The adjustment of the capsule endoscopy screening for colorectal cancer

Technology Agency for Healthcare Research and Quality has recommended screening for colon cancer medium-risk adults aged between 50 and 75 with one of the following: annual testing of occult blood in the stool, sigmoidoscopy every 5 years or colonoscopy every 10 years. However, since 2005, only 59 percent of people aged 50 or older were examined according to these recommendations, and only 50 percent had had a procedure for colon endoscopy (sigmoidoscopy or colonoscopy or, screening techniques that displays both the colon and rectum and remove precancerous polyps) in the last 10 years. The PillCam ® COLON capsule endoscopy measuring only 31 millimeters to 11 meters and contains a miniature video camera at each end of the capsule. (Photo: Given Imaging) The PillCam ® COLON capsule endoscopy measuring only 31 millimeters to 11 meters and contains a miniature video camera at each end of the capsule. (Photo: Given Imaging) Many factors contribute to low rates of endoscopic control, including a shortage of trained medical personnel to perform technical, disparities in access, and the reluctance of people to undergo invasive procedures for screening. "Have a place for a colonoscopy tube is something that is unpleasant for many people think," said Dr. Stephen Taplin, a senior scientist in NCI's Division of the fight against cancer and Population Sciences, Applied Research Program (ARP). One way to increase screening rates for colorectal cancer in May to develop new control technologies that are simpler, more accessible and acceptable to participants. A small device smaller than a fingertip futuristic called endoscopic capsule is being tested and improved to what its developers hope will be a place in the arsenal of cancer screening. Viewing the "black box" of the body Originally developed to explore the small bowel, small bowel, capsule endoscopy (CE) is a small device the size of a large vitamin pill, containing a light, a miniature camera and transmitter that sends images a recording device worn by the patient during the procedure. A patient swallows the CE mark, as a pill, and the capsule is propelled through the digestive system to the normal circulation of the intestine, which transmits images of the intestinal wall along its path. Approved by the FDA for the diagnosis of diseases of the small intestine in 2001, EC has revolutionized medicine in the small intestine, which allows non-invasive imaging of a body part that was previously inaccessible except by exploration surgery. The image of a colon cancer from the PillCam ® COLON. In the first clinical trial of colon capsule endoscopy, PillCam ® COLON identified 14 of the 19 cancers detected by colonoscopy. (Photo: Given Imaging) Image of colon cancer from the PillCam ® COLON. In the first clinical trial of colon capsule endoscopy, PillCam ® COLON identified 14 of the 19 cancers detected by colonoscopy. (Photo: Given Imaging) One of three companies that produce small intestine-EC now has developed a version for the colon, in the hope of producing a less invasive traditional endoscopy for screening for cancer of the rectum and colon. The colon EC has not been approved by the FDA for use in the United States, but is currently being tested in clinical trials and explored by researchers interested in its potential applications. The expectations are not met in the first large trial The EC-colon new imager that contains two videos, one at each end of the antenna, and captures images at a speed of four frames per second, was recently tested in an international clinical trial led by researchers at the University Libre de Bruxelles in Belgium and the manufacturer, Given Imaging, to Yokneam, Israel. The researchers recruited 332 patients with known or suspected disease of the colon in the process. Each patient underwent two EC and the standard colonoscopy the same or the following. Although the capsule was found to be safe, the system of preparation that was necessary to cleanse the bowel (including a clear liquid diet and laxatives) was more active than the speed of standard colonoscopy and the sensitivity of capsule was higher than colonoscopy (which is supposed to have a maximum sensitivity of just over 90 per cent). Advanced adenomas of any size were detected in 52 patients with colonoscopy, but only in 44 patients with EC. Nineteen tumors were detected by colonoscopy, but only 14 of them were considered by the capsule. "With the relatively low sensitivity of the capsule for the detection of lesions of the colon-rectum, [and] his need for more extensive cleaning of the colon compared with colonoscopy and CT Colonography plans ... capsule endoscopy of the colon can not be recommended in this time, "said Dr. Michael Bretthauer Rikshospitalet University Hospital in Oslo in an editorial that accompanied the publication of trial July 16 in The New England Journal of Medicine. The challenges and promises A number of challenges that are on the path of colonic EC to be ready for the clinic, including improved sensitivity, which is related to the amount of data that can be captured by the imaging device, and errors human that may arise in order to analyze large amounts of captured video. Reduce the cost for each procedure will be necessary. Dr. Ram Sriram, a group leader with the National Institute of Standards and Technology Manufacturing Engineering Laboratory, and colleagues at the Laboratory of Information Technology, with contributions from the Asian Institute of Gastroenterology, they are designing software to help the image analysis to automate small - intestinal EC to speed up analysis time (and therefore lower costs) and reduce the risk of human error. Similar software could help reduce costs and increase the accuracy of the EC colon, as well, but before the capsule must be able to capture enough data to software engineers for analysis. The colon is much broader than that of the small intestine, making it more difficult to develop sufficiently sensitive colon EC. Even with a slightly larger, the capsule tends to move a lot and has no accent, if you do not get as many pictures as you need, "said Dr. Sriram." Once you can take pictures so the engineers can do image processing to make technology more responsive. " The issue of simplification of the complex intestinal preparation currently required for colon EC is not insignificant: it is a huge problem, because the preparation is another aspect of the colonoscopy, many people don ' love it, "said Dr. Taplin. But the potential benefits of colon EC likely keep researchers focused on improving technology. For example, CBS promise for telemedicine applications, "said Dr. Sriram, such as helping patients in remote areas who can not travel to see a specialist screening or diagnosis. Furthermore, if improved, low-cost colon EC could be administered by a practitioner, rather than a specialist, which could remove the obstacle of planning, and make it easier for patients to obtain a access "said Taplin." The improvement of any type of screening process is not only to improve the technology, it is to streamline the entire process to make it work "