Developing an Artificial Intelligence-Enabled Capsule Endoscopy cum Endoscopic Ultrasound Device for Evaluation of Digestive Diseases and GI Cancers

This project aims to develop an artificial intelligence enabled magnetically controlled wireless capsule for endoscopy cum endoscopic ultrasound that will be patient friendly, physician friendly and remotely deployable will revolutionize the early diagnosis and treatment of digestive diseases including GI cancer and help save lives and improve outcomes.

In the year 2019, worldwide 4% of common diseases had a gastrointestinal etiology. In 2019, there were 7.32 billion cases of gastrointestinal disease and 2.86 billion total cases of gastrointestinal disease, resulting in 8 million deaths and 277 million disability-adjusted life years (DALYs). Gastrointestinal diseases, including gastritis, IBS, peptic ulcer disease and gastrointestinal cancer, are common in the general population, posing a serious threat to human health and a huge economic burden. In 2018, an estimated 4.8 million new gastrointestinal cancers were diagnosed worldwide and 3.4 million related deaths. Gastrointestinal cancer accounts for 26% of global cancer incidence and 35% of all cancer-related deaths. Gastrointestinal malignancies, namely stomach (about 1.0 million new cases in 2018), liver (840,000 cases), esophagus (570,000 cases), pancreatic (460,000 cases) and colon (1.8 million cases). Most gastrointestinal cancers involve multiple pathological changes, including atrophic gastritis, intestinal metaplasia, dysplasia, and adenocarcinoma, and the risk of gastrointestinal cancer increases progressively in this series of cascade reactions. Most patients with gastric cancer and patients with precancerous lesions do not have specific symptoms. In the absence of effective early screening methods, early diagnosis and treatment are usually low. Therefore, early diagnosis and treatment of gastric cancer and precancerous lesions are essential to reduce gastrointestinal cancer-related mortality and increase the survival of patients with gastrointestinal cancer.

Traditional fiberoptic gastroscopy is considered the best for detecting gastric diseases. However, due to the unpleasant and uncomfortable examination process of unsedated gastroscopy, patients may refuse the necessary endoscopy. Although patients accept painless gastroscopy, it increases costs and risks. In addition, due to limitations of endoscopic equipment and experienced physicians, its use in gastric disease in the general population is limited. Therefore, as an alternative to traditional gastroscopy, a simpler and less invasive control method is needed to increase the early diagnosis and treatment of stomach diseases in the population. Conventional endoscopy evaluates the gastrointestinal (GI) tract with a flexible probe equipped with either an optical image sensor (and light source) or an ultrasound transmitting device. These images of the internal GI structure help diagnose a number of digestive diseases. However, traditional endoscopy requires the use of highly trained personnel, is uncomfortable for patients, and sometimes requires the use of sedation or even anesthetics. In addition, it cannot easily examine all parts of the digestive tract (such as the small intestine). This led to the development of capsule endoscopy, which is an endoscopy performed in the form of a capsule. Capsule endoscopy (CE) also integrates optical sensors in an easily swallowed capsule which allows a minimally invasive examination of the entire digestive tract. Endoscopic ultrasound (EUS), which is a routinely used clinical imaging technique for examining the mucosa of the esophagus and stomach, as well as the walls of the upper and lower gastrointestinal tract. EUS is also useful in evaluating the biliopancreatic region in both benign and malignant disease. Conventional EUS typically uses ultrasound frequencies between 5 and 18 MHz, corresponding to an axial resolution of 0.2 to 0.8 mm and a depth of 2 to 8 cm. Low-frequency (5-20 MHz) imaging enables the observation of organs outside the digestive tract wall, while higher frequencies (>20 MHz) provide a more detailed image of the intestinal wall at the expense of less penetration.

In recent years, there have been successive advances in capsule endoscopy technology, including magnetic guided capsule endoscopy (MCCE) dedicated to the study of gastric diseases. In 2010, development of a portable magnetically steered capsule.

Group Leader

Kunal Das, Lindau Alumnus 2003

Yashoda Super Speciality Hospital, Ghaziabad, Indian