Optical colonoscopy facilitates the detection and removal of premalignant polyps and is the gold standard as a screening and surveillance tool for colorectal cancer (CRC). Despite the demonstrated track record of the procedure, a number of factors limit patient acceptance of this test.
Concerns about adverse events, the required colon-cleansing prep, the need for sedation and pain control, loss of work time, and costs associated with optical colonoscopy are among the issues that negatively affect patient tolerance.
In addition, inadequate cleansing before the test can reduce cancer detection rates and lead to the need for repeat procedures.
Mayo Clinic researchers, in collaboration with others, are working to assess and advance capsule-based technology for CRC screening. According to Elizabeth Rajan, M.D., a gastroenterologist and researcher from Mayo Clinic’s campus in Rochester, Minnesota, one of the newest capsule imaging systems currently being studied is a prepless, disposable and ingestible X-ray imaging capsule.
Prepless, disposable and ingestible X-ray imaging capsule
Prepless, disposable and ingestible X-ray imaging capsuleEnlarge image
The capsule system that Dr. Rajan and others are studying uses an ingestible capsule that emits and detects ultra-low-dose radiation and requires no cathartic cleansing or separation. The capsule generates a 3D reconstruction of the colonic lumen for detection of polyps and cancer. The system also includes a tracking device that utilizes processing units combined with radiofrequency (RF) communication to allow data transmission to an externally worn recorder attached to the lower back. In addition, it utilizes electromagnetic tracking technology to enable the device to track the capsule’s 3D position and orientation within the body.
After ingesting the capsule, patients drink a small amount of contrast agent and fiber supplements with each meal during the capsule passage. Patients can go about their daily activities and return to work. While the capsule travels naturally through the gastrointestinal tract, it scans the colon in a 360-degree arc and sends information to a recorder. Once the capsule is extracted, data from the recorder is downloaded to a workstation and analyzed to create a map of the colon.
Results from clinical trials
Safety and convenience
Researchers from Germany and Israel first assessed the safety of this new generation of the prepless capsule system in two separate studies. The results of those studies were published in Abdominal Radiology in 2017 and demonstrated the safety and feasibility of this device in 141 study participants.
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