SCIENCE CHINA Life Sciences, Volume 61 , Issue 11 : 1304-1309(2018) https://doi.org/10.1007/s11427-018-9353-5

Clinical application of magnetically controlled capsule gastroscopy in gastric disease diagnosis: recent advances

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  • ReceivedJul 20, 2018
  • AcceptedAug 23, 2018
  • PublishedOct 18, 2018


Magnetically controlled capsule gastroscopy (MCCG) is a novel system primarily used for the diagnosis of gastric disease. It consists of an endoscopic capsule with magnetic material inside, external guidance magnet equipment, data recorder and computer workstation. Several clinical trials have demonstrated that MCCG is comparable in accuracy in diagnosing gastric focal disease when compared to conventional gastroscopy. Further clinical studies are needed to test the diagnostic accuracy and improve the functioning of MCCG. This novel MCCG system could be a promising alternative for screening for gastric diseases, with the advantages of no anesthesia required, comfort and high acceptance across populations.

Funded by

the Chang Jiang Scholars Program of Ministry of Education(Q2015190,to,Zhaoshen,Li)

China and the Shanghai Health and Family Planning Commission Plans to Excellent Leaders(2017BR005,to,Zhuan,Liao)


This work was supported by the Chang Jiang Scholars Program of Ministry of Education, China (Q2015190 to Zhuan Liao) and the Shanghai Health and Family Planning Commission Plans to Excellent Leaders (2017BR005 to Zhuan Liao).

Interest statement

The author(s) declare that they have no conflict of interest.


[1] Ang T.L., Fock K.M., Dhamodaran S., Teo E.K., Tan J.. Racial differences in Helicobacter pylori, serum pepsinogen and gastric cancer incidence in an urban Asian population. J Gastroenterol Hepatol, 2005, 20: 1603-1609 CrossRef PubMed Google Scholar

[2] Asl S.M.K.H., Sivandzadeh G.R.. Efficacy of premedication with activated Dimethicone or N-acetylcysteine in improving visibility during upper endoscopy. World J Gastroenterol, 2011, 17: 4213-4217 CrossRef PubMed Google Scholar

[3] Carpi F., Galbiati S., Carpi A.. Magnetic shells for gastrointestinal endoscopic capsules as a means to control their motion. Biomed Pharmacother, 2006, 60: 370-374 CrossRef PubMed Google Scholar

[4] Carpi F., Pappone C.. Magnetic maneuvering of endoscopic capsules by means of a robotic navigation system. IEEE Trans Biomed Eng, 2009, 56: 1482-1490 CrossRef PubMed Google Scholar

[5] Chen W., Zheng R., Baade P.D., Zhang S., Zeng H., Bray F., Jemal A., Yu X.Q., He J.. Cancer statistics in China, 2015. CA-A Cancer J Clin, 2016, 66: 115-132 CrossRef PubMed Google Scholar

[6] Chinese Digestive Endoscopist Committee, Chinese Endoscopist Association, the Health Management and Physical Examination Committee of Digestive Endoscopy, Capsule Endoscopy Collaboration Group of Chinese Society of Digestive Endoscopy, Chinese Anti-Cancer Association, the Society of Oncological Endoscopy, Chinese Society of Health Management. (2017). The China expert consensus of clinical practice for magnetically controlled capsule gastroscopy (2017, Shanghai) (in Chinese). Zhonghua Nei Ke Za Zhi 56, 876–884. Google Scholar

[7] Chinese Society of Digestive Endoscopy, Chinese Anti-Cancer Association, the Society of Oncological Endoscopy. (2014). Consensus opinion on early gastric cancer screening and endoscopic diagnosis and treatment in China (2014, Changsha). Chin J Digest 34, 361–377. Google Scholar

[8] Ching, H.L., Hale, M., Sidhu, R., and McAlindon, M. (2018). Robot magnet-controlled upper gi capsule endoscopy using the ankon navicam® system: first reported experience outside china. Gut 66, PTH-050. Google Scholar

[9] Denzer U.W., Rösch T., Hoytat B., Abdel-Hamid M., Hebuterne X., Vanbiervielt G., Filippi J., Ogata H., Hosoe N., Ohtsuka K., et al. Magnetically guided capsule versus conventional gastroscopy for upper abdominal complaints. J Clin Gastroenterol, 2015, 49: 101-107 CrossRef PubMed Google Scholar

[10] Do T.N., Seah T.E.T., Ho K.Y., Yu H.K., Phee S.J.. Development and testing of a magnetically actuated capsule endoscopy for obesity treatment. PLoS ONE, 2016, 11: e0148035 CrossRef PubMed ADS Google Scholar

[11] Eliakim R.. Where do I see minimally invasive endoscopy in 2020: clock is ticking. Ann Transl Med, 2017, 5: 202 CrossRef PubMed Google Scholar

[12] Gu H., Zheng H., Cui X., Huang Y., Jiang B.. Maneuverability and safety of a magnetic-controlled capsule endoscopy system to examine the human colon under real-time monitoring by colonoscopy: a pilot study (with video). Gastrointest Endosc, 2017, 85: 438-443 CrossRef PubMed Google Scholar

[13] Hale, M., and Mcalindon, M. (2014). Future Development of Capsule Endoscopy. (Berlin: Springer Netherlands), pp. 165–170. Google Scholar

[14] Hale M.F., Rahman I., Drew K., Sidhu R., Riley S.A., Patel P., McAlindon M.E.. Magnetically steerable gastric capsule endoscopy is equivalent to flexible endoscopy in the detection of markers in an excised porcine stomach model: results of a randomized trial. Endoscopy, 2015, 47: 650-653 CrossRef PubMed Google Scholar

[15] Hale M.F., Drew K., Sidhu R., McAlindon M.E.. Does magnetically assisted capsule endoscopy improve small bowel capsule endoscopy completion rate? A randomised controlled trial. Endosc Int Open, 2016, 04: E215-E221 CrossRef PubMed Google Scholar

[16] Iddan G., Meron G., Glukhovsky A., Swain P.. Wireless capsule endoscopy. Nature, 2000, 405: 417 CrossRef PubMed Google Scholar

[17] Isobe Y., Nashimoto A., Akazawa K., Oda I., Hayashi K., Miyashiro I., Katai H., Tsujitani S., Kodera Y., Seto Y., et al. Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry. Gastric Cancer, 2011, 14: 301-316 CrossRef PubMed Google Scholar

[18] Keller J., Fibbe C., Volke F., Gerber J., Mosse A.C., Reimann-Zawadzki M., Rabinovitz E., Layer P., Schmitt D., Andresen V., et al. Inspection of the human stomach using remote-controlled capsule endoscopy: a feasibility study in healthy volunteers (with videos). Gastrointest Endosc, 2011, 73: 22-28 CrossRef PubMed Google Scholar

[19] Keller J., Fibbe C., Volke F., Gerber J., Mosse A.C., Reimann-Zawadzki M., Rabinovitz E., Layer P., Swain P.. Remote magnetic control of a wireless capsule endoscope in the esophagus is safe and feasible: results of a randomized, clinical trial in healthy volunteers. Gastrointest Endosc, 2010, 72: 941-946 CrossRef PubMed Google Scholar

[20] Koulaouzidis, A., Iakovidis, D.K., Karargyris, A., and Rondonotti, E. (2015). Wireless endoscopy in 2020: will it still be a capsule? World J Gastroenterol 21, 5119–5130. Google Scholar

[21] Li, Z.S., Deng, X.M., Sun, T., et al. (2014). China Expert consensus on sedative and anesthesia of digestive endoscope diagnosis and treatment. Chin J Pract Int Med 34, 756–764. Google Scholar

[22] Li K.W.. Frameworks for nurturing and assessing students’ statistical thinking in regression modelling. Springerplus, 2014, 3: O5-45 CrossRef Google Scholar

[23] Li Z., Zou D., Ma X., Chen J., Shi X., Gong Y., Man X., Gao L., Zhao Y., Wang R., et al. Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China. Am J Gastroenterol, 2010, 105: 2570-2577 CrossRef PubMed Google Scholar

[24] Liao Z., Gao R., Xu C., Li Z.S.. Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc, 2010, 71: 280-286 CrossRef PubMed Google Scholar

[25] Liao Z., Duan X.D., Xin L., Bo L.M., Wang X.H., Xiao G.H., Hu L.H., Zhuang S.L., Li Z.S.. Feasibility and safety of magnetic-controlled capsule endoscopy system in examination of human stomach: a pilot study in healthy volunteers. J Interv Gastroenterol, 2012, 2: 155-160 CrossRef PubMed Google Scholar

[26] Liao Z., Hou X., Lin-Hu E.Q., Sheng J.Q., Ge Z.Z., Jiang B., Hou X.H., Liu J.Y., Li Z., Huang Q.Y., et al. Accuracy of magnetically controlled capsule endoscopy, compared with conventional gastroscopy, in detection of gastric diseases. Clin Gastroenterol Hepatol, 2016, 14: 1266-1273.e1 CrossRef PubMed Google Scholar

[27] Lien, G.S., Wu, M.S., Chen, C.N., Liu, C.W., and Suk, F.M. (2018). Feasibility and safety of a novel magnetic-assisted capsule endoscope system in a preliminary examination for upper gastrointestinal tract. Surg Endosc 32, 1937–1944. Google Scholar

[28] Lightdale J.R., Acosta R., Shergill A.K., Chandrasekhara V., Chathadi K., Early D., Evans J.A., Fanelli R.D., Fisher D.A., Fonkalsrud L., et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc, 2014, 79: 699-710 CrossRef PubMed Google Scholar

[29] Neale J.R., James S., Callaghan J., Patel P.. Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy. Eur J Gastroenterol Hepatol, 2013, 25: 778-783 CrossRef PubMed Google Scholar

[30] Qian Y., Wu S., Wang Q., Wei L., Wu W., Wang L., Chu Y.. Combination of five body positions can effectively improve the rate of gastric mucosa’s complete visualization by applying magnetic-guided capsule endoscopy. Gastroenterol Res Practice, 2016, 2016: 1-7 CrossRef PubMed Google Scholar

[31] Rahman I., Kay M., Bryant T., Pelitari S., Salter S., Dimitrov B., Patel P.. Optimizing the performance of magnetic-assisted capsule endoscopy of the upper GI tract using multiplanar CT modelling. Eur J Gastroenterol Hepatol, 2015, 27: 460-466 CrossRef PubMed Google Scholar

[32] Rahman I., Pioche M., Shim C.S., Lee S.P., Sung I.K., Saurin J.C., Patel P.. Magnetic-assisted capsule endoscopy in the upper GI tract by using a novel navigation system (with video). Gastrointest Endosc, 2016, 83: 889-895.e1 CrossRef PubMed Google Scholar

[33] Rahman I., Afzal N.A., Patel P.. The role of magnetic assisted capsule endoscopy (MACE) to aid visualisation in the upper GI tract. Comput Biol Med, 2015, 65: 359-363 CrossRef PubMed Google Scholar

[34] Rex D.K., Adler S.N., Aisenberg J., Burch Jr. W.C., Carretero C., Y., Fein S.A., Fern S.E., Fernandez-Urien Sainz I., Fich A., et al. Accuracy of capsule colonoscopy in detecting colorectal polyps in a screening population. Gastroenterology, 2015, 148: 948-957.e2 CrossRef PubMed Google Scholar

[35] Rey J.F., Ogata H., Hosoe N., Ohtsuka K., Ogata N., Ikeda K., Aihara H., Pangtay I., Hibi T., Kudo S., et al. Feasibility of stomach exploration with a guided capsule endoscope. Endoscopy, 2010, 42: 541-545 CrossRef PubMed Google Scholar

[36] Rey J.F., Ogata H., Hosoe N., Ohtsuka K., Ogata N., Ikeda K., Aihara H., Pangtay I., Hibi T., Kudo S.E., et al. Blinded nonrandomized comparative study of gastric examination with a magnetically guided capsule endoscope and standard videoendoscope. Gastrointest Endosc, 2012, 75: 373-381 CrossRef PubMed Google Scholar

[37] Rondonotti E.. Capsule retention: prevention, diagnosis and management. Ann Transl Med, 2017, 5: 198 CrossRef PubMed Google Scholar

[38] Sacher-Huvelin S., Calès P., Bureau C., Valla D., Vinel J.P., Duburque C., Attar A., Archambeaud I., Benamouzig R., Gaudric M., et al. Screening of esophageal varices by esophageal capsule endoscopy: results of a French multicenter prospective study. Endoscopy, 2015, 47: 486-492 CrossRef PubMed Google Scholar

[39] Shamsudhin, N., Zverev, V.I., Keller, H., Pane, S., Egolf, P.W., Nelson, B.J., and Tishin, A.M. (2017). Magnetically guided capsule endoscopy. Med Phys 44, e91–e111. Google Scholar

[40] Spada C., Pasha S.F., Gross S.A., Leighton J.A., Schnoll-Sussman F., Correale L., González Suárez B., Costamagna G., Hassan C.. Accuracy of first- and second-generation colon capsules in endoscopic detection of colorectal polyps: a systematic review and meta-analysis. Clin Gastroenterol Hepatol, 2016, 14: 1533-1543.e8 CrossRef PubMed Google Scholar

[41] Swain P., Toor A., Volke F., Keller J., Gerber J., Rabinovitz E., Rothstein R.I.. Remote magnetic manipulation of a wireless capsule endoscope in the esophagus and stomach of humans (with videos). Gastrointest Endosc, 2010, 71: 1290-1293 CrossRef PubMed Google Scholar

[42] Tang Y., Cheng S., Wang L., Xu B., Gong B., Shen R.. Sa2054 the clinical utility of magnetically controlled capsule endoscopy in pediatric patients. Gastrointest Endosc, 2016, 83: AB299-AB300 CrossRef Google Scholar

[43] Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J., Jemal A.. Global cancer statistics, 2012. CA-A Cancer J Clin, 2015, 65: 87-108 CrossRef PubMed Google Scholar

[44] Tortora G., Valdastri P., Susilo E., Menciassi A., Dario P., Rieber F., Schurr M.O.. Propeller-based wireless device for active capsular endoscopy in the gastric district. Minim Invasive Ther Allied Technol, 2009, 18: 280-290 CrossRef PubMed Google Scholar

[45] Yao, K. (2013). The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 26, 11–22. Google Scholar

[46] Yatake H., Takeda Y., Katsuda T., Kuroda C., Yamazaki H., Gotanda R., Gotanda T., Yabunaka K., Nagamatsu M.. Improved detection of gastric cancer during screening by additional radiographs as judged necessary by the radiographer. Jpn J Radiol, 2011, 29: 177-186 CrossRef PubMed Google Scholar

[47] Ye, L., Xu, M., Tan, P., Long, L., Wang, H., and Guo, Y. (2017). Clinical study on extracorporal induction of magnetic capsule endoscopy into small intestine. China J Endosc 23, 26–29. Google Scholar

[48] Yim S., Gultepe E., Gracias D.H., Sitti M.. Biopsy using a magnetic capsule endoscope carrying, releasing, and retrieving untethered microgrippers. IEEE Trans Biomed Eng, 2014, 61: 513-521 CrossRef PubMed Google Scholar

[49] Zhu, S.G., Qian, Y.Y., Tang, X.Y., Zhu, Q.Q., Zhou, W., Du, H., An, W., Su, X.J., Zhao, A.J., Ching, H.L., et al. (2018). Gastric preparation for magnetically controlled capsule endoscopy: a prospective, randomized single-blinded controlled trial. Dig Liver Dis 52, 42–47. Google Scholar

[50] Zong, L., Abe, M., Seto, Y., and Ji, J. (2016). The challenge of screening for early gastric cancer in China. Lancet 38, 2606. Google Scholar

[51] Zou, W.B., Hou, X.H., Xin, L., Liu, J., Bo, L.M., Yu, G.Y., Liao, Z., and Li, Z.S. (2015). Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial. Endoscopy 47, 525–528. Google Scholar

  • Figure 1

    (Color online) Robotic MCCG system from China Ankon (Copyright owned by Dr. Zhuan Liao (Liao et al., 2016)).

  • Table 1   Comparison of three MCCG systems


    Capsule endoscopes

    Olympus & Siemens

    Given imaging

    Ankon NaviCam

    General information

    Size (mm)




    Weight (g)




    Battery life (h)








    Frames per second




    Field of view




    Depth of field (mm)




    FDA approval



    Yes (CFDA, 2013)

    Control system

    Control method

    MRI guidance (multiple coils carrying current, electromagnetic field)

    Permanent magnet with manual paddle control

    Permanent magnet with robotic control

    Maximum magnetic field @ working area

    100 mT


    200 mT

    Control distance (air)


    13 cm

    20 cm

    Control distance (water)

    >25 cm

    15 cm

    25 cm

    Maximum continuous magnetic force at 25 cm distance

    1 mN

    4.0 mN

    21.7 mN

    MCE control feedback signals

    Images plus calculated capsule orientation

    Images only

    Images plus calculated and measured capsule location

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