Capsule endoscopy of the future: What's on the horizon?

Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review, we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings. Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years

Use of a 3-D Wireless Power Transfer Technique as a Method for Capsule Localization

Capsule endoscopy has been heralded as a technological milestone in the diagnosis and therapeutics of gastrointestinal (GI) pathologies. The location and position of the capsule within the GI tract are important information for subsequent surgical intervention or local drug delivery. Accurate information of capsule location is therefore required during endoscopy. Although radio frequency (RF)-based, magnetic tracking and video localization have been investigated in the past, the complexity of those systems and potential inaccuracy in the localization data necessitate the scope for further research. This article proposes the dual use of a wireless power transfer (WPT) configuration as a method to enable the determination of the location of an endoscopic capsule. Measurements conducted on a homogeneous agar-based liquid phantom predict a maximum error of 12% between the calculated and measured trajectories of the capsule in a working volume of 100 mm $\times 100$ mm $\times 100$ mm

On Simultaneous Localization and Mapping inside the Human Body (Body-SLAM)

Wireless capsule endoscopy (WCE) offers a patient-friendly, non-invasive and painless investigation of the entire small intestine, where other conventional wired endoscopic instruments can barely reach. As a critical component of the capsule endoscopic examination, physicians need to know the precise position of the endoscopic capsule in order to identify the position of intestinal disease after it is detected by the video source. To define the position of the endoscopic capsule, we need to have a map of inside the human body. However, since the shape of the small intestine is extremely complex and the RF signal propagates differently in the non-homogeneous body tissues, accurate mapping and localization inside small intestine is very challenging. In this dissertation, we present an in-body simultaneous localization and mapping technique (Body-SLAM) to enhance the positioning accuracy of the WCE inside the small intestine and reconstruct the trajectory the capsule has traveled. In this way, the positions of the intestinal diseases can be accurately located on the map of inside human body, therefore, facilitates the following up therapeutic operations. The proposed approach takes advantage of data fusion from two sources that come with the WCE: image sequences captured by the WCE\u27s embedded camera and the RF signal emitted by the capsule. This approach estimates the speed and orientation of the endoscopic capsule by analyzing displacements of feature points between consecutive images. Then, it integrates this motion information with the RF measurements by employing a Kalman filter to smooth the localization results and generate the route that the WCE has traveled. The performance of the proposed motion tracking algorithm is validated using empirical data from the patients and this motion model is later imported into a virtual testbed to test the performance of the alternative Body-SLAM algorithms. Experimental results show that the proposed Body-SLAM technique is able to provide accurate tracking of the WCE with average error of less than 2.3cm

A review of recent innovations in remote health monitoring

The development of remote health monitoring systems has focused on enhancing healthcare services’ efficiency and quality, particularly in chronic disease management and elderly care. These systems employ a range of sensors and wearable devices to track patients’ health status and offer real-time feedback to healthcare providers. This facilitates prompt interventions and reduces hospitalization rates. The aim of this study is to explore the latest developments in the realm of remote health monitoring systems. In this paper, we explore a wide range of domains, spanning antenna designs, small implantable antennas, on-body wearable solutions, and adaptable detection and imaging systems. Our research also delves into the methodological approaches used in monitoring systems, including the analysis of channel characteristics, advancements in wireless capsule endoscopy, and insightful investigations into sensing and imaging techniques. These advancements hold the potential to improve the accuracy and efficiency of monitoring, ultimately contributing to enhanced health outcomes for patients.Publisher's VersionQ2WOS:001130630400001PMID:3813832

Design of an Electromagnetic Coil Array for Wireless Endoscope Capsule Localization

Wireless capsule endoscopy is a technique that visualizes mucosa of gastrointestinal tract. The first wireless capsule endoscope was developed in 2001, and since then, the tech-nology has been in constant development. With its reduced amount of discomfort, ability to visualize the whole gastrointestinal tract and many interesting future prospects, capsule en-doscopy is challenging the conventional procedure, in which a camera module at the end of a tube is inserted to the gastrointestinal tract. In general, the method can be used to diagnose many diseases, such as cancers, Celiac disease and Crohn’s disease. In order to achieve all the future prospects of the technology, for example, active steering of the capsule, biopsy and drug-delivery with the capsule, challenge of detecting the cap-sule’s position and orientation inside human needs to be overcome. Therefore, the localiza-tion challenge is considered in this thesis. The aim is to select an optimal method for localiza-tion based on current research, and to model and develop a prototype that could be utilized in capsule localization. The designed sensor array is evaluated with the help of finite element method -based modelling, sensitivity analysis and practical experiments. Based on the studied literature, an active magnetic field strength -based localization tech-nique was selected for further analysis. According to the literature, the method provides high accuracy and could also be utilized in other purposes, for example, wireless charging and ac-tive locomotion of the capsule. In addition, the method does not suffer from attenuation of the fields within a human body. Therefore, theoretical basis of the magnetic field strength -based localization was presented, and four electromagnetic coil arrays were designed for sensitivity analysis. Contrary to many developed arrays seen in the literature review, all the designed systems were planar, in order to develop a system that could be fitted, for instance, inside a hospital bed. Based on the sensitivity analysis, an array with relatively large sensitivity and optimal number of measurement channels was selected for practical study. In addition, pos-sible markers that could be fitted inside a regular sized endoscopic capsule were numerically modelled. It was found that a resonated solenoid marker with ferrite core causes the largest voltage compared to other modelled targets, and therefore it was constructed for experi-ments. The whole array was built and equipped with electronics and measurement devices to be able to perform testing. Two channels of the array were selected for example measurements, and the results were analysed and compared with modelled values and sensitivity patterns. The system was tested at multiple different heights and positions, and the effect of changing the marker’s orientation with respect to the array was analysed. It was found that the system gives a reasonable response when the marker is oriented along the excitation magnetic field. With this orientation, it was possible to measure significant voltages caused by the marker even at distance of 25 cm from the array. However, when the marker was oriented so that the excitation field could not properly excite it, the measured voltages got smaller. In addition, at certain orientation, the measured voltages did not seem reliable because voltage caused by the marker could not been discriminated from the noise of the system. The study indicates that the method is suitable for localization of resonated solenoid sample with ferrite core, but further improvements are needed to make the system work at each position and orientation of the marker. In addition, an inversion algorithm that estimates marker’s position and orien-tation based on the measured voltage needs to be integrated to the system

Design and implementation of DSP-based magnetic control system for capsule endoscope

PhD ThesisEarly detection methods are key to reducing morbidity rates from digestive tract cancer which is currently one of the fastest growing cancers in the World. Capsule endoscopes (CEs) are a new technology that can be used to improve early detection of the gastrointestinal (GI) tract disorder. The device integrates the technologies such as image processing, optoelectronic engineering, information communication, and biomedical engineering. The capsule is the size and shape of a pill and contains an optoelectronic camera, antenna, transmitter, battery and optoelectronic illuminating light emitting diodes (LEDs). The small size of these devices enables them to offer many advantages over conventional endoscopes such as accessibility to the entire intestine and minimising the risk of perforation, particularly for patients with difficult anatomy (e.g. post-operative scar tissue). Currently used devices are passive and can only follow the natural transit of the intestines, and hence there is considerable interest in methods of controlled actuation for these devices. In this thesis, a novel actuation system based on magnetic levitation is designed, developed and implemented, utilizing a small permanent magnet embedded within the capsule and an arrangement of digitally controlled electromagnets outside the body. The proposed approach is that the magnet can be moved and oriented by DC magnetic force and torque produced by coils placed outside of the human body, with a suitable position feedback sensor enabling closed-loop control. Theoretical analyses of the proposed actuation system are presented which model the magnetic field, force and torque exerted by electromagnetic coil on the embedded magnet. Based on the distribution of the magnetic field, an optimal geometry for the coils is proposed in order to achieve a levitation distance which is realistic for the inspection of the GI tract. Two types of systems are investigated in the thesis, namely single-input single-output (SISO) and multi-input multi-output (MIMO), and the dynamics of these systems are modelled in state space form and hence linear controllers are designed for capsule actuation. The controllers are simulated using Matlab/ Simulink tools to realize the mathematical analysis of the system, and then implemented digitally in real-time using Texas Instruments (TI) TMS320F2812 Digital Signal Processor (DSP) to validate the proposed actuation system. In the SISO system, a linear one degree of freedom (1DOF) proportionalintegral- derivative (PID) controller is designed to move the inserted magnet in the vertical dimension within an area around the operating point and to maintain it at a desired position. A realistic simulation model is designed and implemented to evaluate the proposed controller. Simulation results have shown that the controller is able to successfully hold the embedded magnet in the desired position. For practical validation, the PID controller is implemented in real-time on the DSP system, where pulse width modulation (PWM) is generated to control the coil current, and Hall effect sensors are used for position feedback. Experimental results are obtained under step and square wave input demand. In the proposed system, high frequency noise on the position sensor is initially rejected by hardware implementation of resistor capacitor-low pass filter (RC-LPF) circuit. The accuracy of the position feedback is increased by calibrating the DSP’s on-chip analogue-digital converter (ADC) in order to reduce conversion error due to inherent gain and offset errors. To further reduce the influence of the position feedback noise, an average of ten repeated samples based on mean filter is implemented by the DSP in order to reduce the influctuation of the sensor reading. The tracking performance of the actuation system based on two Hall effect sensors on the opposite coil’s poles is investigated under step trajectory input. In an improved actuation system, position feedback is provided by using an AC magnetic field to obtain the capsule position information, decoupling this from the DC actuation field. The noise of the position feedback in the improved system is reduced by replacing the PWM current drive with a linear power amplifier driven from a digital to analogue converter (DAC), hence reducing AC interference. Positioning sensor noise was found to be further reduced by implementing digital filtering based on a coherent detector using the DSP, without increasing response time. The performance of the actuation system using these position sensors is compared based on settling time, overshoot, steady-state error, and control input parameters in order to validate the proposed improvement in the position feedback. The experimental results have shown that the controller based on both sensing strategies satisfactory control of the magnet’s position. However, the response of the system based on AC position sensing has the shortest settling time, smallest overshoot value and steady-state error. In the MIMO system, several linear controllers such as pole placement (PP), Entire Eigenstructure Assignment (EEA), and linear Quadratic regulator (LQR) techniques are designed and their tracking performances are compared. Simulation results have shown that, based on acceptable control inputs, the LQR controller has the fastest response with minimal overshoot value and steady state error. However, the LQR controller based on 2DOF is unable to maintain stable control of the magnet due to the insufficient position feedback from the two coil sensors. Specifically, it is not possible to achieve a stable 2D system since the orientation angle of the magnet is not resolvable. Therefore, the position feedback is improved by obtaining the device position and orientation information from a pair of 3-axis orthogonal coils. A realistic simulation model for the 3DOF LQR controller is designed and implemented to evaluate the developed system. Simulation results have shown that this controller is can achieve the necessary stability. In conclusion, based on the results from the 1D control system, the thesis shows that the DC magnetic field, which is used for capsule movement, can be also used to provide the controller acceptable position feedback. However, the use of AC magnetic field for positioning purpose provides more accurate position information. In order to implement 2DOF control system successfully, two 3-axis orthogonal coil sensors are considered which are used to provide the actuation algorithm with more accurate feedback of position and orientation information.Ministry of Higher Education, Iraq

Towards tactile sensing active capsule endoscopy

Examination of the gastrointestinal(GI) tract has traditionally been performed using tethered endoscopy tools with limited reach and more recently with passive untethered capsule endoscopy with limited capability. Inspection of small intestines is only possible using the latter capsule endoscopy with on board camera system. Limited to visual means it cannot detect features beneath the lumen wall if they have not affected the lumen structure or colour. This work presents an improved capsule endoscopy system with locomotion for active exploration of the small intestines and tactile sensing to detect deformation of the capsule outer surface when it follows the intestinal wall. In laboratory conditions this system is capable of identifying sub-lumen features such as submucosal tumours.Through an extensive literary review the current state of GI tract inspection in particular using remote operated miniature robotics, was investigated, concluding no solution currently exists that utilises tactile sensing with a capsule endoscopy. In order to achieve such a platform, further investigation was made in to tactile sensing technologies, methods of locomotion through the gut, and methods to support an increased power requirement for additional electronics and actuation. A set of detailed criteria were compiled for a soft formed sensor and flexible bodied locomotion system. The sensing system is built on the biomimetic tactile sensing device, Tactip, \cite{Chorley2008, Chorley2010, Winstone2012, Winstone2013} which has been redesigned to fit the form of a capsule endoscopy. These modifications have required a $360^{o}$ cylindrical sensing surface with $360^{o}$ panoramic optical system. Multi-material 3D printing has been used to build an almost complete sensor assembly with a combination of hard and soft materials, presenting a soft compliant tactile sensing system that mimics the tactile sensing methods of the human finger. The cylindrical Tactip has been validated using artificial submucosal tumours in laboratory conditions. The first experiment has explored the new form factor and measured the device's ability to detect surface deformation when travelling through a pipe like structure with varying lump obstructions. Sensor data was analysed and used to reconstruct the test environment as a 3D rendered structure. A second tactile sensing experiment has explored the use of classifier algorithms to successfully discriminate between three tumour characteristics; shape, size and material hardness. Locomotion of the capsule endoscopy has explored further bio-inspiration from earthworm's peristaltic locomotion, which share operating environment similarities. A soft bodied peristaltic worm robot has been developed that uses a tuned planetary gearbox mechanism to displace tendons that contract each worm segment. Methods have been identified to optimise the gearbox parameter to a pipe like structure of a given diameter. The locomotion system has been tested within a laboratory constructed pipe environment, showing that using only one actuator, three independent worm segments can be controlled. This configuration achieves comparable locomotion capabilities to that of an identical robot with an actuator dedicated to each individual worm segment. This system can be miniaturised more easily due to reduced parts and number of actuators, and so is more suitable for capsule endoscopy. Finally, these two developments have been integrated to demonstrate successful simultaneous locomotion and sensing to detect an artificial submucosal tumour embedded within the test environment. The addition of both tactile sensing and locomotion have created a need for additional power beyond what is available from current battery technology. Early stage work has reviewed wireless power transfer (WPT) as a potential solution to this problem. Methods for optimisation and miniaturisation to implement WPT on a capsule endoscopy have been identified with a laboratory built system that validates the methods found. Future work would see this combined with a miniaturised development of the robot presented. This thesis has developed a novel method for sub-lumen examination. With further efforts to miniaturise the robot it could provide a comfortable and non-invasive procedure to GI tract inspection reducing the need for surgical procedures and accessibility for earlier stage of examination. Furthermore, these developments have applicability in other domains such as veterinary medicine, industrial pipe inspection and exploration of hazardous environments

Conformal antenna-based wireless telemetry system for capsule endoscopy

Capsule endoscopy for imaging the gastrointestinal tract is an innovative tool for carrying out medical diagnosis and therapy. Additional modalities beyond optical imaging would enhance current capabilities at the expense of denser integration, due to the limited space available within the capsule. We therefore need new designs and technologies to increase the smartness of the capsules for a given volume. This thesis presents the design, manufacture and performance characterisation of a helical antenna placed conformally outside an endoscopic capsule, and the characterisation in-silico, in-vitro and in-vivo of the telemetry system in alive and euthanised pigs. This method does not use the internal volume of the capsule, but does use an extra coating to protect the antenna from the surrounding tissue and maintain biocompatibility for safe use inside the human body. The helical antenna, radiating at 433 MHz with a bandwidth of 20 MHz within a muscle-type tissue, presents a low gain and efficiency, which is typical for implantable and ingestible medical devices. Telemetry capsule prototypes were simulated, manufactured and assembled with the necessary internal electronics, including a commercially available transceiver unit. Thermistors were embedded into each capsule shell, to record any temperature increase in the tissue surrounding the antenna during the experiments. A temperature increase of less than 1°C was detected for the tissue surrounding the antenna. The process of coating the biocompatible insulation layer over the full length of the capsule is described in detail. Data transmission programmes were established to send programmed data packets to an external receiver. The prototypes radiated at different power levels ranging from -10 to 10 dBm, and all capsules demonstrated a satisfactory performance at a data rate of 16 kbps during phantom and in-vivo experiments. Data transmission was achieved with low bit-error rates below 10-5. A low signal strength of only -54 dBm still provided effective data transfer, irrespective of the orientation and location of the capsule, and this successfully demonstrated the feasibility of the system

Localization and Tracking of Intestinal Paths for Wireless Capsule Endoscopy

Wireless capsule endoscopy (WCE) is a non-invasive technology used for visual inspection of the human gastrointestinal (GI) tract. Localization of the capsule is a vital component of the system, as this enables physicians to identify the position of abnormalities. Several approaches exist that use the received signal strength (RSS) of the radio frequency (RF) signals for localization. However, few of these utilize the sparseness of the signals. Due to intestinal motility, the capsule positions will change with time. The distance travelled by the capsule in the intestine, however, remains more or less constant with time. In this thesis, a compressive sensing (CS) based localization algorithm is presented, that utilize signal sparsity in the RSS measurements. Different L1-minimization algorithms are used to find the sparse location vector. The performance is evaluated by electromagnetic (EM) simulations performed on a human voxel model, using narrow-band (NB) and ultra wide-band (UWB) signals. From intestinal positions, the distance the capsule has travelled is estimated by use of Kalman- and particle filters. It was found that localization accuracy of a few millimeters is possible under ideal conditions, when the RSS measurements are generated from a path loss model. When using path loss data from the EM simulations, localization accuracy on the order of 20-30 mm was achievable for NB signals. Use of UWB signals resulted in localization errors between 35-60 mm, depending on frequency range and bandwidth. From generated intestinal positions, the travelled distance was estimated with a minimum accuracy of a few millimeters, when using a VNL Kalman filter and moderate amounts of observation noise. The results are found from a limited amount of data. In order to increase the confidence in the presented results, the performance of the localization algorithm and the filters should be evaluated with a larger number of datasets