Low cost imaging and fluid sampling device for gastric adenocarcinoma screening. For East Asia with high prevalence and poor resources.
Story
Team and Intro
We are a team of 2 medical students and one undergraduate. We are rookie makers and hackers. Thank you for reading about our project.
Project Overview
The purpose of this device is to have a minimally invasive, low cost and reusable device capable of collecting image data and biological fluid data to screen for gastric cancer in asymptomatic individuals. We hope to miniaturize and simplify the EGD scope to increase its accessibility to be used in resource poor limited settings where gastric cancer is prevalent.
Minimally Invasive,
- Our goal is to shoot for a very thin cross section area for our device such that introduction into a patients GI tract will not require sedation like that found in certain gastroscopic models. A goal for our cross sectional area would be similar to a NG tube suction. Having the cross sectional area small makes the procedure safer, and does not require global anesthesia.
Low Cost and Reusable
- Gastric adenocarcinoma has the highest prevalence in Eastern Asia, East Europe and South America. Countries that already have developed healthcare infrastructure such as Japan currently do have guidelines for gastric cancer screening that include both EGD and Barium Xray studies. Our low cost goal is to facilitate usage in other countries such as Chinathat similarly have high levels of gastric cancer but do not have the resources necessary to institute a national screening with EGD.
Imaging and Biological Data
- Devices exist that could facilitate either imaging data or biological fluid aspiration. These devices however are not made for the specific purpose of gastric cancer screening and do not have the capabilities to get two types of data. Further, collecting two types of data in one visit will increase the sensitivity of our screening.
Our proposed device would act as a preventative device to identify asymptomatic individuals with very early stages of gastric cancer and allow them the opportunity to undergo definitive EGD diagnosis and subsequent treatment.
Importance
Gastric cancer is one of the most common cancers in the world with 70% of occurrence in the developing world. Approximately 990, 000 people are diagnosed in the world each year(4th leading), and roughly 738, 000(2nd leading) people die (1).
Overall 5 year survival is around 20% in most parts of the world(1). In Japan 5 year survival has been shown to approach is 70% (1). This is most likely secondary to Japan's mass screening programs and early diagnosis.
When any country decides upon screening policy, there is always analysis in terms of costs, harms, benefits in relation to overall levels of disease in a country. Our device stands to decrease the costs and harms associated with traditional screening to be a potential viable new screening option to identify patients early in their disease course and decrease overall mortality.
Device
Our device is intended to be a proof of concept to be further improved in future iterations. Current material costs total around $60 for prototyping. Current code allows for live video, static image capture and LED action.
Components include: LED Light, Arducam 5mp Spy Camera, Raspberry Pi V1.2, Aspiration Tube, 3d Printer Tip Enclosure, Syringe
HowDoesItWork?
Much of the increase in gastric cancer has been in the gastric cardia, an accessible area for imaging via endoscopic means.
The patient will first receive topical anesthesia to temporarily numb the inside of the mouth and throat to minimize a gag reflex. The device will be introduced into the gastrointestinal tract by mouth and slowly entered into the stomach. The device will collect imaging data along the esophagus and stomach and present it in live video and saved still image form. Once inside the stomach, the device will aspirate stomach fluids mechanically via attached syringe to look for biological markers of gastric cancer (2). Upon completion of image and sample collection, the device is pulled up from out of the stomach.
Future Design Changes
Contained fluid aspiration component or use of a thinner aspiration tube will allow us to minimize further the cross sectional area of the entire device at not just the head but its length. This will be important to further minimalize patient discomfort associated with testing.
Application of multicamera setups (two directions or 4) with or without fisheye wide angle lens, will allow higher throughput image sampling at the same amount of time.
Exploration of different techniques to maneuver while within the stomach using multidirectional tethers as a cost effective approach.
Use of a LED strip for lighting within the stomach to provide multidirectional lighting and compact device overall profile
Use of selective wavelength lighting and imaging systems with or without dyes to further accentuate difference between non and cancerous tissue.
References.
1. Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F. Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, and Prevention. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2014;23(5):700-713. doi:10.1158/1055-9965.EPI-13-1057.
2. Matsuoka T, Yashiro M. Biomarkers of gastric cancer: Current topics and future perspective. World Journal of Gastroenterology. 2018;24(26):2818-2832. doi:10.3748/wjg.v24.i26.2818.
Read More Detail : UW-Makeathon: Gastric Cancer Screening Device
