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Yuce and
Tharaka Dissanayake
ISWOOP & DIGITAL STOCK
conventional implantable systems. A small miniaturized electronic pill can reach areas such as the small
intestine and can deliver real time video images wirelessly to an external console. Figure 1 shows an electronic pill system (i.e., wireless endoscopy) for a medical monitoring system. The device travels through the
digestive system to collect image data and transfers
the data to a nearby computer for display with a distance of one meter or more. A high resolution videobased capsule endoscope produces a large amount of
data, which can then be delivered over a high-capacity
wireless link.
Mehmet R. Yuce (mehmet.yuce@monash.edu) is with Electrical and Computer Systems Engineering, Monash University, Clayton, VIC 3800,
Australia, and Tharaka Dissanayake is with Electrical Engineering and Computer Science,
the University of Newcastle, NSW 2308, Australia.
Digital Object Identifier 10.1109/MMM.2012.2205833
Date of publication: 13 September 2012
90
1527-3342/12/$31.002012IEEE
September/October 2012
A recent article [3] gives a good history of capsules from their early development to clinical
implementation. The design of wireless capsules
began in the 1950s. Since then, they have been called
endoradiosondes, capsules, smart pills, electronic pills, radio pills, wireless capsules, wireless endoscopy, video capsules, and so forth. Herein
we will use the term electronic pill when referring
to this technology. Since its early development [4][7],
electronic pill designs have been based on narrowband transmission and thus have a limited number of
camera pixels. Commonly used frequency values have
been ultra-high-frequency (UHF) around 400 MHz.
One of current state-of-the-art technologies for wireless endoscope devices is commercially available by
the company Given Imaging [8]. The pill uses the
Zarlinks radio frequency (RF) chip [9] for wireless
transmission in the medical implant communication
service (MICS) band (402405 MHz). The allowable
channel bandwidth for this band is 300 kHz. It is difficult to assign enough data rate for the high-quality
video data at the moment for real-time monitoring. It
is quite obvious that future electronic pills will target
higher-bandwidth data transmission that could facilitate a better diagnosis.
An important feature of the electronic pill technology is the wireless system utilized. This article
reviews recent attempts in the design of the wireless
telemetry unit for the electronic pill technology and
also discusses challenges and developments for successful implementation of high-resolution video-based
electronic pills.
Monitoring/
Recording
September/October 2012
Camera Pill
with Wireless
Transmitter
91
Reference
Image /
Physological
Sensor
Image
Resolution Frequen.
(Chen, 2009)
[12]
VGA,
0-2 frames/s
307,200
pixels
(Wang, 2008)
[15]
PO1200
CMOS
(Kfouri, 2008)
[19]
Trans.
Modu- Power,
Physical
Data Rate lation Distance Dimension
Power
Supply/
Battery
Current
Power
267 kb/s
FSK
NA
11.3 # 26.7
mm # mm
8 mA
2 # 1.5 V
silver-oxide (24 mW)
1600 # 1200 NA
pixels
NA
AM
High
(variable)
10 # 190
mm # mm
3 V,
wireless
405 mW
CCD
ICX228AL
768 # 494
pixels
UHF
250 kb/s
NA
20 # 100
mm # mm
Li-ion
battery
(Itoh, 2006)
[20]
2-frames/s
On-chip
CMOS
320 # 240
pixels
20 MHZ
BPSK
48 cm
10 # 20
mm # mm
2V
coin cell
(CR1025)
2.6 mW
(Park, 2002)
[17]
OV7910
CMOS
510 # 492
pixels
315 MHZ/ NA
433 MHz
AM
NA
11 X 7
mm # mm
5V
NA
(Yu, 2009)
[36]
NA
NA
915 MHz
2. 5 Mb/s OOK
(400ns)
25 dBm
8 # 23
(00-sized)
Wireless
power
NA
(Moon, 2007)
[18]
Stimulation
434 MHz
4 kb/s
ASK
5.35 dBm 11 mm #
21 mm
(Johannessen,
2006) [13]
pH and
temperature
433 MHz
4 kb/s
OOK
NA, 1m
12 # 36 mm, 2 # 1.5 V
15.5 mW
8g
SR48 Ag2O
(Valdastri,
2004) [14]
Multichannel
433 MHz
13 kb/s
ASK
5.6 mW
5m
27 # 19 #
19 mm3
3-V
coin cell
(CR1025)
(Farrar, 1960)
[35]
Pressure
3 kb/s
FM
7 mm #
25 mm
Wireless
power
FM
433 MHz
100 kHz
2.5 Mb/s
silver-oxide 4.6 mA
cells
92
A recent study [16] demonstrated a prototyping system to achieve a high data rate transmission (2 Mb/s)
for higher image resolution. This systems enabled
an image resolution up-to 1520 frames/s using a
compression technique similar to Joint Photograpic
Experts Group. It uses a transmitter based on a Colpitts oscillator consisting of a small number of components and consuming little power. The device operates
at 144 MHz, lower than most of the systems that are
operating at UHF, but requiring a larger antenna that,
in turn, will increase the physical size. In [17], Park
etal., also uses a simple amplitude modulation (AM).
It is designed with a mixer and an oscillator circuit
together with a CMOS image sensor and loop antenna
to form a capsule-shaped telemetry device. This device
uses an external control unit to control the capsule
within the human body. The same group later developed a different version of their device that uses an
electric stimulation technique to move the capsule up
and down inside the small intestines [18]. The stimulating electrical voltage was controlled externally
by adjusting the amplitude of the stimulating pulse
September/October 2012
September/October 2012
93
BW
Country/Region
Comment
MICS
402405
300 KHz/
channel
United States,
Australia, Europe,
Japan
[8]Given Imaging
WMTS
608614
13951400
14271432
1.5 MHz
5-6 MHz
U.S., Canada
None
High Freq.
ISM
24002483
57255875
20 MHz,
40 MHz
Worldwide
[21]
Mid-ISM
433434 MHz
315 MHz
kHz range
Worldwide
[12][14],
[18]433 MHz
[17]315 MHz
865868 MHz
Europe
902928 MHz
200500
kHz/1015
channels
MHz
USA, Canada,
Australia
[36]
Low ISM
13.5513.567
26.9527.283
40.6640.70
kHz range,
14 kHz for
13 MHz
Worldwide
None
UWB
3.110.6
>500MHz
International
[26]
94
compared to the other available bands [25]. The maximum transmission power is limited to 41 dBm/MHz.
Such a low signal level will have an insignificant EMI
effect on medical equipment in the medical environment. The current drawback of UWB technology is that
there are not a large number of devices currently available in the market that can be used in a fully integrated
or complete system. Experimental results have shown
that the UWB communication can achieve a data rate
equal to or higher than 100 Mb/s for electronic pill
applications [26].
Besides EMI, one must also ensure that EM radiation from electronic pill devices located inside the
body does not cause any harm to the human body.
There have been studies reporting biological effects
such as changes in blood pressure, DNA damage, and
effects on nerve cells due to exposure of EM radiation
[27]. Thus, the EM and RF exposure levels should not
exceed the RF/microwave safety standards established
by communication authorities (e.g., the U.S. Federal
Communications Commission) [28].
The MICS band has been regulated for a low emission power (25 W, comparable to UWB) and, thus, low
EM radiation. UWB and MICS bands will provide the
September/October 2012
vcc
vcc
CDC_Blk: Blocking dc
RFC
R1
Digital Data
from Camera
Rdata
Antenna
CDC_Blk
Out
Antenna
R1
Digital Date
from Camera
L1
Out
Crystal
Q1
Q1
CDC
Rdata
C1
CV
C1
C3
R3
Diode
L1
C2
CDC_Blk
R4
R3
R5
R4
(a)
C2
(b)
Figure 2. E-pill transmitters based on RF Colpitts oscillator: (a) a common collector Colpitts oscillator and (b) a common base
Colpitts oscillator with crystal.
most suitable telemetry designs in medical environments and, most likely, will continue to be the choice
of designers.
(1)
To measure pressure inside the body with early electronic pills, a diaphragm was used to move an iron
core inside the oscillation coil (L1 in the Figure 2). As
the induction changes, the amount of the frequency
change was dependent on the pressure change. In the
case of video imaging in modern electronic pills, digital data converted from image signals are applied to
the input, as shown in Figure 2 [16]. The transmitter
in Figure 2(a) uses a varactor (variable capacitor; Cv)
to generate FSK or FM modulated signals for wireless transmission of medical data or images. The
value of the variable capacitor changes with respect
to the amplitude of the input signal, which could
beimage data from a camera, or a physiological signal such as temperature or pH level in electronic pill
applications.
In a real implementation, the values of inductors
and capacitors will have tolerance variations that
will result in potential offsets in the transmission
frequency, making it difficult to recover the transmit-
September/October 2012
95
96
September/October 2012
Model
Company
Frequency
Transmission Physical
Data Rate Power (dBm) Dimension (mm) Tx
Mica2
Crossbow
(MPR400)
38.4 kb/s
868/916 MHz,
433 MHz, 315 MHz
MicAz
2400 MHz to
2483.5 MHz
(IEEE 802.15.4)
Crossbow
250 kb/s
Rx
Micro
Controller
8 mA
at 3.3 V
8 mA
at 3.3 V
-20 to 10
58 # 32 # 7 mm3 25 mA
18 g
at 3.3 V
24 to 0
20 to 10
25 # 6 mm2
3g
25 mA
at 3.3 V
8 mA
at 3.3 V
8mA at
3.3 V
Mica2DOT Crossbow
38.4 kb/s
868/916 MHz,
433 MHz, 315 MHz
250 kb/s
25 to 0
66 # 32.6 #
7 mm3
17.7 mA
at 3 V
20 mA
at 3 V
1.8 mA
at 3 V
T-node
SOWNet
52.2 kb/s
20 to +5
Diameter of
23 mm
25 mA
at 3 V
12 mA
at 3 V
~6.2 mA
at 2.4 V
Sensium
Toumaz
868/915 MHz
50 kb/s
23 to 7
90 # 45 #
10 mm3
2.6 mA
at 1.2 V
2.09 mA 0.03 mA
at 1.2 V at 1.2 V
25 mm
adjustment. This capsule with posture and orientation control has the ability to stay in a specific area
of the intestine to obtain higher-quality images.
Another endoscope, EndoCapsule, developed by
Olympus, was mainly used in Europe but, in 2007,
received marketing clearance from the U.S. Food and
Drug Administration (FDA). The device contains
six LEDs with adjustable illumination to maintain
optimal imaging. The electronic pill by SmartPill is
designed to measure pressure, pH, and temperature
as it passes through the gastrointestinal (GI) tract. A
receiving device worn by the patient collects data and
is later examined by a physician. Another commercially available capsule for endoscopy is MiroCam.
This system has a different wireless transmission
compared to other capsule technologies. Instead of
using RF signals to transmit images, MiroCam uses
natural electrical impulses in the human body as the
transport medium] [32].
September/October 2012
(a)
23 mm
Currently, the battery, one of the essential components in electronic pills, provides the power source
to the active electronic components in the device.
Although small miniature rechargeable battery technologies are available, the lifetime they provide may
not satisfy the desired operation time for detecting
and transmitting enough useful data from inside
the body. As given in Table 4, current electronic pills
have limited operational time as a result of the battery technology used. One way to enhance this operational lifetime is to charge the battery wirelessly.
Alternatively, a completely wireless power system
could also be used. In batteryless systems, it is necessary to bring the charging transmitter very close to
(b)
97
Freq.
(MHz)
Micron, CMOS
EndoCapsule Olympus
Optical
CCD camera, 1
920 # 1080
Sayaka
RF System
Lab
CCD Image
sensor
MiroCam
IntroMedic
Camera (320 #
320 pixel)
OMOM
capsule
ChongQing
JinShan
Science &
Technology
SmartPill
SmartPill
Corp.
Model
Company
Acidity (pH),
pressure,
temperature
Data
Rate
Physical
Dimension
Image Rate
Operation
and Resolution Time
11 mm # 26 mm, 14 images/s,
or 2,600 color
< 4 gr
images
8 hr
Battery
11 mm # 26 mm, 2 images/s
3.8 gr
8 hr
Wireless
Power
9 mm # 23 mm 30 images/s
8 hr
(870,000
images )
Body as
transmitted
channel
Battery
11 mm # 24 mm 3 images/s
3.4 gr
11+ hr
(118,800
images)
98
Power
Source
Battery
13 mm # 26 mm Only sensor
discrete data
8 hr
September/October 2012
higher data rates, which increase resolution and performance, and less interference effects on the other
wireless system in medical centers. A small antenna
is also possible with a wideband high-frequency
technology. To make a UWB transmission feasible
for electronic pills, because of the strong attenuation
through the body tissue, higher transmitted signal
levels at the transmitter must be accommodated [26]
but keeping the signal output less than the regulatory
limit of 41dBm/MHz. The UWB signal power can be
arranged so that when the signal is radiated through
the skin, the power level should meet this FCC mask
without violating safety requirements.
Future Developments
Although low-frequency transmission has commonly been used in electronic pills, high-frequency
links can also be used and offer such advantages as
physically small electronics and antennas and high
data rate transmission. These improvements with
high-frequency links are partially offset by higher
path and tissue penetration loss. Thus, in order to
provide good wireless communication performance,
the receiver should be placed very close to the human
body (i.e., wearable) to reduce the impact of these
losses. In the future, multiple antenna array connected to a wearable receiver could be used to receive
images from all directions, as well as to increase the
sensitivity of the received signal for a better signal
transmission.
Another important area for study is reduction of
the pill size and associated antennas. The overall
length and width of commercially available electronic pills is usually 26 mm x 11 mm, which is barely
smaller than the average diameter of the adult upper
esophagus.
Electronic pills travel within the body unlike stationed implants. Because of this movement, increasing
transmit power levels from the pill will not increase
the heat much at the tissue of a certain body part.
Thus higher transmitted signal levels can be used at
the transmitter side of the electronic pill inside the
body if it can be ensured that the pill does not lodge
in a certain location. The only section of the body that
the device will stay is the stomach, a watery environment, full of acidic material that can reduce the effect
of localized heating. Considering the strong attenuation through body tissue, the transmitter power level
can be adjusted in the system without violating power
levels of regulations (i.e., FCC regulations) [25]. Of
course, the power levels should not reach above regulated in-body tissue specific absorption rates (SAR);
this is especially important for UWB-based electronic
pill designs.
Small batteries are used or are being considered
to supply the energy to the electronic pills, but even
the smallest batteries still take a considerable amount
September/October 2012
99
(110 cm) 20 cm
Long-Range Data
Transmission
up to 10 m
Second
Wireless
External Unit
(Gateway, Wearable
Device)
Data Telemetry
Up to 30 cm
Wireless Link
Wireless Link
Skin
Wireless
Receiver
Health-Care Station:
Diagnosis, Data Analysis
by Medical Professions
Wi-Fi , Bluetooth,
GSM, UWB
Battery
100
Figure 5. An electronic pill technology with wireless power embedded and wireless gateway for long-range data transmission. The available electronic pill devices have a dimension of
26 mm # 11 mm.
Body
Signal
Processing
and
Computation
Supply
Power
Transmitter
Coil
Wireless Power
Coil
Power
Receiver
Voltage
Regulators
Sensors
< 26 mm
pH, Temp.
Camera
< 11 mm
Monitoring /
Recording
Conclusions
This article has reviewed the systems proposed and
currently commercialized for electronic pills. The
article illustrates some of the challenges and design
issues related to the implementation of a video-based
pill. Electronic pills must operate and co-exist with
other network devices operating in similar frequency
bands to ensure an interference-free, reliable wireless
link. Although the design of electronic pills has a long
history, current designs show the technology is still in
its infancy, mainly due to the small size requirement,
which prevents designers from including complex
design techniques. As the feature size of integrated
circuit technology is further reduced and functionality increased, future electronic pills designers will use
these new technology and techniques, leading to completely self autonomous micro-robots that will contain sufficient functionality to go to designated areas
within the patient. A high-capacity radio system is currently necessary for electronic pill technology in order
to visually examine the digestive tract wirelessly with
more detailed images. Although it is known that tissue
imposes strong attenuation at higher frequencies, it
may be necessary to use high frequency technologies,
such as UWB, to increase the data rate transmission
of electronic pills. Due to the high data rate capacity
(e.g., 100 Mb/s), a wideband electronic pill can transmit raw video data without any compression, resulting
September/October 2012
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101