Standardized examination procedure of magnetically controlled capsule endoscopy

Abstract

Magnetically controlled capsule endoscopy (MCE), a painless noninvasive screening tool for gastric diseases, has been an emerging diagnostic modality in clinical practice.1Liao Z. Duan X.D. Xin L. et al.Feasibility and safety of magnetic-controlled capsule endoscopy system in examination of human stomach: a pilot study in healthy volunteers.J Interv Gastroenterol. 2012; 2: 155-160Google Scholar, 2Zou W.B. Hou X.H. Xin L. et al.Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial.Endoscopy. 2015; 47: 525-528Google Scholar, 3Liao Z. Hou X. Lin-Hu E.Q. et al.Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases.Clin Gastroenterol Hepatol. 2016; 14: 1266-1273 e1Google Scholar, 4Qian Y.Y. Zhu S.G. Hou X. et al.Preliminary study of magnetically controlled capsule gastroscopy for diagnosing superficial gastric neoplasia.Dig Liver Dis. 2018; 50: 1041-1046Google Scholar, 5Zhao A.J. Qian Y.Y. Sun H. et al.Screening for gastric cancer with magnetically controlled capsule gastroscopy in asymptomatic individuals.Gastrointest Endosc. 2018; 88: 466-474 e1Google Scholar, 6Chen X. Gao F. Zhang J. Screening for gastric and small intestinal mucosal injury with magnetically controlled capsule endoscopy in asymptomatic patients taking enteric-coated aspirin.Gastroenterol Res Pract. 2018; 2018: 2524698Google Scholar, 7Tang Y. Cheng S. Wang L. et al.Sa2054 The clinical utility of magnetically controlled capsule endoscopy in pediatric patients [abstract].Gastrointest Endosc. 2016; 83: AB299-AB300Google Scholar Because the magnetic capsule in the stomach can be accurately controlled through multidimensional rotation and adaptive matching of an external C-arm robot, the diagnostic accuracy of MCE for detecting gastric focal lesions is comparable with that of conventional EGD.2Zou W.B. Hou X.H. Xin L. et al.Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial.Endoscopy. 2015; 47: 525-528Google Scholar, 3Liao Z. Hou X. Lin-Hu E.Q. et al.Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases.Clin Gastroenterol Hepatol. 2016; 14: 1266-1273 e1Google Scholar The MCE system (Ankon Technologies Co, Ltd, Shanghai, China) consists of a guidance magnet robot, a computer workstation with ESNavi software (Ankon Technologies Co, Ltd), an endoscopic capsule, a capsule locator, and a data recorder (Fig. 1).2Zou W.B. Hou X.H. Xin L. et al.Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial.Endoscopy. 2015; 47: 525-528Google Scholar The capsule measures 26.8 × 11.6 mm, weighs 4.8 g, and has a permanent magnet inside its dome. Images are captured and recorded at 2 frames per second (fps) with a resolution of 480 × 480 pixels. The view angle of the capsule is 140°, and the view depth is 0 to 60 mm. The battery life of the capsule is more than 8 hours. The guidance magnet robot is a C-arm type robot, with 2 rotational and 3 translational degrees of freedom. The magnetic field generated by the magnetic robot can reach a maximum of 200 mT and is adjustable. The computer workstation with ESNavi software is designed for real-time viewing and controlling. The capsule locator is a device for activating the capsule and detecting whether it is inside the human body. The data recorder is used for receiving image data by wireless transmission from the capsule endoscope. There are 2 joysticks on the workstation desktop (Fig. 2). The left joystick controls capsule orientation in 2 rotational axes (horizontal and vertical directions), and the right joystick controls capsule location in 3 translational axes (forward/backward, up/down, left/right). The location and orientation of the capsule can be controlled not only manually by operat