WO2009061007A1 - Capsule blood detection system and method - Google Patents

Capsule blood detection system and method Download PDF

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Publication number
WO2009061007A1
WO2009061007A1 PCT/JP2008/070825 JP2008070825W WO2009061007A1 WO 2009061007 A1 WO2009061007 A1 WO 2009061007A1 JP 2008070825 W JP2008070825 W JP 2008070825W WO 2009061007 A1 WO2009061007 A1 WO 2009061007A1
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WO
WIPO (PCT)
Prior art keywords
capsule
detector
blood content
light
calibration
Prior art date
Application number
PCT/JP2008/070825
Other languages
French (fr)
Inventor
Kazuhiro Gono
Takeshi Suga
Original Assignee
Olympus Medical Systems Corp.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Medical Systems Corp. filed Critical Olympus Medical Systems Corp.
Priority to EP08847506.6A priority Critical patent/EP2227133B8/en
Priority to KR1020107010172A priority patent/KR101140036B1/en
Priority to JP2010517225A priority patent/JP2011502554A/en
Priority to CN200880115052.6A priority patent/CN101848673B/en
Publication of WO2009061007A1 publication Critical patent/WO2009061007A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/041Capsule endoscopes for imaging
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002Operational features of endoscopes
    • A61B1/00057Operational features of endoscopes provided with means for testing or calibration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147Holding or positioning arrangements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/042Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by a proximal camera, e.g. a CCD camera
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/06Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/06Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/065Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/07Endoradiosondes
    • A61B5/073Intestinal transmitters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02Operational features
    • A61B2560/0223Operational features of calibration, e.g. protocols for calibrating sensors

Definitions

  • the invention relates to the use of capsule type endoscopes in patients. More specifically, the invention relates to detecting, positioning, and calibrating capsule type endoscopes for use in a living patient with the goal of utilizing blood content detection to locate and determine abnormalities in living tissue.
  • Endoscopes have long been used by physicians to enter the internal area of a patient in order to carry out a function at that location.
  • the endoscope comprises an optical system and an illumination system that enable the physician to locate the distal end of the endoscope in the desired area to enable the physician to view that area at a location external of the patient.
  • capsule endoscopes which are capsules containing image capture devices, such as digital cameras, that are swallowed by the patient and travel to a location of interest within the patient, such as the intestinal track, to study the colon in a search for lesions. Once at that location, the capsule endoscope gathers captured images to aid the physician to carry out some diagnosis of the patient.
  • the invention relates to swallowable capsules having the capability to measure blood content of tissue comprising, for example, the digestive track.
  • Exemplary configurations of such devices are described in related corresponding patent applications entitled “Method and Solution for Correlating Image and Tissue Characteristic Data” and “Blood Content Detecting Capsule” co-filed herewith and incorporated by reference herein.
  • Such devices enable doctors and clinicians to detect EIBS for screening of lesions or tumors or when combined with image capture devices within the capsules facilitate the location of cancerous and pre-cancerous lesions or tumors.
  • Exemplary configurations for such capsule include, for example, a light source that emits polarized light onto a region of the superficial mucous membrane and a light detector that receives light interacted with that tissue and the hemoglobin contained therein.
  • the interacted light from the tissue is returned at a different polarization angle than the emitted light.
  • This return angle and magnitude of the detected interacted light can be measured and is indicative of the blood content in that mucus tissue.
  • the information relative to the blood content can be transmitted by the capsule to a receiving instrument external of the patient so that the physician can monitor the blood content in the tissue and use that information in determining the existence or proximate location of a lesion.
  • a technique for the measurement of Hb through the use of polarized light has been disclosed in Y. L.
  • a capsule is provided that is small enough to be swallowed by a patient and it has a blood content detector contained therein.
  • the blood content detector includes a light source and a light detector oriented such that polarized white light from the light source travels through a measurement widow formed in the capsule to impinge upon living tissue of the patient where interacted light from the tissue and hemoglobin contained therein is detected by the light detector.
  • the angle of the reflected light is analyzed as indicative of blood content in that tissue and generates signals representative of that blood content that are transmitted to a data processing means, such as a computer, where the information as to the blood content is processed and made available to a user.
  • the present invention includes various means to orient the capsule so that it is in actual contact with the tissue being analyzed and the light impinges upon the tissue.
  • one embodiment uses the shape of the capsule to achieve the desired orientation.
  • Another embodiment provides weights strategically located within the capsule to bring about the desired orientation and yet another embodiment has the blood content detector mounted within an inner module that is movable within an outer capsule.
  • mirrors are provided to direct the light from the illuminating means to the light receiving means in order to further miniaturize the capsule.
  • the present invention also includes a proximity detector that detects the proximity of the capsule detector to the living tissue and, in particular, to verify when there is an actual contact between the capsule and that tissue.
  • the proximity detector can be of various types and may include a distance detection system that determine the distance between the capsule and the living tissue so that a signal can be provided as that actual contact is imminent so that a blood content measurement can be taken at the time of contact.
  • Fig 1 is a schematic view of an exemplary in vivo sensing system in accordance with the present invention.
  • Fig. 2 is a cross sectional diagram showing an exemplary capsule constructed in accordance with the present invention.
  • Fig. 3 is block diagram illustrating the functions carried out within an exemplary processing apparatus of the present invention.
  • Fig. 4 is a cross sectional schematic showing an exemplary shape of a capsule in accordance with the present invention.
  • Fig. 5 is cross sectional schematic showing a further exemplary embodiment of the invention.
  • Fig. 6 is a cross sectional diagram showing another exemplary embodiment of the present invention.
  • Figs. 7A-7B are cross sectional diagrams illustrating the exemplary use of weights to position a blood content detector of the present invention.
  • Fig. 8 is a cross sectional diagram illustrating an alternate orientation system of the present invention relative to that shown in Figs. 7A-7B.
  • Figs. 9A-9D are cross sectional diagrams illustrating a further orientation system of the present invention.
  • Fig. 10 is a schematic view of an alternate embodiment of the present invention using mirrors to guide the light traveling to and from the tissue of the patient.
  • Fig. 11 is a schematic view of a further exemplary embodiment utilizing mirrors in the light path.
  • Fig. 12 is a cross sectional diagram of the present capsule having various proximity detecting systems.
  • Fig. 13 is a graph plotting time vs. distance between a capsule and the living tissue of a patient.
  • Fig. 14 is a cross sectional diagram illustrating a calibration system usable with the present invention.
  • Fig. 15 is a cross sectional diagram illustrating an alternate calibration system usable with the present invention.
  • Fig. 1 there is shown a schematic view of an in vivo sensing system illustrating the use of the present invention.
  • a capsule 10 that is moving slowly in a colon 12 of a patient 14 and an external processing unit 16 that receives data sent from the capsule 10, analyzes that data and displays the result.
  • the stream of data and information can be, for example, communicated wirelessly along a path 18 to the external processing unit 16.
  • two pieces of spectrum information of body living tissue are acquired to obtain information about the blood content in the superficial portion of the mucous membrane or other living tissue.
  • This embodiment uses a polarization spectrum of a first orientation having the same polarization direction as incident light from a capsule light source, referred to as a horizontal polarization and a corresponding orthogonal polarization spectrum which has the polarization direction perpendicular to incident light from the capsule light source.
  • a technique for determining the hemoglobin content of tissue through the use of polarized light has been disclosed in Y. L. Kim, Y. Liu, R. K. WaIi, H. K. Roy, M. J. Goldberg, A. K. Kromin, K. Chen, and V.
  • a difference operation between the first or horizontal polarization spectrum and the perpendicular polarization spectrum is performed in the capsule 10 and the result is transmitted to the processing unit 16. It is alternatively suitable in accordance with the invention for the difference operation to be carried out in the processing unit 16 or other external device whereby data indicative of the horizontal polarization spectrum and the perpendicular spectrum are sent to the processing unit 16 by the capsule 10.
  • the capsule 10 comprises an enclosure 20 with the components of the device encased within the enclosure 20.
  • the enclosure 20 is designed to be of a size that is relatively easy for a patient to swallow and can generally have a diameter of approximately 10 mm.
  • a blood content detector 22 which includes various components used to determine the blood content of living tissue by means of an optical detector.
  • a light detector 28 and a light source 24 including, for example a white LED 26.
  • the path of the light travels in the direction of the arrows A, where the wide angle light is absorbed by a light absorbing member 30 so that only a narrow angle of light (close to parallel light) can pass through an opening 32 after passing through a linear polarizing element 34 where the light is polarized.
  • a suitable size of an illumination region can be, for example, in the range of approximately 0.1 mm 2 and 100 mm 2 .
  • the polarized light thereafter passes through a lens 36 and an opening 32 and the linear polarizing element 34 are disposed along the location of the focal length of the lens.
  • the light coming for the light source 24 is a narrow-angle light that impinges on a small region of tissue.
  • it is possible to alter the direction in which the parallel light travels by using a lens to direct through a measurement window 38 to impinge upon a living tissue 40 of the patient in vivo.
  • Interacted light from the living tissue 40 and the hemoglobin contained therein returns along the direction of the arrows B to the light detector 28 as light with a specific reflection angle.
  • the return interacted light passes again through the optical light path converter 36 where the light thereafter passes through two linear polarizing elements, that is, a first linear polarizing element 42 and a second linear polarizing element 44 that are orthogonal to each other.
  • the linear polarizing elements 42 and 44 transmit beams of polarized light perpendicular to each other and the polarization direction of the first linear polarizing element 42 of the light receiving means 28 is the same as that of the linear polarizing element 34 of the illuminating means 24, and the second linear polarizing element 44 passes through the polarization spectrum orthogonal thereto. Beams of light that have been transmitted through each of the linear polarizing elements 42, 44 are passed on by a transmissive grating 46 in the directions with the different diffusion angles for each wavelength of light. That light then is sensed by a light sensor 48.
  • a light sensor 48 which enables spectroscopy in two kinds of polarization states; the horizontal polarization spectrum and the perpendicular polarization spectrum.
  • Measured spectrum data is then sent to a data transmitter 50 where it is transmitted to the processing unit 16 of Fig. 1.
  • a power supply 52 powers the components of the capsule 10.
  • Fig. 3 there is shown a block diagram illustrating the functions carried out within the processing unit 16. Initially there is a data receiving means 54 that receives the information and data from the capsule 10 (Fig. 1) via an antenna 56.
  • a data receiving means 54 that receives the information and data from the capsule 10 (Fig. 1) via an antenna 56.
  • wireless radio transmission is expected, data transmission using alternative techniques such as acoustic or infrared schemes are likewise useable in accordance with the invention.
  • Equation (1) shows an example of white correction.
  • represents wavelength.
  • ⁇ I ( ⁇ ) indicates the measured difference polarization spectrum.
  • ⁇ lw( ⁇ ) is a spectrum measured by using what is known as a standard white plate and is calculated by summing the white horizontal polarization spectrum Iw 11 (X) and the white perpendicular polarization spectrum Iw x ( ⁇ ), as shown in the denominator of equation (1) .
  • the difference between the horizontal polarization spectrum In ( ⁇ ) and the perpendicular polarization spectrum I ⁇ ( ⁇ ) is calculated in the data transmitter 50 and a signal indicative of ⁇ I ( ⁇ ) is transmitted by the data transmitter 50 to the processing unit 16.
  • a blood content estimator 60 calculates the blood content by using equation (2) below, which is shown in, for example, M. P. Siegel, Y. L. Kim, H. K. Roy, R. K. WaIi, and V. Backman, Assessment of blood supply in superficial tissue by polarization-gated elastic light-scattering spectroscopy, Applied Optics, Vol. 45, 335-342 (2006) .
  • the blood content estimator 60 calculates the blood quantity by using a model equation, such as equation (2), and provides a corresponding blood content value to an indicator such as, for example, a display 62.
  • the corresponding blood characteristic information can then be displayed to the user by the display 62.
  • a power supply 64 to power the processing unit 16 and a controller 66 to carry out the various control functions needed to process and display the information.
  • Fig. 4 there is shown a schematic view of exemplary embodiment of the capsule 10 wherein a cross section of the enclosure 20 is a substantially elliptical shape. Because the enclosure 20 has a substantially elliptical shape, the elongated regions along larger curvature B will more likely be positioned along tissue as it traverses the digestive tract than the region of smaller curvature A. Thus, the measurement window 38 is located in the region along the larger curvature B.
  • the measurement window 38 is disposed in that downward location.
  • the measurement window 38 is disposed in such location in Fig. 2 and the lens 36, the light source 24 and the light detector 28 are disposed on the device facing the measurement window 38 in order to direct the illumination light on a desired location of the living tissue 40.
  • While the capsule 10 in the prior exemplary embodiment is based upon orienting the measurement window by the characteristic shape of the capsule enclosure 20, a further exemplary embodiment achieves the proper orientation by means of the weight balance of the capsule enclosure 20.
  • a capsule 10 where the enclosure 20 itself is circular in cross section and weights 68 are provided proximate the measurement window 38.
  • the weights 68 are provided at a location away from the center of the capsule 10.
  • the measurement window 38 in this embodiment is located along the outer surface of the capsule enclosure 20 in the deviated direction, thus locating the measurement window 38 in the desired position contacting the living tissue 40 so as to attain the same effect as the embodiment of Fig. 4, the difference being that with this embodiment, the orientation of the capsule 10 is achieved by the addition of the weights 68, whereas with the prior embodiment, the desired orientation was achieved by the shape of the capsule 10 itself.
  • Fig 6 there is shown a cross sectional diagram showing the exemplary embodiment of Fig. 2 using the same identification numbers as were used in Fig. 2 for corresponding features.
  • weights 68 that are located at the sides of the measurement window 38 so as to orient the capsule 10 in contact with the living issue 40 in order to properly direct the light toward the living tissue 40 and to receive the return reflected light.
  • the weights 68 can be made of metal such as stainless steel or glass with a relatively high specific gravity. Even when the shape of the capsule 10 is of an elliptical shape as shown in Fig. 4, the measurement window 38 may be located in any given position by means of a weight. As can be seen in Figs. 7A and 7B, even if the measurement window cannot be disposed or located in the desired position as shown in Fig. 7A, a measurement can be made as shown in Fig. 7B. As can be seen, the weight of the weight 68 is not specified and may vary according to the design of the capsule. It is established so that the measurement window faces downwardly when the capsule 10 is disposed on a flat panel set perpendicular to the vertical direction.
  • Fig 8 there is shown a cross sectional diagram showing another exemplary embodiment of the present invention.
  • the desired orientation of the capsule 10 is achieved by deviating the center of gravity from the center of the capsule 10, i.e., that is, by changing the layout within the capsule 10.
  • the center of gravity can be made to deviate by partially placing a hollow or lightweight part 46 in the upper position so that the measurement window 38 faces downwardly to contact the living tissue 40.
  • FIGs. 9A-9D there is shown a still further exemplary embodiment of the present invention.
  • an outer capsule 72 that is comprised of a transparent material to allow the transmission of light therethrough.
  • a moveable inner module 74 having mounted therein, the blood content detector 22.
  • FIG. 9A there is a cross sectional diagram of the inner module 74
  • Fig. 9B there is a cross sectional diagram of the outer capsule 72.
  • Fig. 9C there can be seen the inner module 74 movably mounted within the outer capsule 72.
  • the movement of the inner module 74 can be accomplished by, for example, a gimbal arrangement, not shown, that can be a conventional mounting mechanism that permits the blood content detector 22 to move therein.
  • Fig. 9D there is shown a cross sectional diagram taken along the line 9D-9D of Fig. 9C illustrating the movement of the inner module 74 from its position at location X to its position at location Y. Accordingly, at position X, it can be seen that the measurement window 38 is located to the side and not facing the living tissue 40 where it must be to take a reading of the blood flow in that living tissue 40.
  • the weights 68 thus operate to bring the inner module 74 to its position at location Y where the free movement of the inner module 74 within the outer capsule 72 repositions the measurement window 38 to the desired position contacting the living tissue 40 for a blood content reading.
  • the outer capsule 72 can have a substantially circular cross-section ellipsoidal shape as well as other possible shapes.
  • Fig. 10 there is shown a schematic view of the present invention where the lens (Fig. 2) has been replaced with a mirror arrangement in order to result in further miniaturization of the capsule 10.
  • the light emitted by the light source 24 is reflected by two mirrors, a first mirror 76 and a second mirror 78 as that light passes through the window 38 to reach the living tissue 40.
  • the interacted light from the living tissue 40 is reflected off of two mirrors, the common, second mirror 78, and a third mirror 80 prior to reaching a photodetector 82.
  • the optical axis to the mirrors is inclined or at a non-90 degree angle with respect to the measurement window 38 so as to eliminate reflections from surfaces of the measurement window 38.
  • a spectroscope is suitable for the photodetector 82.
  • the illuminating light (polarized light) is emitted from the light source 24 so as to be parallel with the rotation symmetry axes of the first mirror 76 and the second mirror 78 (corresponding to the optical axes) .
  • Emitted light passes through a hole formed at the center of the first mirror 76 and reaches the surface of the living tissue 40.
  • the light interacted with the living tissue 40 is reflected by the second mirror 78 and the third mirror 80 and reaches the spectroscope (photodetector 82) .
  • the surface of the living tissue 40 is positioned at the combined focus of the first and second mirrors 76, 78 so that the position of the spectroscope of the scattered light reaches varies depending on the scattering angle. Furthermore, the scattered light becomes in parallel with the optical axis near the spectroscope.
  • the mirrors should be arranged so that the image point (of the virtual image) of the first mirror 76 when the object point is the combined focus coincides with the
  • Fig. 11 there is shown a schematic view similar to that of the Fig. 10 embodiment, however, the optical axes of the mirrors are perpendicular to the outer layer of the capsule 10 and the measurement window 38 is a wedge-shaped transparent member. This embodiment enables the reduction of stray light coming through the measurement window 38 and eliminates the need for inclining the optical axes of the mirrors as in the Fig. 8 embodiment, thereby simplifying the structure of the capsule 10.
  • Fig. 12 there is shown a simplified cross sectional diagram of the capsule 10 of the present invention and, to explain this embodiment, Fig 12 has been simplified with respect to Fig. 2 for example, it being understood that the capsule 10 of Fig. 12 can have the similar components as described with respect to Fig. 2.
  • the capsule 10 of Fig. 12 includes the capsule 20, the blood content detector 22, the illuminating means 16, the light receiving means 28 and the measurement window 38 that is shown to be contacting the living tissue 40.
  • the device it is important that the device be in actual contact with the living tissue 40 in order to obtain a valid reading of the blood content in that tissue.
  • a contact detector that alerts the user when there has been actual contact between the capsule 10 and the living tissue 40 of the patient.
  • there can be a proximity detector that senses the approach of the capsule 10 to the living tissue 40 and which includes a contacting predicting means that sends a command to the overall system to commence a measurement of the blood content in the living tissue 40 when the actual contact is imminent.
  • the term "proximity detector” will refer to a detector that senses the nearing and imminent proximity of the capsule to the living tissue as well as where the proximity is to the point where there is actual contact between the capsule and the living tissue.
  • a proximity detector that comprises an image sensor 84 such as a camera, and which is directed toward the living tissue 32 along a path that is generally proximate to the path of the illuminating directed toward that living tissue 32 by the illuminating means 16.
  • the image sensor 84 can receive the image of the living tissue 40 through the measurement window 38 or through an alternate window.
  • the image sensor 84 includes an image analysis 86 that analyzes the image from the image sensor 84.
  • the entire captured image takes on a substantially single color range.
  • that color range is typically a red color and the phenomenon is referred to as "redout".
  • That image can, therefore, be analyzed in the image analysis 86 by comparing the signal value with the threshold for the average color of red.
  • the system can detect the contact between the capsule 10 and the living tissue 40 of the patient.
  • a signal can then be sent by the image analysis 86 wirelessly to enable the capsule 10 so that the light intensity of the illuminating means (light source) 24 can be intensified in order to obtain a reading of the blood content in that tissue, the actual contact having been verified.
  • the proximity detector may be a mechanical detector 88 located on the external contacting surface of the capsule 10 and the mechanical detector 88 can be sensitive to the mechanical contact between the capsule 10 and the living tissue 40.
  • a proximity sensor include an electromagnetic signal sensor 90, a laser 92 and a laser detector 94, a piezoelectric device 96, and an optical detector 98.
  • an intensity detector there can be a system for detecting the distance between the capsule 10 and the living tissue 40 such that the distance determination means can predict how long the capsule 10 will take to come into actual contact with the living tissue and the system can signal the measurement system to start the onset of a measurement at the moment of contact .
  • the timeline of all system operations can be adjusted so that the time for that command to the actual start of a measurement is completely equivalent to the expected time until the contact of the capsule with the living tissue. Controlling the measurement system in such manner enables the accurate measurement even while a capsule is in contact with the living tissue.
  • the experienced time of contact does not always match the time of actual contact.
  • the system may therefore have a means of monitoring the measurement results and evaluating the measurement results for their applicability in subsequent steps based on the fluctuation among different sets of measurement data or by comparing the final results with a predetermined threshold.
  • a capsule measurement type of device is highly desirable, however, it must be accurate at the time it is used. It is possible to correct a spectroscopic error due to a production error in the production process (which means storing correction data in the capsule) . However, it is not possible to cope with an error of spectroscopic measurement value due to an optical element caused by vibration during transportation and changes of spectroscopic characteristics of illumination over time. Therefore, it is of great importance that the capsule be capable of easily being calibrated right before use.
  • Fig. 14 there is shown a schematic view of a calibration system that meets those requirements.
  • the capsule 10 is covered by a protective cap 100 so as to maintain the sterile conditions of the capsule 10.
  • the protective cap 100 can be made of a transparent material that allows sterilizing gas to pass through but does not allow bacteria to penetrate.
  • the protective cap 100 includes a white diffuser plate 102 that is disposed inside of the protective cap 100 so as to function as a calibration means, As can be seen, a beam of light emitted from the illuminating means 24 is diffused and reflected by the white diffuser plate 102 and directed to the light receiving means 28 and Iw ( ⁇ ) is measured and transmitted to the data processing means 58 (Fig. 1) where it is used in the equations carried out therein.
  • the capsule 10 maintains the sterile condition with the protective cap 100 affixed thereto, a user can conduct calibration before using the device and then remove the protective cap 100 from a notch 104, and can use the capsule 10 in a condition that is both sterilized and calibrated.
  • a calibration means is provided inside the protective cap 100, calibration can be carried out near the outer surface of the capsule 10. Accordingly, because the quantity of the blood can be measured by making the outer surface of the capsule 10 come in contact with the living tissue of the patient, calibration can be carried out almost in the same state as an actual use thereof, thereby achieving highly accurate calibration. Furthermore, since the protective cap 100 and the white diffuser plate 102 are integrated into one unit, a user does not have to align the position of the calibration means with that of the capsule 10 so as to enable simple, easy operation.
  • a container 105 that contains the capsule 10 and a white diffuser plate 102 is disposed within the container 105.
  • the container 105 is shown in the open position in Fig. 13.
  • the container 105 has a recess 106 shaped like the outer shape of the capsule 10 and positioning can be accomplished by placing the capsule 10 within the recess 106.
  • At least a portion of the protective cap 100 reached by the light emitted from the light source 24 is made of a material that is transparent with respect to the wavelength of the illuminating light.
  • calibration is carried out by use of the white diffuser plate 102.
  • the user carries out calibration before using the capsule 10 and, by removing the protective cap 100 from the notch 104 (Fig 14), and again the user has a capsule 10 that is both sterile and calibrated.
  • the material for that white diffuser plate 102 can be more widespread, thereby reducing the cost of the calibration system.
  • a further advantage is that calibration can be carried out before the container 104 is opened which makes it possible that the effect of outside lights including room light, can be eliminated.

Abstract

Provided is a capsule (10) for determining the blood content of living tissue in vivo in a patient to detect tumors. The capsule (10) includes a light source and a light detector for directing light onto the tissue and for receiving interacted light therefrom. By analyzing the interacted light, a determination can be made of the blood content of that tissue. There are various ways of positioning the capsule (10) so that it contacts the tissue in the desired orientation of the light source (24) and light detector (28). There is also a system for determining the actual contact between the capsule and the tissue. A calibration system is also used that allows a self calibration that can be carried out easily and accurately just prior to the use of the capsule (10).

Description

DESCRIPTION
CAPSULE BLOOD DETECTION SYSTEM AND METHOD
TECHNICAL FIELD
The invention relates to the use of capsule type endoscopes in patients. More specifically, the invention relates to detecting, positioning, and calibrating capsule type endoscopes for use in a living patient with the goal of utilizing blood content detection to locate and determine abnormalities in living tissue.
BACKGROUND ART
Endoscopes have long been used by physicians to enter the internal area of a patient in order to carry out a function at that location. Traditionally, the endoscope comprises an optical system and an illumination system that enable the physician to locate the distal end of the endoscope in the desired area to enable the physician to view that area at a location external of the patient. More recently, there has been developed capsule endoscopes which are capsules containing image capture devices, such as digital cameras, that are swallowed by the patient and travel to a location of interest within the patient, such as the intestinal track, to study the colon in a search for lesions. Once at that location, the capsule endoscope gathers captured images to aid the physician to carry out some diagnosis of the patient.
Moreover, scientists have discovered a detectible increase in the blood content of superficial mucous membrane proximate cancerous and precancerous lesions in the colon as described, for example, in R. K. WaIi, H. K. Roy, Y. L. Kim, Y. Liu, J. L. Koetsier, D. P. Kunte, M. J. Goldberg, V. Turzhitsky, and V. Backman, Increased Microvascular Blood Content is an Early Event in Colon Carcinogenesis, Gut Vol. 54, 654-660 (2005), which is incorporated by reference herein. This phenomenon is referred to as an early increase in blood supply (EIBS) .
DISCLOSURE OF INVENTION
The invention relates to swallowable capsules having the capability to measure blood content of tissue comprising, for example, the digestive track. Exemplary configurations of such devices are described in related corresponding patent applications entitled "Method and Solution for Correlating Image and Tissue Characteristic Data" and "Blood Content Detecting Capsule" co-filed herewith and incorporated by reference herein. Such devices enable doctors and clinicians to detect EIBS for screening of lesions or tumors or when combined with image capture devices within the capsules facilitate the location of cancerous and pre-cancerous lesions or tumors. Exemplary configurations for such capsule include, for example, a light source that emits polarized light onto a region of the superficial mucous membrane and a light detector that receives light interacted with that tissue and the hemoglobin contained therein. The interacted light from the tissue is returned at a different polarization angle than the emitted light. This return angle and magnitude of the detected interacted light can be measured and is indicative of the blood content in that mucus tissue, Thus, the information relative to the blood content can be transmitted by the capsule to a receiving instrument external of the patient so that the physician can monitor the blood content in the tissue and use that information in determining the existence or proximate location of a lesion, A technique for the measurement of Hb through the use of polarized light has been disclosed in Y. L. Kim, Y. Liu, R. K. WaIi, H. K. Roy, M. J. Goldberg, A. K. Kromin, K. Chen, and V. Backman, Simultaneous measurement of angular and spectral properties of light scattering for characterization of tissue microarchitecture and its alteration in early precancer, IEEE J. SeI. Top. Quant. Elec, Vol. 9, 243-256 (2003) and M. P. Siegel, Y. L. Kim, H. K. Roy, R. K. WaIi, and V. Backman, Assessment of blood supply in superficial tissue by polarization-gated elastic light-scattering spectroscopy, Applied Optics, Vol. 45, 335-342 (2006) and the entirety of those articles are incorporated herein by reference.
However, one issue confronted by such a capsule is that it is necessary for the capsule to be in direct contact with the tissue, or at least in extremely close proximity thereto for the light source and light detector to accurately detect blood content. As such, because the capsule itself is not readily maneuverable within the patient, there must be system that enables the capsule to be positioned in the proper orientation with respect to the tissue. Another issue with the use of such a capsule is that it is further important that there be some system that verifies the existence of the contact so that the capsule can actually obtain valid information as to the blood content in that tissue. Also, it is important that there be some calibration system for the blood content detection system of the capsule that is extremely reliable and that can be used on site prior to use with a patient. The present invention provides methods and capsule devices that overcome these issues. In accordance with the present invention, a capsule is provided that is small enough to be swallowed by a patient and it has a blood content detector contained therein. The blood content detector includes a light source and a light detector oriented such that polarized white light from the light source travels through a measurement widow formed in the capsule to impinge upon living tissue of the patient where interacted light from the tissue and hemoglobin contained therein is detected by the light detector. The angle of the reflected light is analyzed as indicative of blood content in that tissue and generates signals representative of that blood content that are transmitted to a data processing means, such as a computer, where the information as to the blood content is processed and made available to a user.
As such, the present invention includes various means to orient the capsule so that it is in actual contact with the tissue being analyzed and the light impinges upon the tissue. To that end, one embodiment uses the shape of the capsule to achieve the desired orientation. Another embodiment provides weights strategically located within the capsule to bring about the desired orientation and yet another embodiment has the blood content detector mounted within an inner module that is movable within an outer capsule. In one exemplary embodiment, mirrors are provided to direct the light from the illuminating means to the light receiving means in order to further miniaturize the capsule.
The present invention also includes a proximity detector that detects the proximity of the capsule detector to the living tissue and, in particular, to verify when there is an actual contact between the capsule and that tissue. The proximity detector can be of various types and may include a distance detection system that determine the distance between the capsule and the living tissue so that a signal can be provided as that actual contact is imminent so that a blood content measurement can be taken at the time of contact.
Finally, there is a calibration system that can be used to calibrate the capsule easily and accurately just prior to the time of use.
These and other features and advantages of the present invention will become more readily apparent during the following detailed description taken in conjunction with the drawings herein.
BRIEF DESCRIPTION OF DRAWINGS
Fig 1 is a schematic view of an exemplary in vivo sensing system in accordance with the present invention. Fig. 2 is a cross sectional diagram showing an exemplary capsule constructed in accordance with the present invention.
Fig. 3 is block diagram illustrating the functions carried out within an exemplary processing apparatus of the present invention.
Fig. 4 is a cross sectional schematic showing an exemplary shape of a capsule in accordance with the present invention.
Fig. 5 is cross sectional schematic showing a further exemplary embodiment of the invention.
Fig. 6 is a cross sectional diagram showing another exemplary embodiment of the present invention.
Figs. 7A-7B are cross sectional diagrams illustrating the exemplary use of weights to position a blood content detector of the present invention.
Fig. 8 is a cross sectional diagram illustrating an alternate orientation system of the present invention relative to that shown in Figs. 7A-7B. Figs. 9A-9D are cross sectional diagrams illustrating a further orientation system of the present invention.
Fig. 10 is a schematic view of an alternate embodiment of the present invention using mirrors to guide the light traveling to and from the tissue of the patient.
Fig. 11 is a schematic view of a further exemplary embodiment utilizing mirrors in the light path.
Fig. 12 is a cross sectional diagram of the present capsule having various proximity detecting systems. Fig. 13 is a graph plotting time vs. distance between a capsule and the living tissue of a patient.
Fig. 14 is a cross sectional diagram illustrating a calibration system usable with the present invention.
Fig. 15 is a cross sectional diagram illustrating an alternate calibration system usable with the present invention.
BEST MODE(S) FOR CARRYING OUT THE INVENTION
Referring first to Fig. 1, there is shown a schematic view of an in vivo sensing system illustrating the use of the present invention. In Fig. 1, therefore, there can be seen a capsule 10 that is moving slowly in a colon 12 of a patient 14 and an external processing unit 16 that receives data sent from the capsule 10, analyzes that data and displays the result. The stream of data and information can be, for example, communicated wirelessly along a path 18 to the external processing unit 16.
In an exemplary configuration of the capsule 10, two pieces of spectrum information of body living tissue are acquired to obtain information about the blood content in the superficial portion of the mucous membrane or other living tissue. This embodiment uses a polarization spectrum of a first orientation having the same polarization direction as incident light from a capsule light source, referred to as a horizontal polarization and a corresponding orthogonal polarization spectrum which has the polarization direction perpendicular to incident light from the capsule light source. As stated, a technique for determining the hemoglobin content of tissue through the use of polarized light has been disclosed in Y. L. Kim, Y. Liu, R. K. WaIi, H. K. Roy, M. J. Goldberg, A. K. Kromin, K. Chen, and V. Backman, Simultaneous measurement of angular and spectral properties of light scattering for characterization of tissue microarchitecture and its alteration in early precancer, IEEE J. SeI. Top. Quant. Elec, Vol. 9, 243-256 (2003) and M. P. Siegel, Y. L. Kim, H. K. Roy, R. K. WaIi, and V. Backman, Assessment of blood supply in superficial tissue by polarization-gated elastic light-scattering spectroscopy, Applied Optics, Vol. 45, 335-342 (2006) and the entirety of those articles are incorporated herein by reference.
In this embodiment, a difference operation between the first or horizontal polarization spectrum and the perpendicular polarization spectrum is performed in the capsule 10 and the result is transmitted to the processing unit 16. It is alternatively suitable in accordance with the invention for the difference operation to be carried out in the processing unit 16 or other external device whereby data indicative of the horizontal polarization spectrum and the perpendicular spectrum are sent to the processing unit 16 by the capsule 10.
Referring now to Fig. 2, there is shown a cross sectional diagram showing the construction of an exemplary- capsule 10 of the present invention. As can be seen, the capsule 10 comprises an enclosure 20 with the components of the device encased within the enclosure 20. The enclosure 20 is designed to be of a size that is relatively easy for a patient to swallow and can generally have a diameter of approximately 10 mm.
Contained within the enclosure 20, there can be seen a blood content detector 22 which includes various components used to determine the blood content of living tissue by means of an optical detector. There is, therefore a light detector 28 and a light source 24 including, for example a white LED 26. The path of the light travels in the direction of the arrows A, where the wide angle light is absorbed by a light absorbing member 30 so that only a narrow angle of light (close to parallel light) can pass through an opening 32 after passing through a linear polarizing element 34 where the light is polarized. By reducing the size of the opening 32, the illuminated region of tissue can likewise be reduced. A suitable size of an illumination region can be, for example, in the range of approximately 0.1 mm2 and 100 mm2.
The polarized light thereafter passes through a lens 36 and an opening 32 and the linear polarizing element 34 are disposed along the location of the focal length of the lens. As such, the light coming for the light source 24 and is a narrow-angle light that impinges on a small region of tissue. Furthermore, it is possible to alter the direction in which the parallel light travels by using a lens to direct through a measurement window 38 to impinge upon a living tissue 40 of the patient in vivo.
Interacted light from the living tissue 40 and the hemoglobin contained therein returns along the direction of the arrows B to the light detector 28 as light with a specific reflection angle. As can be seen, the return interacted light passes again through the optical light path converter 36 where the light thereafter passes through two linear polarizing elements, that is, a first linear polarizing element 42 and a second linear polarizing element 44 that are orthogonal to each other. By that means, the linear polarizing elements 42 and 44 transmit beams of polarized light perpendicular to each other and the polarization direction of the first linear polarizing element 42 of the light receiving means 28 is the same as that of the linear polarizing element 34 of the illuminating means 24, and the second linear polarizing element 44 passes through the polarization spectrum orthogonal thereto. Beams of light that have been transmitted through each of the linear polarizing elements 42, 44 are passed on by a transmissive grating 46 in the directions with the different diffusion angles for each wavelength of light. That light then is sensed by a light sensor 48.
By doing so, each wavelength component of light can reach different locations on a light sensor 48 which enables spectroscopy in two kinds of polarization states; the horizontal polarization spectrum and the perpendicular polarization spectrum. Measured spectrum data is then sent to a data transmitter 50 where it is transmitted to the processing unit 16 of Fig. 1. A power supply 52 powers the components of the capsule 10. Turning now to Fig. 3, there is shown a block diagram illustrating the functions carried out within the processing unit 16. Initially there is a data receiving means 54 that receives the information and data from the capsule 10 (Fig. 1) via an antenna 56. In the embodiment, although wireless radio transmission is expected, data transmission using alternative techniques such as acoustic or infrared schemes are likewise useable in accordance with the invention. In such case, a data transmitter in the capsule and a data receiver in the processing unit would be provided that conform to another's technology, accordingly. The data received by the data receiver 54 is provided to a data preprocessor 58. The data preprocessor 58 executes white correction. Equation (1) shows an example of white correction.
(1) Δlc(λ) = Δl(λ)/Δlw(λ) = (In(λ) - Ix(X))Z(Iw11(X) + Iw1 (λ))
In equation (1), λ represents wavelength. ΔI (λ) indicates the measured difference polarization spectrum. Δlw(λ) is a spectrum measured by using what is known as a standard white plate and is calculated by summing the white horizontal polarization spectrum Iw11(X) and the white perpendicular polarization spectrum Iwx (λ), as shown in the denominator of equation (1) . In the numerator of equation (1) , the difference between the horizontal polarization spectrum In (λ) and the perpendicular polarization spectrum I± (λ) is calculated in the data transmitter 50 and a signal indicative of ΔI (λ) is transmitted by the data transmitter 50 to the processing unit 16.
A blood content estimator 60 calculates the blood content by using equation (2) below, which is shown in, for example, M. P. Siegel, Y. L. Kim, H. K. Roy, R. K. WaIi, and V. Backman, Assessment of blood supply in superficial tissue by polarization-gated elastic light-scattering spectroscopy, Applied Optics, Vol. 45, 335-342 (2006) .
( 2 ) Δl (λ) = Δlscattering ( λ) exp [ -αAPG (λ) ]
As stated, the blood content estimator 60 calculates the blood quantity by using a model equation, such as equation (2), and provides a corresponding blood content value to an indicator such as, for example, a display 62. The corresponding blood characteristic information can then be displayed to the user by the display 62. In addition there is a power supply 64 to power the processing unit 16 and a controller 66 to carry out the various control functions needed to process and display the information.
Turning now to Fig. 4, there is shown a schematic view of exemplary embodiment of the capsule 10 wherein a cross section of the enclosure 20 is a substantially elliptical shape. Because the enclosure 20 has a substantially elliptical shape, the elongated regions along larger curvature B will more likely be positioned along tissue as it traverses the digestive tract than the region of smaller curvature A. Thus, the measurement window 38 is located in the region along the larger curvature B. Returning briefly to Fig. 2, it can be seen that the measurement window 38 is disposed in that downward location. The measurement window 38 is disposed in such location in Fig. 2 and the lens 36, the light source 24 and the light detector 28 are disposed on the device facing the measurement window 38 in order to direct the illumination light on a desired location of the living tissue 40.
While the capsule 10 in the prior exemplary embodiment is based upon orienting the measurement window by the characteristic shape of the capsule enclosure 20, a further exemplary embodiment achieves the proper orientation by means of the weight balance of the capsule enclosure 20.
Accordingly, turning to Fig. 5, there is shown a capsule 10 where the enclosure 20 itself is circular in cross section and weights 68 are provided proximate the measurement window 38. The weights 68 are provided at a location away from the center of the capsule 10. When the center of gravity deviates from the center of the enclosure 20, the outer surface of the enclosure 20 in the deviated direction is likely to come into contact with the living tissue 40 of the patient as shown in Fig. 5.
As such, the measurement window 38 in this embodiment is located along the outer surface of the capsule enclosure 20 in the deviated direction, thus locating the measurement window 38 in the desired position contacting the living tissue 40 so as to attain the same effect as the embodiment of Fig. 4, the difference being that with this embodiment, the orientation of the capsule 10 is achieved by the addition of the weights 68, whereas with the prior embodiment, the desired orientation was achieved by the shape of the capsule 10 itself.
Turning now to Fig 6, there is shown a cross sectional diagram showing the exemplary embodiment of Fig. 2 using the same identification numbers as were used in Fig. 2 for corresponding features. As can be seen in Fig. 6, however, there has been added the weights 68 that are located at the sides of the measurement window 38 so as to orient the capsule 10 in contact with the living issue 40 in order to properly direct the light toward the living tissue 40 and to receive the return reflected light.
The weights 68 can be made of metal such as stainless steel or glass with a relatively high specific gravity. Even when the shape of the capsule 10 is of an elliptical shape as shown in Fig. 4, the measurement window 38 may be located in any given position by means of a weight. As can be seen in Figs. 7A and 7B, even if the measurement window cannot be disposed or located in the desired position as shown in Fig. 7A, a measurement can be made as shown in Fig. 7B. As can be seen, the weight of the weight 68 is not specified and may vary according to the design of the capsule. It is established so that the measurement window faces downwardly when the capsule 10 is disposed on a flat panel set perpendicular to the vertical direction. Turning next to Fig 8, there is shown a cross sectional diagram showing another exemplary embodiment of the present invention. In this embodiment, instead of the use of weights, the desired orientation of the capsule 10 is achieved by deviating the center of gravity from the center of the capsule 10, i.e., that is, by changing the layout within the capsule 10. In Fig. 8, the center of gravity can be made to deviate by partially placing a hollow or lightweight part 46 in the upper position so that the measurement window 38 faces downwardly to contact the living tissue 40.
Turning now to Figs. 9A-9D, there is shown a still further exemplary embodiment of the present invention. In this embodiment there is an outer capsule 72 that is comprised of a transparent material to allow the transmission of light therethrough. Within that outer capsule 72, there is disposed a moveable inner module 74 having mounted therein, the blood content detector 22. As such, in Fig 9A, there is a cross sectional diagram of the inner module 74 and in Fig. 9B, there is a cross sectional diagram of the outer capsule 72. In Fig. 9C, there can be seen the inner module 74 movably mounted within the outer capsule 72. The movement of the inner module 74 can be accomplished by, for example, a gimbal arrangement, not shown, that can be a conventional mounting mechanism that permits the blood content detector 22 to move therein.
In Fig. 9D, there is shown a cross sectional diagram taken along the line 9D-9D of Fig. 9C illustrating the movement of the inner module 74 from its position at location X to its position at location Y. Accordingly, at position X, it can be seen that the measurement window 38 is located to the side and not facing the living tissue 40 where it must be to take a reading of the blood flow in that living tissue 40. The weights 68 thus operate to bring the inner module 74 to its position at location Y where the free movement of the inner module 74 within the outer capsule 72 repositions the measurement window 38 to the desired position contacting the living tissue 40 for a blood content reading. In this embodiment, the outer capsule 72 can have a substantially circular cross-section ellipsoidal shape as well as other possible shapes. Turning now to Fig. 10, there is shown a schematic view of the present invention where the lens (Fig. 2) has been replaced with a mirror arrangement in order to result in further miniaturization of the capsule 10. As such, with this embodiment, the light emitted by the light source 24 is reflected by two mirrors, a first mirror 76 and a second mirror 78 as that light passes through the window 38 to reach the living tissue 40. In a similar manner, the interacted light from the living tissue 40 is reflected off of two mirrors, the common, second mirror 78, and a third mirror 80 prior to reaching a photodetector 82. As can be seen the optical axis to the mirrors is inclined or at a non-90 degree angle with respect to the measurement window 38 so as to eliminate reflections from surfaces of the measurement window 38. In this embodiment, a spectroscope is suitable for the photodetector 82.
In the Fig. 10 embodiment, the illuminating light (polarized light) is emitted from the light source 24 so as to be parallel with the rotation symmetry axes of the first mirror 76 and the second mirror 78 (corresponding to the optical axes) . Emitted light passes through a hole formed at the center of the first mirror 76 and reaches the surface of the living tissue 40. The light interacted with the living tissue 40 is reflected by the second mirror 78 and the third mirror 80 and reaches the spectroscope (photodetector 82) . The surface of the living tissue 40 is positioned at the combined focus of the first and second mirrors 76, 78 so that the position of the spectroscope of the scattered light reaches varies depending on the scattering angle. Furthermore, the scattered light becomes in parallel with the optical axis near the spectroscope.
The mirrors should be arranged so that the image point (of the virtual image) of the first mirror 76 when the object point is the combined focus coincides with the
"focal point of the second mirror 78". Where the first mirror 76 is a hyperboloid mirror and the second mirror 78 is a parabaloid mirror, optical aberrations may be reduced. Turning now to Fig. 11, there is shown a schematic view similar to that of the Fig. 10 embodiment, however, the optical axes of the mirrors are perpendicular to the outer layer of the capsule 10 and the measurement window 38 is a wedge-shaped transparent member. This embodiment enables the reduction of stray light coming through the measurement window 38 and eliminates the need for inclining the optical axes of the mirrors as in the Fig. 8 embodiment, thereby simplifying the structure of the capsule 10.
Turning now to Fig. 12, there is shown a simplified cross sectional diagram of the capsule 10 of the present invention and, to explain this embodiment, Fig 12 has been simplified with respect to Fig. 2 for example, it being understood that the capsule 10 of Fig. 12 can have the similar components as described with respect to Fig. 2. As such, the capsule 10 of Fig. 12 includes the capsule 20, the blood content detector 22, the illuminating means 16, the light receiving means 28 and the measurement window 38 that is shown to be contacting the living tissue 40.
As explained, with the capsule, it is important that the device be in actual contact with the living tissue 40 in order to obtain a valid reading of the blood content in that tissue. In this embodiment, there is a contact detector that alerts the user when there has been actual contact between the capsule 10 and the living tissue 40 of the patient. As an alternative, there can be a proximity detector that senses the approach of the capsule 10 to the living tissue 40 and which includes a contacting predicting means that sends a command to the overall system to commence a measurement of the blood content in the living tissue 40 when the actual contact is imminent. As used herein the term "proximity detector" will refer to a detector that senses the nearing and imminent proximity of the capsule to the living tissue as well as where the proximity is to the point where there is actual contact between the capsule and the living tissue.
Accordingly, in Fig. 12, in one exemplary embodiment, there is a proximity detector that comprises an image sensor 84 such as a camera, and which is directed toward the living tissue 32 along a path that is generally proximate to the path of the illuminating directed toward that living tissue 32 by the illuminating means 16. The image sensor 84 can receive the image of the living tissue 40 through the measurement window 38 or through an alternate window. The image sensor 84 includes an image analysis 86 that analyzes the image from the image sensor 84.
Basically, when an image sensor gets too close to a target so as to contact that target, the entire captured image takes on a substantially single color range. In the case of living tissue, that color range is typically a red color and the phenomenon is referred to as "redout". That image can, therefore, be analyzed in the image analysis 86 by comparing the signal value with the threshold for the average color of red. By such means, the system can detect the contact between the capsule 10 and the living tissue 40 of the patient. A signal can then be sent by the image analysis 86 wirelessly to enable the capsule 10 so that the light intensity of the illuminating means (light source) 24 can be intensified in order to obtain a reading of the blood content in that tissue, the actual contact having been verified. As stated, when the redout condition is sensed, the light intensity of the illuminating means 24 is immediately increased so as to be a level sufficient for spectrometry and the measurement of the blood performed. After the measurement, the light intensity of the illuminating means 24 is rapidly returned to the pre-measurement value. In another exemplary embodiment, the proximity detector may be a mechanical detector 88 located on the external contacting surface of the capsule 10 and the mechanical detector 88 can be sensitive to the mechanical contact between the capsule 10 and the living tissue 40. Further alternative embodiments of a proximity sensor include an electromagnetic signal sensor 90, a laser 92 and a laser detector 94, a piezoelectric device 96, and an optical detector 98. As an alternate embodiment of an intensity detector, there can be a system for detecting the distance between the capsule 10 and the living tissue 40 such that the distance determination means can predict how long the capsule 10 will take to come into actual contact with the living tissue and the system can signal the measurement system to start the onset of a measurement at the moment of contact .
Turning to the graph of Fig. 13, taken along with Fig. 12, signals transmitted from the distance sensor are continuously monitored for determining the distance between the capsule and the living tissue. The graph plots distance (D) between the capsule 10 and the living tissue 40 versus time (t) . As can be seen, as the time progresses, the distance is narrowed to time ti which is the point that a distance-detecting processor has determined that the actual contact is imminent. Thus, at ti, the distance- detecting processor determines that the capsule will likely contact the living tissue before the next measurement of the distance according to the trend in the time axis, the processor commands the measurement system to start a measurement of the blood flow. Accordingly at time t∑, the actual measurement is taken. The timeline of all system operations can be adjusted so that the time for that command to the actual start of a measurement is completely equivalent to the expected time until the contact of the capsule with the living tissue. Controlling the measurement system in such manner enables the accurate measurement even while a capsule is in contact with the living tissue.
In fact, the experienced time of contact does not always match the time of actual contact. The system may therefore have a means of monitoring the measurement results and evaluating the measurement results for their applicability in subsequent steps based on the fluctuation among different sets of measurement data or by comparing the final results with a predetermined threshold. When considering the degree of invasion and acceptability by a patient, a capsule measurement type of device is highly desirable, however, it must be accurate at the time it is used. It is possible to correct a spectroscopic error due to a production error in the production process (which means storing correction data in the capsule) . However, it is not possible to cope with an error of spectroscopic measurement value due to an optical element caused by vibration during transportation and changes of spectroscopic characteristics of illumination over time. Therefore, it is of great importance that the capsule be capable of easily being calibrated right before use.
Turning, therefore, to Fig. 14, there is shown a schematic view of a calibration system that meets those requirements. In particular, the capsule 10 is covered by a protective cap 100 so as to maintain the sterile conditions of the capsule 10. The protective cap 100 can be made of a transparent material that allows sterilizing gas to pass through but does not allow bacteria to penetrate. The protective cap 100 includes a white diffuser plate 102 that is disposed inside of the protective cap 100 so as to function as a calibration means, As can be seen, a beam of light emitted from the illuminating means 24 is diffused and reflected by the white diffuser plate 102 and directed to the light receiving means 28 and Iw (λ) is measured and transmitted to the data processing means 58 (Fig. 1) where it is used in the equations carried out therein. Accordingly in this embodiment because the capsule 10 maintains the sterile condition with the protective cap 100 affixed thereto, a user can conduct calibration before using the device and then remove the protective cap 100 from a notch 104, and can use the capsule 10 in a condition that is both sterilized and calibrated.
In addition, since a calibration means is provided inside the protective cap 100, calibration can be carried out near the outer surface of the capsule 10. Accordingly, because the quantity of the blood can be measured by making the outer surface of the capsule 10 come in contact with the living tissue of the patient, calibration can be carried out almost in the same state as an actual use thereof, thereby achieving highly accurate calibration. Furthermore, since the protective cap 100 and the white diffuser plate 102 are integrated into one unit, a user does not have to align the position of the calibration means with that of the capsule 10 so as to enable simple, easy operation.
Turning, finally to Fig. 15, there is shown a further exemplary embodiment of the calibration system of the present invention. In this embodiment, there is a container 105 that contains the capsule 10 and a white diffuser plate 102 is disposed within the container 105.
The container 105 is shown in the open position in Fig. 13. The container 105 has a recess 106 shaped like the outer shape of the capsule 10 and positioning can be accomplished by placing the capsule 10 within the recess 106. At least a portion of the protective cap 100 reached by the light emitted from the light source 24 is made of a material that is transparent with respect to the wavelength of the illuminating light. As with the Fig 12 embodiment, calibration is carried out by use of the white diffuser plate 102.
In this embodiment, the user carries out calibration before using the capsule 10 and, by removing the protective cap 100 from the notch 104 (Fig 14), and again the user has a capsule 10 that is both sterile and calibrated. In addition, when compared to the Fig. 14 embodiment, because the white diffuser plate 102 is disposed inside the container 104, the material for that white diffuser plate 102 can be more widespread, thereby reducing the cost of the calibration system. A further advantage is that calibration can be carried out before the container 104 is opened which makes it possible that the effect of outside lights including room light, can be eliminated. Those skilled in the art will readily recognize numerous adaptations and modifications which can be made to the of the present invention which will result in an improved device and method of using the same, yet all of which will fall within the scope and spirit of the present invention as defined in the following claims. Accordingly, the invention is to be limited only by the following claims and their equivalents.

Claims

1. A device comprising a capsule (10) having a blood content detector (22) .
2. The device of claim 1 further comprising an image capture device disposed in the capsule.
3. The device of claim 1 wherein the blood content detector (22) is an optical detector.
4. The device of claim 3 further comprising a measurement window (38) formed within the capsule (10) and wherein the optical detector (22) is disposed adjacent the window (38).
5. The device of claim 4 wherein the capsule (10) is configured to locate the window (38) in contact with living tissue when employed in vivo.
6. The device of claim 5 wherein the configuration includes a shape for facilitating the window (38) positioning in vivo.
7. The device of claim 5 wherein the configuration includes a center of gravity to utilize gravity for facilitating the window (38) positioning in vivo.
8. The device of claim 7 further comprising at least one weight (68) to achieve the center of gravity.
9. The device of claim 1 wherein the blood content detector (22) is selectively moveable within the capsule
(10).
10. The device of claim 9 further comprising a module (74) moveably disposed within the capsule (10) , wherein the blood content detector (22) is mounted to the module (74) .
11. The device of claim (10) wherein the capsule (10) has at least a part of a circular cross-section shape.
12. The device of claim (10) wherein the capsule (10) has at least a part of an ellipsoidal cross-section shape.
13. The device of claim 10 further comprising a gimbal, wherein the blood content detector (22) is mounted to the gimbal .
14. The device of claim 10 further comprising at least one measurement window (38) disposed within the capsule (10), wherein the blood content detector (22) is an optical detector.
15. The device of claim 14 wherein the blood content detector (22) comprises a light source and an optical detector.
16. The device of claim 15 wherein the blood content detector (22) further comprises at least one reflector.
17. A device of claim 16 wherein the at least one reflector is positioned within the capsule (10) to reflect light produced by the light source (24) through the measurement window (38) onto the surface of a living tissue.
18. A system disposable in a lumen of a living organism comprising: a blood content detector (22); and a proximity detector.
19. The system of claim 18 wherein the proximity detector is electrically coupled to the blood content detector (22) for communicating an activation signal to the detector.
20. The system of claim 18 wherein the blood content detector (22) and proximity detector are disposed in an endoscope.
21. The system of claim 18 wherein the blood content detector (22) and proximity detector are disposed within a capsule (10) .
22. The system of claim 18 wherein the proximity detector is a mechanical detector.
23. The system of claim 18 wherein the proximity detector is an optical detector.
24. The system of claim 18 wherein the proximity detector is an electromagnetic signal sensor.
25. The system of claim 18 wherein the proximity detector is located on the surface of the system for contact with in vivo tissue.
26. The system of claim 23 wherein the optical detector includes a laser and laser detector.
27. The system of claim 24 wherein the electromagnetic signal sensor is a piezoelectric device.
28. The system of claim 23 wherein the optical detector is an image sensor.
29. The system of claim 28 wherein the image sensor detects proximity to living tissue by the proportion of an image that is substantially within a single color range.
30. The system of claim 28 wherein the image sensor detects contact with living tissue by determining when a sensed image is substantially within a single color range.
31. The system of claim 13 wherein said color range is red.
32. A method for activating a blood content detection system comprising: positioning a blood content detector (22) in a lumen of a living organism; detecting the proximity of the blood content detector (22) relative to wall of the lumen; generating a proximity signal; and triggering the blood content detector (22) when the proximity signal satisfies a triggering condition.
33. The method of claim 32, wherein the positioning is performed by an endoscope or capsule (10).
34. The method of claim 32, wherein the detecting is performed by mechanical detection, optical detection, or electromagnetic sensing.
35. A calibration system for a blood content detector comprising: a receptacle for receiving a capsule containing a blood content detector (22) ; an illumination reflector disposed within the receptacle.
36. The calibration system of claim 35 further comprising: a processor; and a transceiver coupled to the processor for transmitting and receiving data to and from the capsule (10).
37. The calibration system of claim 35 wherein the illumination reflector is a diffuser plate.
38. The calibration system of claim 35 wherein the receptacle is a protective cap (100) for the capsule (10) .
39. The calibration system of claim 38 wherein the protective cap (100) forms a sterile barrier around the capsule (10) during calibration.
40. A calibration method for a capsule (10) having a blood content detector (22) comprising: disposing the capsule (10) in a calibration receptacle; causing a light source of the capsule (10) to illuminate a calibration region of the receptacle; generating a signal based on a light characteristic detected from the calibration region; and determining at least one calibration factor based on the generated signal.
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