Chromoendoscopy in magnetically guided capsule endoscopy

BioMedical Engineering OnLine

Philip W Mewes⁴  Stefan Foertsch³  Aleksandar Lj Juloski⁴  Elli Angelopoulou²  Stefan K Goelder¹  Dirk Guldi³  Joachim Hornegger⁴  Helmut Messmann¹ 

[1] Medizinische Klinik III, Klinikum Augsburg, Stenglinstr.2, Augsburg 86156, Germany

[2] Pattern Recognition Lab, University of Erlangen-Nuremberg, Martensstrasse 3, Erlangen Germany

[3] Department of Chemistry and Pharmacy, Friedrich-Alexander University, Egerlandstr. 3, Erlangen 91058, Germany

[4] Siemens AG, Healthcare Sector, Allee Am Roethelheimpark 2, Erlangen 91052, Germany

关键词: Staining;    Indigo carmine;    Methylene blue;   

Others  :  797830
DOI  :  10.1186/1475-925X-12-52

 received in 2013-03-08, accepted in 2013-06-05,  发布年份 2013

【 摘 要 】

Background

Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study.

Methods

We propose a modified preparation protocol which adds a staining step to the existing MGCE preparation protocol. An optimal staining concentration is quantitatively determined for different stain types and pathologies. To that end 190 pig stomach tissue samples with and without lesion imitations were stained with different dye concentrations. Quantitative visual criteria are introduced to measure the quality of the staining with respect to mucosa and lesion visibility. Thusly determined optimal concentrations are tested in an ex-vivo pig stomach experiment under magnetic guidance of an endoscopic capsule with the modified protocol.

Results

We found that the proposed protocol modification does not impact the visibility in the stomach or steerability of the endoscopy capsule. An average optimal staining concentration for the proposed protocol was found at 0.4% for Methylene blue and Indigo carmine. The lesion visibility is improved using the previously obtained optimal dye concentration.

Conclusions

We conclude that chromoendoscopy may be applied in MGCE and improves mucosa and lesion visibility. Systematic evaluation provides important information on appropriate staining concentration. However, further animal and human in-vivo studies are necessary.

【 授权许可】

   
2013 Mewes et al.; licensee BioMed Central Ltd.

【 图 表 】

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