Theme 1 of the Sonopill project will investigate clinical potential of Ultrasound Capsule Endoscopy. The initial goal is to identify the unmet clinical needs that may be fulfilled by Sonopill as a diagnostic or therapeutic device. During the development of Sonopill, members of Theme 1 will also examine multimodal imaging capabilities for the purposes of diagnosis and treatment at the bench level and progress with further refinement of Sonopill culminating in Translational studies for introduction into clinical practice. Both bench and clinical research will be done in cooperation with Themes 2, 3, 4 and 5 in order to develop device specifications for optimisation and improved capsule-based endoscopic diagnosis.
SONOPILL aims to combine capsule endoscoopy, with what has been described as "one of the great technical developments" in conventional endoscopy, where "by combining ultrasonography and endoscopy, (EUS) opened an entirely new dimension in imaging" (Sivak, 2006). To achieve this in a capsule format will require a combination of several developments in ultrasound systems, including Therapeutics capabilities. Theme 2 will focus on conceptual development, design and early prototyping. Work in this theme will begin on ERIC, the diagnostic capsule from the starting point of a technique already proven commercially with a single transmitting transducer and a receiving array.
The focus of Theme 3 is the integration in ERIC and CAIT of capabilities created in Theme2, Theme 4 and Theme 5. There are two fundamental approaches: one to realise all functionality envisaged for Sonopill in a large envelope then to shrink this by incremental research, and the other to establish the physical envelope and to determine the functionality that fits in it - increasing this as research progresses. Theme 3 will take the second path, aided in its early stages by the use of tethered capsules. In SONOPILL the tether will be functional, with three benefits: avoiding the need for a local power supply; allowing wired communcation; and providing a degree of positional control. A fully autonomous capsule has greater potential for access and for patient mobility during its passage and this will be explored in later stages of our research.
Sonopill Theme 4 – POSITIONING
T4 is crucial for the clinical functioning of the Sonopill and its positioning is an important step. T4 will explore, evaluate, and design a prototype mechanism for compatible positioning of the Sonopill.
The positioning theme will look at the anatomical and physiological nature of the GI tract and focus on the complicated motility of the small bowel and locomotion.
The Sonopill will operate in two main modes, i.e. for diagnosis and for therapy.
The initial ultrasound scan of a patient targets the region of interest and when this step is complete the Sonopill will focus on the particular target. The Sonopill diagnostic purpose will include its precise repositioning to obtain better and optimal ultrasound image of the specific object.
The therapeutic mode of the Sonopill requires controlled positioning of the source of ultrasound where it will remain fairly stable and stationary, and for this a stable platform will be designed.
The guiding principle of Theme 5 is to exploit previous innovations in capsule sensing to complement ultrasound and optical imaging and to provide competitive technologies for comparison. For example, diagnostic specificity may increase by combining in ERIC increased ultrasonic backscatter from cancer with autofluorescence imaging (AFI). Similarly whilst ultrasound is one means of mild or intense hyperthermia for therapy, microwave ablation will also be explored as both potentially complementary and a competitor. Finally we will consider other multimodal opportunities relating to localisation, ie detection of the capsule's position in the body.