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Tethered capsule endomicroscopy enables less invasive imaging of gastrointestinal tract microstructure


Here we introduce tethered capsule endomicroscopy, which involves swallowing an optomechanically engineered pill that captures cross-sectional microscopic images of the gut wall at 30 μm (lateral) × 7 μm (axial) resolution as it travels through the digestive tract. Results in human subjects show that this technique rapidly provides three-dimensional, microstructural images of the upper gastrointestinal tract in a simple and painless procedure, opening up new opportunities for screening for internal diseases.

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Figure 1: Tethered capsule endomicroscopy schematics.
Figure 2: Tethered capsule endomicroscopy.
Figure 3: Tethered capsule endomicroscopy data from a patient with a diagnosis of Barrett's esophagus and high-grade dysplasia, and intramucosal carcinoma.

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  1. Cullen, K.A., Hall, M.J. & Golosinskiy, A. Ambulatory surgery in the United States, 2006. Natl. Health. Stat. Report. 1–25 (2009).

  2. Maffei, M. & Dumonceau, J.M. Transnasal esogastroduodenoscopy (EGD): comparison with conventional EGD and new applications. Swiss Med. Wkly. 138, 658–664 (2008).

    PubMed  Google Scholar 

  3. Wasielica-Berger, J., Baniukiewicz, A., Wroblewski, E., Chwiesko, A. & Dabrowski, A. Magnification endoscopy and chromoendoscopy in evaluation of specialized intestinal metaplasia in Barrett's esophagus. Dig. Dis. Sci. 56, 1987–1995 (2011).

    Article  Google Scholar 

  4. Seibel, E.J. et al. Tethered capsule endoscopy, a low-cost and high-performance alternative technology for the screening of esophageal cancer and Barrett's esophagus. IEEE Trans. Biomed. Eng. 55, 1032–1042 (2008).

    Article  Google Scholar 

  5. Yun, S.H. et al. Comprehensive volumetric optical microscopy in vivo. Nat. Med. 12, 1429–1433 (2006).

    Article  CAS  Google Scholar 

  6. Evans, J.A. et al. Identifying intestinal metaplasia at the squamocolumnar junction by using optical coherence tomography. Gastrointest. Endosc. 65, 50–56 (2007).

    Article  Google Scholar 

  7. Evans, J.A. et al. Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett′s esophagus. Clin. Gastroenterol. Hepatol. 4, 38–43 (2006).

    Article  Google Scholar 

  8. Poneros, J.M. et al. Diagnosis of specialized intestinal metaplasia by optical coherence tomography. Gastroenterology 120, 7–12 (2001).

    Article  CAS  Google Scholar 

  9. Ramirez, F.C., Shaukat, M.S., Young, M.A., Johnson, D.A. & Akins, R. Feasibility and safety of string, wireless capsule endoscopy in the diagnosis of Barrett's esophagus. Gastrointest. Endosc. 61, 741–746 (2005).

    Article  Google Scholar 

  10. Kiesslich, R., Goetz, M., Vieth, M., Galle, P.R. & Neurath, M.F. Confocal laser endomicroscopy. Gastrointest. Endosc. Clin. N. Am. 15, 715–731 (2005).

    Article  Google Scholar 

  11. Wallace, M.B. & Fockens, P. Probe-based confocal laser endomicroscopy. Gastroenterology 136, 1509–1513 (2009).

    Article  Google Scholar 

  12. Quirini, M. et al. Feasibility proof of a legged locomotion capsule for the GI tract. Gastrointest. Endosc. 67, 1153–1158 (2008).

    Article  Google Scholar 

  13. Kim, B., Lee, M.G., Lee, Y.P., Kim, Y. & Lee, G. An earthworm-like micro robot using shape memory alloy actuator. Sens. Actuators A Phys. 125, 429–437 (2006).

    Article  CAS  Google Scholar 

  14. Vakoc, B.J., Tearney, G.J. & Bouma, B.E. Real-time microscopic visualization of tissue response to laser thermal therapy. J. Biomed. Opt. 12, 020501 (2007).

    Article  Google Scholar 

  15. Yun, S., Tearney, G., de Boer, J., Iftimia, N. & Bouma, B. High-speed optical frequency-domain imaging. Opt. Express 11, 2953–2963 (2003).

    Article  CAS  Google Scholar 

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We thank B. Puricelli for his valuable assistance in the conduct of the clinical studies and M. Shishkov for useful discussions pertaining to device design. This work was supported in part by US National Institutes of Health grants NIH R01DK091923 (G.J.T.) and NIH R01CA103769 (G.J.T.).

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Authors and Affiliations



M.J.G., R.W.C., K.A.G., M.J.S., B.E.B., M.R. and G.J.T. designed the devices used. J.S.S., M.J.G., M.R., L.E.K. and G.J.T. designed the study. J.S.S., N.S.N., L.E.K., K.A.G., M.J.G. and G.J.T. conducted the study. G.J.T., M.J.G. and K.A.G. processed the data. G.J.T. and M.J.G. wrote the manuscript, and all authors contributed to the review and editing of the manuscript.

Corresponding author

Correspondence to Guillermo J Tearney.

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Competing interests

G.J.T., B.E.B. and M.J.S. receive sponsored research funding from Ninepoint Medical. G.J.T. amd B.E.B. are consultants for Ninepoint Medical. G.J.T., N.S.N., B.E.B. and M.J.S. have the rights to receive royalties under a licensing arrangement between Massachusetts General Hospital and Ninepoint Medical.

Supplementary information

Supplementary Video 1

Tethered capsule endomicroscopy fall-through dataset from a normal volunteer, obtained in vivo. (MOV 60498 kb)

Supplementary Video 2

Tethered capsule endomicroscopy pull-back dataset from a patient with known Barrett's esophagus, obtained in vivo (MOV 36801 kb)

Supplementary Video 3

Three-dimensional fly through movie, rendered from the Supplementary Movie 2 dataset (MOV 47758 kb)

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Gora, M., Sauk, J., Carruth, R. et al. Tethered capsule endomicroscopy enables less invasive imaging of gastrointestinal tract microstructure. Nat Med 19, 238–240 (2013).

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