Wireless Video Capsule Endoscopy
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Wireless Video Capsule Endoscopy
David Cave MD PhDProfessor of Medicine
University of Massachusetts Medical School
1st Invitational Workshop on Body Area Network Technology and Applications
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DisclosuresDavid Cave
• Recipient of research funds from and consultant for Given Imaging
• Recipient of research funds from Intromedic• Consultant for Olympus Corp
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Anatomy of the small intestine
Tools available
Esophago-gastro-duodenoscopyPush enteroscopyDeep enteroscopy
Colonoscopy Deep enteroscopy
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What is Capsule Endoscopy?
• Capsule endoscopy (CE) allows for direct, non-invasive visual examination of the gastrointestinal tract
• Images are transmitted from a disposable, ingestible wireless video capsule and are downloaded for clinical review
• CE has become the gold standard in evaluating suspected disease of the small bowel
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1999 20072000 2003
Hardware
Software
Capsule
Evolution of Capsule Endoscopy
OMOMMirocamCapsocam
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Capsule Endoscopy Systems
Given PillCam SB2 Olympus EndoCapsule
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Capsule Endoscopes
IntroMedicMiroCam
Given ImagingSB / SB2
OlympusEndoCapsule
Size 11x24mm 11x26mm 11x26mm
Weight 3.4g 3.45g --
Resolution 320 x 320 256 x 256 --
Rate 3 fps 2 fps 2 fps
Time 11 hours 8 hours 8 hours
Field of View 150° 140° / 156° 145°
Communication HBC RF RF
Real Time Viewer Yes Yes Yes
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Clinical Applications for CE(ASGE Technology Status Evaluation Report)
Small Bowel Capsule Endoscopy:
• Obscure GI bleeding including iron deficiency anemia (IDA)
• Suspected Crohn’s disease
• Suspected small intestinal tumors and surveillance in patients with polyposis syndromes
• Suspected or refractory malabsorptive syndromes(celiac disease)
Gastrointestinal Endoscopy 2006;63(4):539-545
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Clinical Applications for CE[Other]
• Chronic diarrhea
• Assessment of disease activity of Crohn’s disease.
• Detection of strictures
• Abdominal pain?????
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The Problem
• Where is the lesion/capsule?
• Current localization algorithms are not useful
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Anatomy of the small intestine
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Video capsule desktop
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What do we use to assess position of the VCE?
• Time– Assumption: motion is linear between pylorus and
ileo-cecal valve• Factors that alter motility
– Disease process– Adhesions
• Blood stimulates gut motility• Transit incomplete 15-25% of the time
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Assessment of motor function
• New insight into intestinal motor function via noninvasive endoluminal image analysis
• Malagelada C et al; Gastroenterology 2008 Oct;135(4):1155-62
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Conclusions
• Is there a methodology that could improve location of a VCE?
• 1- longitudinally• 2- in 3 D with reference to fixed points