Tethered capsule endoscopy, a low-cost and high-performance alternative technology for the screening of esophageal cancer and Barrett's esophagus
Tethered capsule endoscopy, a low-cost and high-performance alternative technology for the screening of esophageal cancer and Barrett's esophagus
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DOI：
10.1109/tbme.2008.915680
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发表时间：
2008-03-01
影响因子：
4.6
通讯作者：
Kimmey, Michael B.
中科院分区：
文献类型：
--
作者：
Seibel, Eric J.;Carroll, Robert E.;Kimmey, Michael B.
食管癌是目前美国增长最快的癌症。为了帮助对抗最近发病率的上升，我们的实验室开发了一种低成本的栓系胶囊内窥镜系统（TCE），旨在提高食管癌的早期检测。TCE包含一个谐振光纤激光扫描器（1.6 mm O.D.）其在远端尖端处适合于6.4-mm易于吞咽的胶囊。系留部分包含在近端处复用到三个激光二极管的单模光纤。该设计提供了优于当前内窥镜技术的两个主要优点。首先，由于其尺寸小，TCE可以在患者不适最小的情况下吞咽，从而避免镇静。第二，通过定向激光成像，TCE在战略上定位为采用几种新兴的基于激光的诊断技术，如窄带、高光谱和荧光成像。据信，这种成像技术与异型增生的新生物标志物的组合将极大地帮助鉴定癌前病症，例如巴雷特食管（BE）。当探针被吞咽时，光纤扫描仪以15 Hz的帧速率捕获胃食管连接处的高分辨率、宽视场彩色图像（500行，0.05 mm分辨率）。当太空舱被系绳慢慢收回时，视频图像被记录下来。附带的软件通过拼接单个帧来从视频输出中生成全景图像，以帮助模式识别。这份初步报告描述了独特的TCE系统设计的基本原理，体外和体内初步测试的结果，以及对这种新平台技术作为开发低成本食管癌筛查项目基础的优点的讨论。
Esophageal cancer is currently the fastest growing cancer in the United States. To help combat the recent rise in morbidity, our laboratory has developed a low-cost tethered capsule endoscope system (TCE) aimed at improving early detection of esophageal cancer. The TCE contains a resonant fiberoptic laser scanner (1.6 mm O.D.) which fits into 6.4-mm easy-to-swallow capsule at the distal tip. The tethered portion contains a single mode optical fiber multiplexed to three laser diodes at the proximal end. This design offers two main advantages over current endoscope technology. First, because of its small size, the TCE can be swallowed with minimal patient discomfort, thereby obviating sedation. Second, by imaging via directed laser light, the TCE is strategically positioned to employ several burgeoning laser-based diagnostic technologies, such as narrow-band, hyperspectral, and fluorescence imaging. It is believed that the combination of such imaging techniques with novel biomarkers of dysplasia will greatly assist in identifying precancerous; conditions such as Barrett's esophagus (BE). As the probe is swallowed, the fiber scanner captures high resolution, wide-field color images of the gastroesophageal junction (500 lines at 0.05-mm resolution) currently at 15-Hz frame rate. Video images are recorded as the capsule is slowly retracted by its tether. Accompanying software generates panoramic images from the video output by mosaicing individual frames to aid in pattern recognition. This initial report describes the rationale for the unique TCE system design, results from preliminary testing in vitro and in vivo, and discussion on the merits of this new platform technology as a basis for developing a low-cost screening program for esophageal cancer.