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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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2
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Ho AHY, Lui RN. The current and future clinical applications of capsule endoscopy. J Gastroenterol Hepatol 2024; 39:28-33. [PMID: 38238541 DOI: 10.1111/jgh.16490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Agnes H Y Ho
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rashid N Lui
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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3
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Liu W, Choi SJ, George D, Li L, Zhong Z, Zhang R, Choi SY, Selaru FM, Gracias DH. Untethered shape-changing devices in the gastrointestinal tract. Expert Opin Drug Deliv 2023; 20:1801-1822. [PMID: 38044866 PMCID: PMC10872387 DOI: 10.1080/17425247.2023.2291450] [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: 09/30/2023] [Accepted: 12/01/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Advances in microfabrication, automation, and computer engineering seek to revolutionize small-scale devices and machines. Emerging trends in medicine point to smart devices that emulate the motility, biosensing abilities, and intelligence of cells and pathogens that inhabit the human body. Two important characteristics of smart medical devices are the capability to be deployed in small conduits, which necessitates being untethered, and the capacity to perform mechanized functions, which requires autonomous shape-changing. AREAS COVERED We motivate the need for untethered shape-changing devices in the gastrointestinal tract for drug delivery, diagnosis, and targeted treatment. We survey existing structures and devices designed and utilized across length scales from the macro to the sub-millimeter. These devices range from triggerable pre-stressed thin film microgrippers and spring-loaded devices to shape-memory and differentially swelling structures. EXPERT OPINION Recent studies demonstrate that when fully enabled, tether-free and shape-changing devices, especially at sub-mm scales, could significantly advance the diagnosis and treatment of GI diseases ranging from cancer and inflammatory bowel disease (IBD) to irritable bowel syndrome (IBS) by improving treatment efficacy, reducing costs, and increasing medication compliance. We discuss the challenges and possibilities associated with ensuring safe, reliable, and autonomous operation of these smart devices.
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Affiliation(s)
- Wangqu Liu
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Soo Jin Choi
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Derosh George
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ling Li
- Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Zijian Zhong
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruili Zhang
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Si Young Choi
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Florin M. Selaru
- Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - David H. Gracias
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Chemistry, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21218, USA
- Sidney Kimmel Comprehensive Cancer Center (SKCCC), Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Center for MicroPhysiological Systems (MPS), Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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A self-powered ingestible wireless biosensing system for real-time in situ monitoring of gastrointestinal tract metabolites. Nat Commun 2022; 13:7405. [PMID: 36456568 PMCID: PMC9715945 DOI: 10.1038/s41467-022-35074-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
Information related to the diverse and dynamic metabolite composition of the small intestine is crucial for the diagnosis and treatment of various diseases. However, our current understanding of the physiochemical dynamics of metabolic processes within the small intestine is limited due to the lack of in situ access to the intestinal environment. Here, we report a demonstration of a battery-free ingestible biosensing system for monitoring metabolites in the small intestine. As a proof of concept, we monitor the intestinal glucose dynamics on a porcine model. Battery-free operation is achieved through a self-powered glucose biofuel cell/biosensor integrated into a circuit that performs energy harvesting, biosensing, and wireless telemetry via a power-to-frequency conversion scheme using magnetic human body communication. Such long-term biochemical analysis could potentially provide critical information regarding the complex and dynamic small intestine metabolic profiles.
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Awad A, Trenfield SJ, Pollard TD, Ong JJ, Elbadawi M, McCoubrey LE, Goyanes A, Gaisford S, Basit AW. Connected healthcare: Improving patient care using digital health technologies. Adv Drug Deliv Rev 2021; 178:113958. [PMID: 34478781 DOI: 10.1016/j.addr.2021.113958] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/12/2021] [Accepted: 08/29/2021] [Indexed: 12/22/2022]
Abstract
Now more than ever, traditional healthcare models are being overhauled with digital technologies of Healthcare 4.0 increasingly adopted. Worldwide, digital devices are improving every stage of the patient care pathway. For one, sensors are being used to monitor patient metrics 24/7, permitting swift diagnosis and interventions. At the treatment stage, 3D printers are under investigation for the concept of personalised medicine by allowing patients access to on-demand, customisable therapeutics. Robots are also being explored for treatment, by empowering precision surgery, rehabilitation, or targeted drug delivery. Within medical logistics, drones are being leveraged to deliver critical treatments to remote areas, collect samples, and even provide emergency aid. To enable seamless integration within healthcare, the Internet of Things technology is being exploited to form closed-loop systems that remotely communicate with one another. This review outlines the most promising healthcare technologies and devices, their strengths, drawbacks, and opportunities for clinical adoption.
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Affiliation(s)
- Atheer Awad
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Sarah J Trenfield
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Thomas D Pollard
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Jun Jie Ong
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Moe Elbadawi
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Laura E McCoubrey
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Alvaro Goyanes
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., Henwood House, Henwood, Ashford, Kent TN24 8DH, UK; Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia, Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782, Spain
| | - Simon Gaisford
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., Henwood House, Henwood, Ashford, Kent TN24 8DH, UK
| | - Abdul W Basit
- UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; FabRx Ltd., Henwood House, Henwood, Ashford, Kent TN24 8DH, UK.
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Capsule Endoscopy: Pitfalls and Approaches to Overcome. Diagnostics (Basel) 2021; 11:diagnostics11101765. [PMID: 34679463 PMCID: PMC8535011 DOI: 10.3390/diagnostics11101765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022] Open
Abstract
Capsule endoscopy of the gastrointestinal tract is an innovative technology that serves to replace conventional endoscopy. Wireless capsule endoscopy, which is mainly used for small bowel examination, has recently been used to examine the entire gastrointestinal tract. This method is promising for its usefulness and development potential and enhances convenience by reducing the side effects and discomfort that may occur during conventional endoscopy. However, capsule endoscopy has fundamental limitations, including passive movement via bowel peristalsis and space restriction. This article reviews the current scientific aspects of capsule endoscopy and discusses the pitfalls and approaches to overcome its limitations. This review includes the latest research results on the role and potential of capsule endoscopy as a non-invasive diagnostic and therapeutic device.
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7
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Tziortziotis I, Laskaratos FM, Coda S. Role of Artificial Intelligence in Video Capsule Endoscopy. Diagnostics (Basel) 2021; 11:1192. [PMID: 34209029 PMCID: PMC8303156 DOI: 10.3390/diagnostics11071192] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
Capsule endoscopy (CE) has been increasingly utilised in recent years as a minimally invasive tool to investigate the whole gastrointestinal (GI) tract and a range of capsules are currently available for evaluation of upper GI, small bowel, and lower GI pathology. Although CE is undoubtedly an invaluable test for the investigation of small bowel pathology, it presents considerable challenges and limitations, such as long and laborious reading times, risk of missing lesions, lack of bowel cleansing score and lack of locomotion. Artificial intelligence (AI) seems to be a promising tool that may help improve the performance metrics of CE, and consequently translate to better patient care. In the last decade, significant progress has been made to apply AI in the field of endoscopy, including CE. Although it is certain that AI will find soon its place in day-to-day endoscopy clinical practice, there are still some open questions and barriers limiting its widespread application. In this review, we provide some general information about AI, and outline recent advances in AI and CE, issues around implementation of AI in medical practice and potential future applications of AI-aided CE.
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Affiliation(s)
- Ioannis Tziortziotis
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
| | - Faidon-Marios Laskaratos
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
| | - Sergio Coda
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
- Photonics Group-Department of Physics, Imperial College London, Exhibition Rd, South Kensington, London SW7 2BX, UK
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8
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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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9
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Intelligent automated drug administration and therapy: future of healthcare. Drug Deliv Transl Res 2021; 11:1878-1902. [PMID: 33447941 DOI: 10.1007/s13346-020-00876-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
In the twenty-first century, the collaboration of control engineering and the healthcare sector has matured to some extent; however, the future will have promising opportunities, vast applications, and some challenges. Due to advancements in processing speed, the closed-loop administration of drugs has gained popularity for critically ill patients in intensive care units and routine life such as personalized drug delivery or implantable therapeutic devices. For developing a closed-loop drug delivery system, the control system works with a group of technologies like sensors, micromachining, wireless technologies, and pharmaceuticals. Recently, the integration of artificial intelligence techniques such as fuzzy logic, neural network, and reinforcement learning with the closed-loop drug delivery systems has brought their applications closer to fully intelligent automatic healthcare systems. This review's main objectives are to discuss the current developments, possibilities, and future visions in closed-loop drug delivery systems, for providing treatment to patients suffering from chronic diseases. It summarizes the present insight of closed-loop drug delivery/therapy for diabetes, gastrointestinal tract disease, cancer, anesthesia administration, cardiac ailments, and neurological disorders, from a perspective to show the research in the area of control theory.
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10
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Yang YJ. The Future of Capsule Endoscopy: The Role of Artificial Intelligence and Other Technical Advancements. Clin Endosc 2020; 53:387-394. [PMID: 32668529 PMCID: PMC7403015 DOI: 10.5946/ce.2020.133] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022] Open
Abstract
Capsule endoscopy has revolutionized the management of small-bowel diseases owing to its convenience and noninvasiveness. Capsule endoscopy is a common method for the evaluation of obscure gastrointestinal bleeding, Crohn’s disease, small-bowel tumors, and polyposis syndrome. However, the laborious reading process, oversight of small-bowel lesions, and lack of locomotion are major obstacles to expanding its application. Along with recent advances in artificial intelligence, several studies have reported the promising performance of convolutional neural network systems for the diagnosis of various small-bowel lesions including erosion/ulcers, angioectasias, polyps, and bleeding lesions, which have reduced the time needed for capsule endoscopy interpretation. Furthermore, colon capsule endoscopy and capsule endoscopy locomotion driven by magnetic force have been investigated for clinical application, and various capsule endoscopy prototypes for active locomotion, biopsy, or therapeutic approaches have been introduced. In this review, we will discuss the recent advancements in artificial intelligence in the field of capsule endoscopy, as well as studies on other technological improvements in capsule endoscopy.
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Affiliation(s)
- Young Joo Yang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Korea
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11
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Beardslee LA, Banis GE, Chu S, Liu S, Chapin AA, Stine JM, Pasricha PJ, Ghodssi R. Ingestible Sensors and Sensing Systems for Minimally Invasive Diagnosis and Monitoring: The Next Frontier in Minimally Invasive Screening. ACS Sens 2020; 5:891-910. [PMID: 32157868 DOI: 10.1021/acssensors.9b02263] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ingestible electronic systems that are capable of embedded sensing, particularly within the gastrointestinal (GI) tract and its accessory organs, have the potential to screen for diseases that are difficult if not impossible to detect at an early stage using other means. Furthermore, these devices have the potential to (1) reduce labor and facility costs for a variety of procedures, (2) promote research for discovering new biomarker targets for associated pathologies, (3) promote the development of autonomous or semiautonomous diagnostic aids for consumers, and (4) provide a foundation for epithelially targeted therapeutic interventions. These technological advances have the potential to make disease surveillance and treatment far more effective for a variety of conditions, allowing patients to lead longer and more productive lives. This review will examine the conventional techniques, as well as ingestible sensors and sensing systems that are currently under development for use in disease screening and diagnosis for GI disorders. Design considerations, fabrication, and applications will be discussed.
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Affiliation(s)
- Luke A. Beardslee
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - George E. Banis
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Sangwook Chu
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - Sanwei Liu
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
| | - Ashley A. Chapin
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
| | - Justin M. Stine
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland 20742, United States
| | - Pankaj Jay Pasricha
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Reza Ghodssi
- Institute for Systems Research, University of Maryland, College Park, Maryland 20742, United States
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, United States
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland 20742, United States
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Affiliation(s)
- Jihong Min
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Yiran Yang
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Zhiguang Wu
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical EngineeringDivision of Engineering and Applied ScienceCalifornia Institute of Technology Pasadena CA 91125 USA
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13
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The future of capsule endoscopy in clinical practice: from diagnostic to therapeutic experimental prototype capsules. GASTROENTEROLOGY REVIEW 2019; 15:179-193. [PMID: 33005262 PMCID: PMC7509905 DOI: 10.5114/pg.2019.87528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 02/08/2023]
Abstract
Capsule endoscopy (CE) is indicated as a first-line clinical examination for the detection of small-bowel pathology, and there is an ever-growing drive for it to become a method for the screening of the entire gastrointestinal tract (GI). Although CE's main function is diagnosis, the research for therapeutic capabilities has intensified to make therapeutic capsule endoscopy (TCE) a target within reach. This manuscript presents the research evolution of CE and TCE through the last 5 years and describes notable problems, as well as clinical and technological challenges to overcome. This review also reports the state-of-the-art of capsule devices with a focus on CE research prototypes promising an enhanced diagnostic yield (DY) and treatment. Lastly, this article provides an overview of the research progress made in software for enhancing DY by increasing the accuracy of abnormality detection and lesion localisation.
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Wang M, Shi Q, Song S, Hu C, Meng MQH. A Novel Relative Position Estimation Method for Capsule Robot Moving in Gastrointestinal Tract. SENSORS 2019; 19:s19122746. [PMID: 31248092 PMCID: PMC6630487 DOI: 10.3390/s19122746] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 12/19/2022]
Abstract
Recently, a variety of positioning and tracking methods have been proposed for capsule robots moving in the gastrointestinal (GI) tract to provide real-time unobstructed spatial pose results. However, the current absolute position-based result cannot match the GI structure due to its unstructured environment. To overcome this disadvantage and provide a proper position description method to match the GI tract, we here present a relative position estimation method for tracking the capsule robot, which uses the moving distance of the robot along the GI tract to indicate the position result. The procedure of the proposed method is as follows: firstly, the absolute position results of the capsule robot are obtained with the magnetic tracking method; then, the moving status of the robot along the GI tract is determined according to the moving direction; and finally, the movement trajectory of the capsule robot is fitted with the Bézier curve, where the moving distance can then be evaluated using the integral method. Compared to state-of-the-art capsule tracking methods, the proposed method can directly help to guide medical instruments by providing physicians the insertion distance in patients’ bodies, which cannot be done based on absolute position results. Moreover, as relative distance information was used, no reference tracking objects needed to be mounted onto the human body. The experimental results prove that the proposed method achieves a good distance estimation of the capsule robot moving in the simulation platform.
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Affiliation(s)
- Min Wang
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Qinyuan Shi
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Shuang Song
- Shenzhen Engineering Lab for Medical Intelligent Wireless Ultrasonic Imaging Technology, Harbin Institute of Technolgoy, Shenzhen 518055, China.
| | - Chao Hu
- Ningbo Institute of Technology, Zhejiang University, Ningbo 315000, China.
| | - Max Q-H Meng
- Robotics, Perception and Artificial Intelligence Lab, The Chinese University of Hong Kong, N.T., Hong Kong 999077, China.
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15
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Zhang R, Zheng Y, Poon CC, Shen D, Lau JY. Polyp detection during colonoscopy using a regression-based convolutional neural network with a tracker. PATTERN RECOGNITION 2018; 83:209-219. [PMID: 31105338 PMCID: PMC6519928 DOI: 10.1016/j.patcog.2018.05.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A computer-aided detection (CAD) tool for locating and detecting polyps can help reduce the chance of missing polyps during colonoscopy. Nevertheless, state-of-the-art algorithms were either computationally complex or suffered from low sensitivity and therefore unsuitable to be used in real clinical setting. In this paper, a novel regression-based Convolutional Neural Network (CNN) pipeline is presented for polyp detection during colonoscopy. The proposed pipeline was constructed in two parts: 1) to learn the spatial features of colorectal polyps, a fast object detection algorithm named ResYOLO was pre-trained with a large non-medical image database and further fine-tuned with colonoscopic images extracted from videos; and 2) temporal information was incorporated via a tracker named Efficient Convolution Operators (ECO) for refining the detection results given by ResYOLO. Evaluated on 17,574 frames extracted from 18 endoscopic videos of the AsuMayoDB, the proposed method was able to detect frames with polyps with a precision of 88.6%, recall of 71.6% and processing speed of 6.5 frames per second, i.e. the method can accurately locate polyps in more frames and at a faster speed compared to existing methods. In conclusion, the proposed method has great potential to be used to assist endoscopists in tracking polyps during colonoscopy.
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Affiliation(s)
- Ruikai Zhang
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Yali Zheng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Carmen C.Y. Poon
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
- Corresponding author
| | - Dinggang Shen
- Department of Radiology and Biomedical Research Imaging Center (BRIC), University of North Carolina, Chapel Hill, NC, USA
- Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea
- Corresponding author at: Department of Radiology and Biomedical Research Imaging Center (BRIC), University of North Carolina, Chapel Hill, NC, USA.
| | - James Y.W. Lau
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
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Alsunaydih FN, Redoute JM, Yuce MR. A Locomotion Control Platform With Dynamic Electromagnetic Field for Active Capsule Endoscopy. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 6:1800710. [PMID: 29888143 PMCID: PMC5991866 DOI: 10.1109/jtehm.2018.2837895] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 04/01/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022]
Abstract
Conventional radiological and endoscopic techniques utilizing long tubes were ineffective in visualizing the small bowel mucosa until the development of wireless capsule endoscopy (WCE). WCE is a revolutionary endoscopic technology that can diagnose the complete gastrointestinal tract. However, the existing capsule technologies are passive, and thus they cannot be navigated to or held in a specific location. The design of an active capsule will present the opportunity to move and stop a device at any targeted locations leading to numerous medical applications such as drug delivery or collecting tissue samples for examinations in the laboratory. This paper implements a new locomotion methodology for WCE systems using an electromagnetic platform. The platform produces a dynamic electromagnetic field to control the motion of the capsule. The strength and the direction of the electromagnetic field that is generated by the platform are continuously adjusted in order to maintain the equilibrium state during the capsule movement. We present the detailed design of the proposed platform with an experimental setup with polyvinyl chloride tubes and ex vivo to demonstrate the performance of the capsule motion.
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Affiliation(s)
- Fahad N Alsunaydih
- Department of Electrical and Computer Systems EngineeringMonash UniversityMelbourneVIC3800Australia
| | - Jean-Michel Redoute
- Department of Electrical and Computer Systems EngineeringMonash UniversityMelbourneVIC3800Australia
| | - Mehmet R Yuce
- Department of Electrical and Computer Systems EngineeringMonash UniversityMelbourneVIC3800Australia
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