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Jpn J Appl Phys. The present article focuses on the Medtronic Given Imaging platform on which most of the literature exists.
The capsule, easily ingested, moves from the mouth to the anus via the bowels peristaltic waves M2A-was how it was originally called. The second generation PillCam SB2 is in the market a few years now. It has a broader angle of view, degrees, better optics with ALC automatic light control , altogether allowing much better small bowel mucosal coverage.
The 3 rd generation-PillCam SB3 released about 1 year ago, has an adaptive frame rate allowing it to transmit up to six frames per second according to its speed of movement and has even better optics. Most of the new generation capsules in the market provide about 12 hours or more of battery time, thus allowing full view of the small bowel in practically all patients.
Upon completion of the study, downloading into a Reporting and Processing of Images and Data computer workstation RAPID 9 is done, and the examination seen as a continuous film. Many supporting gadgets were developed and added in the past 15 years. Some examples are the localization system, blood detecting monitor, the ability to see simultaneously a double or quadric picture, the quick viewer mode, or the single picture adjustment mode.
Now a day, most of the systems in the market have different color enhancement features in their software. PillCam Colon2, the 2 nd generation colonic capsule Medtronic, USA is available now for a few years all over the world. Important tools—polyp size estimator and the use of the FICE technique have also been added to the new software. The preparation for the procedure takes into account I bowel cleanliness; II completion of the study within 11 hours battery time. This includes a clear liquid diet the day prior to the procedure.
On that evening, 2 liters of PEG solution are given, and repeated early morning, of the day of the procedure. The capsule is ingested an hour later.
Later on, when the capsule enters the small intestine, either Sodium Phosphate 30 mL boost, or a sachet of PicoLax followed by a liter of water is given, in order to move it to the colon and allow its exit through while photographing. All these indications have been looked at quite intensively over the past 15 years. A few studies comparing it to virtual colonoscopy in patients with incomplete colonoscopy were published with good results 16 , After observing the guide robot, the treatment robot is swallowed and docked with the guide robot, which reduces the time needed to navigate the target lesion.
Several approaches have recently been proposed to enhance the imaging capability of present-day CE. Jang et al. Moving apart from conventional white-light imaging, Demosthenous et al. Because physicians would only need to examine whether the observed fluorescence level exceeded a predefined threshold, early-stage SB cancer could be cost-effectively screened by eliminating the present CE reviewing process.
Several research groups have attempted to develop CE with biopsy capabilities. Micro-jaw forceps and two multiscale magnetic-based robotic devices including centimeter-scaled untethered magnetically actuated soft capsule endoscope MASCE and a submillimeter-scale self-folding micro-gripper have been previously reported [ 49 , 50 ]. Son et al. B-MASCE was developed to enable axial jabbing motion of the needle and rolling locomotion in the stomach for biopsy.
A magnetic field is employed for the control and torque of the magnet in CE, and four soft legs guide the penetration of the needle into the target lesion. In addition to diagnostic capsules, several therapeutic capsule prototypes have been proposed by various research groups. Stewart et al. When drug-filled microbubbles arrive at the target lesion, the drug is released by US. Leung et al. This capsule was composed of a gas generation chamber, an acid injector, and a circuit box with flexible joints.
The balloon was inflated by acid injection into a gas generation chamber filled with base powder, resulting in hemostasis by tamponade at the bleeding site. However, the time-consuming and tedious reading process and lack of active locomotion are major challenges for the widespread use of CE in clinical practice. Although published studies showed the promising diagnostic accuracy of the CNN system, several challenges need to be overcome for its clinical application in real-world practice.
Further multicenter, prospective studies and external validation will provide robust evidence for the performance of the CNN system in CE. Moreover, in the colon, magnetically guided CE showed the potential for clinical use as an alternative method to conventional endoscopy. Further technical advancements in CE in terms of active locomotion, image enhancement, and therapeutic approaches are being actively investigated and could be integrated into patient management in the near future.
Conflicts of Interest: The authors have no financial conflicts of interest. National Center for Biotechnology Information , U. Journal List Clin Endosc v. Clin Endosc. Published online Jul Young Joo Yang 1, 2. Author information Article notes Copyright and License information Disclaimer. Received May 15; Accepted May This article has been cited by other articles in PMC. Abstract Capsule endoscopy has revolutionized the management of small-bowel diseases owing to its convenience and noninvasiveness.
Keywords: Artificial intelligence, Capsule endoscopy, Convolutional neural network, Locomotion. Application of artificial intelligence in capsule endoscopy Since late , AI has been developed to detect SB abnormalities based on CE images. Table 1. Open in a separate window. Challenges and future direction for the application of artificial intelligence in the field of capsule endoscopy Although many research groups have obtained remarkable results on the use of AI in the field of CE, AI has not yet been applied in real-world patient management beyond clinical studies.
Recent studies on capsule prototypes With respect to the locomotion of the capsule, Fontana et al. Footnotes Conflicts of Interest: The authors have no financial conflicts of interest.
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