- Institute of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (U.D.); (M.M.B.); (R.K.); (G.B.)
| | - Maria M. Buijs
- Institute of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (U.D.); (M.M.B.); (R.K.); (G.B.)
- Department of Surgery, Odense University Hospital, 5700 Svendborg, Denmark
| | - Rasmus Kroijer
- Institute of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (U.D.); (M.M.B.); (R.K.); (G.B.)
- Department of Surgery, Odense University Hospital, 5700 Svendborg, Denmark
| | - Gunnar Baatrup
- Institute of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (U.D.); (M.M.B.); (R.K.); (G.B.)
- Department of Surgery, Odense University Hospital, 5700 Svendborg, Denmark
| | - Esmaeil S. Nadimi
- Faculty of Engineering, Applied Artificial Intelligence and Data Science, Maersk Mc-Kinney Moller Institute, University of Southern Denmark, 5230 Odense, Denmark;
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28
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Roß T, Reinke A, Full PM, Wagner M, Kenngott H, Apitz M, Hempe H, Mindroc-Filimon D, Scholz P, Tran TN, Bruno P, Arbeláez P, Bian GB, Bodenstedt S, Bolmgren JL, Bravo-Sánchez L, Chen HB, González C, Guo D, Halvorsen P, Heng PA, Hosgor E, Hou ZG, Isensee F, Jha D, Jiang T, Jin Y, Kirtac K, Kletz S, Leger S, Li Z, Maier-Hein KH, Ni ZL, Riegler MA, Schoeffmann K, Shi R, Speidel S, Stenzel M, Twick I, Wang G, Wang J, Wang L, Wang L, Zhang Y, Zhou YJ, Zhu L, Wiesenfarth M, Kopp-Schneider A, Müller-Stich BP, Maier-Hein L. Comparative validation of multi-instance instrument segmentation in endoscopy: Results of the ROBUST-MIS 2019 challenge. Med Image Anal 2020; 70:101920. [PMID: 33676097 DOI: 10.1016/j.media.2020.101920] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/22/2020] [Accepted: 11/24/2020] [Indexed: 12/27/2022]
Abstract
Intraoperative tracking of laparoscopic instruments is often a prerequisite for computer and robotic-assisted interventions. While numerous methods for detecting, segmenting and tracking of medical instruments based on endoscopic video images have been proposed in the literature, key limitations remain to be addressed: Firstly, robustness, that is, the reliable performance of state-of-the-art methods when run on challenging images (e.g. in the presence of blood, smoke or motion artifacts). Secondly, generalization; algorithms trained for a specific intervention in a specific hospital should generalize to other interventions or institutions. In an effort to promote solutions for these limitations, we organized the Robust Medical Instrument Segmentation (ROBUST-MIS) challenge as an international benchmarking competition with a specific focus on the robustness and generalization capabilities of algorithms. For the first time in the field of endoscopic image processing, our challenge included a task on binary segmentation and also addressed multi-instance detection and segmentation. The challenge was based on a surgical data set comprising 10,040 annotated images acquired from a total of 30 surgical procedures from three different types of surgery. The validation of the competing methods for the three tasks (binary segmentation, multi-instance detection and multi-instance segmentation) was performed in three different stages with an increasing domain gap between the training and the test data. The results confirm the initial hypothesis, namely that algorithm performance degrades with an increasing domain gap. While the average detection and segmentation quality of the best-performing algorithms is high, future research should concentrate on detection and segmentation of small, crossing, moving and transparent instrument(s) (parts).
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Affiliation(s)
- Tobias Roß
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany; University of Heidelberg, Germany, Seminarstraße 2, 69117 Heidelberg, Germany.
| | - Annika Reinke
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany; University of Heidelberg, Germany, Seminarstraße 2, 69117 Heidelberg, Germany
| | - Peter M Full
- University of Heidelberg, Germany, Seminarstraße 2, 69117 Heidelberg, Germany; Division of Medical Image Computing (MIC), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Martin Wagner
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Hannes Kenngott
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Martin Apitz
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Hellena Hempe
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Diana Mindroc-Filimon
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Patrick Scholz
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany; HIDSS4Health - Helmholtz Information and Data Science School for Health, Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Thuy Nuong Tran
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Pierangela Bruno
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany; Department of Mathematics and Computer Science, University of Calabria, 87036 Rende, Italy
| | - Pablo Arbeláez
- Universidad de los Andes, Cra. 1 No 18A - 12, 111711 Bogotá, Colombia
| | - Gui-Bin Bian
- University of Chinese Academy Sciences, 52 Sanlihe Rd., Beijing, China; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100864 Beijing, China
| | - Sebastian Bodenstedt
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Bautzner Landstraße 400, 01328 Dresden, Germany
| | | | | | - Hua-Bin Chen
- University of Chinese Academy Sciences, 52 Sanlihe Rd., Beijing, China; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100864 Beijing, China
| | - Cristina González
- Universidad de los Andes, Cra. 1 No 18A - 12, 111711 Bogotá, Colombia
| | - Dong Guo
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Shahe Campus:No.4, Section 2, North Jianshe Road, 610054
- Qingshuihe Campus:No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, China
| | - Pål Halvorsen
- SimulaMet, Pilestredet 52, 0167 Oslo, Norway; Oslo Metropolitan University (OsloMet), Pilestredet 52, 0167 Oslo, Norway
| | - Pheng-Ann Heng
- Department of Computer Science and Engineering, The Chinese University of Hong Kong, Chung Chi Rd, Ma Liu Shui, Hong Kong, China
| | - Enes Hosgor
- caresyntax, Komturstraße 18A, 12099 Berlin, Germany
| | - Zeng-Guang Hou
- University of Chinese Academy Sciences, 52 Sanlihe Rd., Beijing, China; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100864 Beijing, China
| | - Fabian Isensee
- University of Heidelberg, Germany, Seminarstraße 2, 69117 Heidelberg, Germany; Division of Medical Image Computing (MIC), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Debesh Jha
- SimulaMet, Pilestredet 52, 0167 Oslo, Norway; Department of Informatics, UIT The Arctic University of Norway, Hansine Hansens vei 54, 9037 Tromsø, Norway
| | - Tingting Jiang
- Institute of Digital Media (NELVT), Peking University, 5 Yiheyuan Rd, Haidian District, 100871 Peking, China
| | - Yueming Jin
- Department of Computer Science and Engineering, The Chinese University of Hong Kong, Chung Chi Rd, Ma Liu Shui, Hong Kong, China
| | - Kadir Kirtac
- caresyntax, Komturstraße 18A, 12099 Berlin, Germany
| | - Sabrina Kletz
- Institute of Information Technology, Klagenfurt University, Universitätsstraße 65-67, 9020 Klagenfurt, Austria
| | - Stefan Leger
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Bautzner Landstraße 400, 01328 Dresden, Germany
| | - Zhixuan Li
- Institute of Digital Media (NELVT), Peking University, 5 Yiheyuan Rd, Haidian District, 100871 Peking, China
| | - Klaus H Maier-Hein
- Division of Medical Image Computing (MIC), Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Zhen-Liang Ni
- University of Chinese Academy Sciences, 52 Sanlihe Rd., Beijing, China; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100864 Beijing, China
| | | | - Klaus Schoeffmann
- Institute of Information Technology, Klagenfurt University, Universitätsstraße 65-67, 9020 Klagenfurt, Austria
| | - Ruohua Shi
- Institute of Digital Media (NELVT), Peking University, 5 Yiheyuan Rd, Haidian District, 100871 Peking, China
| | - Stefanie Speidel
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Bautzner Landstraße 400, 01328 Dresden, Germany
| | | | | | - Gutai Wang
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Shahe Campus:No.4, Section 2, North Jianshe Road, 610054
- Qingshuihe Campus:No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, China
| | - Jiacheng Wang
- Department of Computer Science, School of Informatics, Xiamen University, 422 Siming South Road, 361005 Xiamen, China
| | - Liansheng Wang
- Department of Computer Science, School of Informatics, Xiamen University, 422 Siming South Road, 361005 Xiamen, China
| | - Lu Wang
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Shahe Campus:No.4, Section 2, North Jianshe Road, 610054
- Qingshuihe Campus:No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, China
| | - Yujie Zhang
- Department of Computer Science, School of Informatics, Xiamen University, 422 Siming South Road, 361005 Xiamen, China
| | - Yan-Jie Zhou
- University of Chinese Academy Sciences, 52 Sanlihe Rd., Beijing, China; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100864 Beijing, China
| | - Lei Zhu
- Department of Computer Science and Engineering, The Chinese University of Hong Kong, Chung Chi Rd, Ma Liu Shui, Hong Kong, China
| | - Manuel Wiesenfarth
- Division of Biostatistics, German Cancer Research Center, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Annette Kopp-Schneider
- Division of Biostatistics, German Cancer Research Center, Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Lena Maier-Hein
- Computer Assisted Medical Interventions (CAMI), German Cancer Research Center, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
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Xu Y, Li K, Meng MQH. A Novel Approach for Automatic State Detection of A Magnetically Actuated Capsule. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:4766-4769. [PMID: 33019056 DOI: 10.1109/embc44109.2020.9176691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In recent years, the Simultaneous Magnetic Actuation and Localization (SMAL) technology has been developed to accelerate and locate the wireless capsule endoscopy (WCE) in the intestine. In this paper, we propose a novel approach to detect the state of the capsule for improving the localization results. By creating a function to fit the relationship between the theoretical values of the actuating magnetic field and the measurement results, we present an algorithm for automatic estimation of the capsule state according to the fitting parameters. Experiment results on phantoms demonstrate the feasibility of the proposed method for detecting different states of the capsule during magnetic actuation.
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Rindi G, Wiedenmann B. Neuroendocrine neoplasia of the gastrointestinal tract revisited: towards precision medicine. Nat Rev Endocrinol 2020; 16:590-607. [PMID: 32839579 DOI: 10.1038/s41574-020-0391-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2020] [Indexed: 02/06/2023]
Abstract
Over the past 5 years, a number of notable research advances have been made in the field of neuroendocrine cancer, specifically with regard to neuroendocrine cancer of the gastrointestinal tract. The aim of this Review is to provide an update on current knowledge that has proven effective for the clinical management of patients with these tumours. For example, for the first time in the tubular gastrointestinal tract, well-differentiated high-grade (grade 3) tumours and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) are defined in the WHO classification. This novel classification enables efficient identification of the most aggressive well-differentiated neuroendocrine tumours and helps in defining the degree of aggressiveness of MiNENs. The Review also discusses updates to epidemiology, cell biology (including vesicle-specific components) and the as-yet-unresolved complex genetic background that varies according to site and differentiation status. The Review summarizes novel diagnostic instruments, including molecules associated with the secretory machinery, novel radiological approaches (including pattern recognition techniques), novel PET tracers and liquid biopsy combined with DNA or RNA assays. Surgery remains the treatment mainstay; however, peptide receptor radionuclide therapy with novel radioligands and new emerging medical therapies (including vaccination and immunotherapy) are evolving and being tested in clinical trials, which are summarized and critically reviewed here.
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Affiliation(s)
- Guido Rindi
- Università Cattolica del Sacro Cuore, Rome, Italy.
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Bertram Wiedenmann
- Charité, Campus Virchow Klinikum and Charité Mitte, University Medicine Berlin, Berlin, Germany
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Han D, Yan G, Wang Z, Jiang P, Liu D, Zhao K, Ma J. The Modelling, Analysis, and Experimental Validation of a Novel Micro-Robot for Diagnosis of Intestinal Diseases. MICROMACHINES 2020; 11:E896. [PMID: 32992512 PMCID: PMC7601751 DOI: 10.3390/mi11100896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
Intestinal-related diseases all around the world are increasing nowadays, and gradually become stubborn diseases threatening human health, and even lives. Diagnosis methods have attracted more and more attention. This article concerns a non-invasive way, a novel micro-robot, to diagnose intestinal diseases. This proposed micro-robot is a swallowable device, 14 mm in diameter, like a capsule. In order to make it possible for the micro-robot to move forward, backward, or anchor itself at a suspicious lesion point in the intestine with different lumen diameter sections, two key mechanisms have been proposed. One is an expanding mechanism with two-layer folded legs for anchoring. The designed expanding mechanism could realize a large variable diameter ratio, upwards of 3.43. In addition, a pair of specific annular gears instead of a traditional pinion drive is devised not only saving limited space, but also reducing energy loss. The other mechanism is a telescoping mechanism, possessing a self-locking lead screw nut system, which is used to obtain axial motion of the micro-robot. Then, the kinematics and dynamics of the micro-robot are analyzed. After that, the following experiments, including force tests and locomotion tests, are constructed. A good match is found between the theoretical results and the experimental data. Finally, in vitro experiments are performed with a prototype to verify the safety and reliability of the proposed micro-robot in porcine intestine.
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Affiliation(s)
- Ding Han
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Guozheng Yan
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Zhiwu Wang
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Pingping Jiang
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Dasheng Liu
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Kai Zhao
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jin Ma
- School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (G.Y.); (Z.W.); (P.J.); (D.L.); (K.Z.); (J.M.)
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai 200240, China
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Abstract
PURPOSE OF REVIEW Advanced endoscopy procedures are technically challenging and require extensive training. Recent technological advances made in computer science and robotics have the potential to enhance the performance of complex intraluminal and transluminal interventions and potentially optimize precision and safety. This review covers the different technologies used for robot-assisted interventions in the gastrointestinal tract, organized according to their clinical availability, and focusing on flexible endoscopy-based systems. RECENT FINDINGS In the curvilinear gastrointestinal anatomy, robotic technology can enhance flexible endoscopes to augment effectiveness, safety, and therapeutic capabilities, particularly for complex intraluminal and transluminal interventions. Increased visual angles, increased degrees of freedom of instrumentation, optimized navigation, and locomotion, which may lead to a reduced physician learning curve and workload, are promising achievements with the promise to ultimately replace conventional endoscopy techniques for screening and therapeutic endoscopy. SUMMARY The majority of these devices are not commercially available yet. The best clinical applications are also currently being researched. Nonetheless, robotic assistance may encourage surgeons to use flexible endoscopes to administer surgical therapies and increase interest among gastroenterologists in advanced therapies. Robotics may be a means to overcome the technical obstacles of incisionless natural orifice procedures and favor an increased adoption of complex endoscopic procedures such as third-space therapies.
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