Diagnosis of Barrett’s esophagus and esophageal varices using a magnetically assisted capsule endoscopy system

Abstract

BackgroundMagnetically Assisted Capsule Endoscopy (MACE) potentially offers a comfortable, patient friendly and community-based alternative to gastroscopy (EGD). This pilot study aims to explore whether this approach can be used to accurately diagnose Barrett's oesophagus and esophageal varices. MethodsThe MiroCam Navi capsule system was used to examine the upper gastrointestinal tract in patients due to undergo a clinically indicated EGD. A total of 50 participants were enrolled, of which 34 had known pathology, 17 Barrett's Esophagus (BE), 17 Esophageal Varices (EV), with 16 controls. Patients underwent the MACE procedure, with the operator blinded to the indication and any previous endoscopic diagnoses. The subsequent EGD was performed by an endoscopist blinded to the MACE findings. Diagnostic yield, comfort and patient preference between the two modalities were compared. ResultsParticipants had a mean age of 61 years old, a M: F of 2.1:1, a mean BMI of 29.5, with an average chest measurement of 105.3cms. 47 patients undertook both procedures, 3 patients were unable to swallow the capsule. With the use of the magnet, it was possible to hold the capsule within the esophagus for a mean duration of 190 secs and up to a maximum of 634 secs. A correct real-time MACE diagnosis was made in 11/15 patients with EV (sensitivity 73.3% (44.9-92.2%) and specificity 100% (89.1-100%) and 15/16 patients with BE (sensitivity 93.8% (69.8-99.8%) and a specificity of 100% (88.8-100%). MACE was considered more comfortable than conventional endoscopy (p<0.0001) with a mean score of 9.2 with MACE compared to 6.7 with EGD, when assessed on a 10-point scale. No MACE or EGD related adverse events occurred. ConclusionThis pilot study demonstrates that MACE is both safe and well tolerated by patients. Accuracy for the diagnosis of BE was high and may therefore have a role in screening for this condition.

Screening value for gastrointestinal lesions of magnetic‐controlled capsule endoscopy in asymptomatic individuals

“…MCE overcomes these limitations by promoting gastric emptying of the capsule and providing sufficient battery power 17 . Reflux esophagitis (5.07%) was the most common esophageal lesion observed on MCE; however, this detection rate was lower than that reported by a study based on endoscopic evaluation (6.4%), 40 which indicates that an improved MCE procedure (through the string system or magnetic assistance) can ensure accurate esophageal evaluation 41,42 . The detection rate of Barrett's esophagus, which is a precursor of esophageal adenocarcinoma, was lower than that reported by a previous Italian study (0.68% vs 1.3%) 43 …”

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

“…A complete gastric mucosal examination becomes possible by employing a navigation system that guides the active WCE for a more accurate and reliable control of the capsule gastroscope in the gastric cavity. The MiroCam-Navi system, developed by Intromedic Ltd. (Seoul, Korea), was designed by modifying the standard MiroCam ® SB capsule including a permanent magnet, hence allowing a controlled exploration of the gastric cavity ( Figure 1 D) [ 38 ]. Steering is controlled by a hand-held, hammer-like, permanent magnet and the images from the WCE are transmitted to a real-time viewing device via wireless communication from an external belt.…”

“… Commercially available gastroscopes: ( A ) Olympus gastroscope (courtesy of Olympus Corp.) [ 31 ]; ( B ) EG Scan gastroscope (IntroMedic, Seoul, Korea; courtesy of IntroMedic Ltd.); ( C ) PillCam TM capsule endoscope [ 35 , 36 , 37 ]; ( D ) MiroCam-Navi system by Intromedic Ltd. (Seoul, Korea) [ 38 ]; ( E ) Navicam by Ankon Technologies Co., Ltd. (Wuhan, Shanghai, China; courtesy of ANKON Co., Ltd.) [ 39 ]; ( F ) OMOM Capsule Endoscopy platform by Jinshan Science & Technology (Group) Co., Ltd. (Chongqing, China;courtesy of Jinshan Science & Technology (Group) Co., Ltd.) [ 40 ]; ( G ) Standing-type magnetically controlled capsule endoscopy system by JIFU Medical Technologies Co., Ltd. (Shenzhen, China) [ 41 ]. …”

The Future of Capsule Endoscopy: The Role of Artificial Intelligence and Other Technical Advancements

“…The prospective study by Ching et al demonstrated that magnetically assisted CE (MACE) had better diagnostic yield than EGD in patients investigated for iron deficiency anemia [ 42 ]. Beg et al evaluated the performance of MACE for the detection of Barrett’s esophagus and esophageal varix using a handheld magnet for the capture of the capsule, and MACE correctly diagnosed 15 of 16 cases of Barrett’s esophagus and 11 of 15 cases of esophageal varix [ 43 ]. These results show the feasibility of magnetically guided CE for the diagnosis of GI disease, and further clinical trials with respect to superior performance, cost-effectiveness, and safety are warranted for clinical implementation.…”