A Novel Control Method of Magnetic Navigation Capsule Endoscope for Gastrointestinal Examination

Abstract:

Magnetic navigation capsule endoscopy (MNCE) has been widely used for gastric examination because of its advantages of high examination accuracy, speed, and minimal injury. However, the insufficient driving force and single control strategy of currently commercialized products have become challenges for applying in the active inspection of the intestinal tract. To solve these problems, based on the existing cardiac interventional magnetic navigation system, the MNCE system with a dual-joystick navigation control method is proposed, which can achieve manipulation of the position and posture of the capsule endoscope for the whole gastrointestinal (GI) tract. The maximum workspace of the system has an opening diameter of 480 mm, the control region is a spherical area with a diameter of 200 mm, the magnetic field is 0.15 T, the maximum driving force is 250 mN, and the average inspection speed is 6.4 mm/s. The results of model tests and ex vivo experiments demonstrate that the system can generate sufficient force to drive the capsule and achieve the 3-D precision inspection of the GI tract. It also proves the engineering feasibility of the proposed control method, which significantly improves the inspection efficiency and is expected to rapidly promote the system to clinical applications.

摘要：

磁导航胶囊内窥镜（MNCE）具有检查准确率高、速度快、损伤小等优点，已被广泛应用于胃部检查。然而，目前商品化产品的驱动力不足、控制策略单一，已成为应用于肠道主动检查的挑战。针对这些问题，在现有心脏介入磁导航系统的基础上，提出了双摇杆导航控制方式的MNCE系统，可实现对整个胃肠道（GI）的胶囊内窥镜的位姿操纵。系统最大工作空间直径为480 mm，控制区域为直径为200 mm的球形区域，磁场为0.15 T，最大驱动力为250 mN，平均检测速度为6.4毫米/秒。模型试验和体外实验结果表明，该系统可以产生足够的力来驱动胶囊，实现胃肠道的3D精密检查。这也证明了所提出的控制方法的工程可行性，显着提高了检测效率，有望迅速将该系统推广到临床应用。

 In this paper, based on the existing cardiac intervention magnetic navigation (CIMN) [28], an MNCE system for GI examination is developed in the Institute of Electrical Engineering, Chinese Academy of Science (IEE, CAS), which is composed of 8 symmetrically distributed iron core electromagnetic structures (Fig. 1). The MNCE system could provide a workspace with a diameter of 480 mm and a spherical controllable region with a diameter of 200 mm, which is enough to accommodate adults with normal weight. The electromagnetic system provides a central maximum magnetic flux density of 0.15 T and a maximum driving force of 250 mN. In addition, the proposed dual-joystick navigation control method includes two current control methods and three joystick control modes, in which the asynchronous control mode can especially increase the checking efficiency.

本文在现有心脏介入磁导航（CIMN）[28]的基础上，中国科学院电工研究所（IEE，CAS）研制了一套用于胃肠道检查的MNCE系统，该系统由8个对称组成 分布式铁芯电磁结构（图1）。 MNCE系统可以提供一个直径为480 mm的工作空间和一个直径为200 mm的球形可控区域，足以容纳正常体重的成年人。 电磁系统提供0.15 T的中心最大磁通密度和250 mN的最大驱动力。 此外，所提出的双摇杆导航控制方法包括两种电流控制方法和三种摇杆控制模式，其中异步控制模式尤其可以提高检查效率。

The application of CIMN and MNCE follows that the controllable magnetic field is generated by external equipment to drive an object containing permanent magnets for diagnosis and treatment. Table Ⅱ summarizes the comparison of CIMN and MNCE. According to different controlled objects and physical environments, different control methods need to be developed. Here, the control methods of the large-cavity heart and the stomach are similar, but the dynamic environment of the heart needs a dynamic control method, which controls the catheter to follow the heartbeat to prevent perforation events. The flexible dual-joystick control method is more suitable for narrow and curved bowel examinations. In terms of control, CIMN requires higher precision than MNCE. In addition, CIMN makes more use of magnetic torque to drive the tip of the catheter to change direction. The length of the catheter advancing is controlled by a stepping motor. GI examination adopts an unfettered capsule, and the posture and position of the capsule can achieve a higher degree of freedom. With the new type of controlled carriers, the magnetic navigation system will be expected to realize drug delivery, biopsy, targeted therapy, and wider applications.

In this paper, based on the existing CIMN system, the MNCE system integrated with a novel dual-joystick navigation control methodology is presented, which could perform capsule endoscope movement for the digestive tract examination. Model tests and ex-vivo experiments proved the feasibility of three control modes in the stomach and intestine. In ex-vivo experiments, a complete three-dimensional intestinal examination process, including lesion detection, movement pattern test, and round-trip movement is successfully demonstrated. In conclusion, the MNCE system with the dual-joystick control strategy provides a more flexible and active intestinal examination.

In future, to achieve precise and intelligent inspection of the digestive tract, medical imaging (X-ray, ultrasound), electromagnetic wave (radio frequency), magnetic field positioning system for closed-loop control of the capsule endoscope will be developed. At present, the method of shielding X-ray detectors with permalloy shells effectively reduces image distortion.The existing X-ray imaging system will be applied to in-vivo experiments and evaluate the control performance of the MNCE system. Furthermore, the next-generation miniaturized equipment will be manufactured to develop a path to clinical application.

TABLE Ⅱ

The Comparison of CIMN and MNCE

Application	CIMN	MNCE
Controlled object	Catheter	Capsule endoscope
Physical environment	Heart (Dynamic, large cavity)	Stomach (Large cavity) Intestine (Narrow, curved cavity)
Control principle	Magnetic torque combined with stepper motor drive	Magnetic torque(Magnetic field direction) and gradient control
Control precision	Higher	General

本文在现有 CIMN 系统的基础上，提出了一种结合新型双操纵杆导航控制方法的 MNCE 系统，该系统可以进行胶囊内窥镜移动以进行消化道检查。模型试验和离体实验证明了三种控制模式在胃和肠中的可行性。在离体实验中，成功演示了完整的肠道三维检查过程，包括病变检测、运动模式测试和往返运动。总之，具有双操纵杆控制策略的 MNCE 系统提供了更加灵活和主动的肠道检查。

 原文链接