Medical Musings: Swallow hard for these exams

February 03, 2012

A fascinating, rapidly emerging concept in the medical field is use of a capsule that is swallowed and captures images that are remotely reviewed. In current versions, the pill-sized plastic capsules take photos at random intervals, a technique that isn't considered adequate for cancer screening.

Newer systems are elaborate and much higher-tech. Two recently caught my attention.

This illustration from a Check-Cap patent is a detailed look at the capsule. 60 refers to the radiation source; 64 is a control unit; and 62 is a detector.

An Israeli company called Cap-Check uses an imaging capsule that contains a tiny device that transmits X-rays, with minimal radiation, to the intestinal wall and back. The analysis of distances creates three-dimensional images of the colon's internal surface. That allows the detection of polyps within the same range of accuracy as standard colonoscopy. Bowel cleansing is unnecessary, since X-ray technology, unlike optics, can "see through" colon content. The information is transmitted to a device like a wristwatch.

Huge market

"Check-Cap intends to establish the next gold standard in colon cancer screening, meeting the enormous medical need of an estimated 35 million patients annually in a fast-growing $25B market," the company states on its Web site.

GE yesterday announced it is investing in Check-Cap and will develop, design and produce miniature cadmium-zinc-telluride (CZT) diagnostic imaging sensors inside each Check-Cap capsule.

Check-Cap expects to introduce its capsule in the European Union in late 2013, subject to CE Mark regulatory approval. The company also is working with the United States Food & Drug Administration to gain entry to the United States market.

Swimming capsules

Another interesting approach to colonoscopies is under development at Brigham & Women's Hospital in Boston. In this approach, a plastic capsule is guided by a conventional MRI (magnetic resonance imaging) machine that rotates tiny wire coils in the capsule. That creates a tail-like motion, propelling the capsule inside a human body. Images are delivered in real time to doctors who can guide the capsule to explore areas of interest.

The work is being funded by the Center for Integration of Medicine and Innovative Technology, a consortium of hospitals and universities in Boston. The research team is looking for a commercial sponsor.

One of the drawbacks is the significant cost of using an MRI machine--up to $1,000 an hour.

My colleague, Stephen Moore, reported on a swallowable type of device last year.

These  capsules are not major markets for plastics, but they show the important role plastics play in enabling medical innovations.


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