Post written by Zhuan Liao, MD, from the National Clinical Research Center for Digestive Diseases, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.

This study aimed to assess the feasibility and safety of the US capsule endoscopy (USCE) system.

EUS is essential in diagnosing and staging esophageal subepithelial lesions and tumors. However, EUS is invasive, relies on highly trained endoscopists, and typically requires sedation. The newly developed USCE, which incorporates white-light and US imaging modalities into a tethered capsule, is a minimally invasive method for obtaining superficial and submucosal information of the esophagus.

Our study greatly expands the work of previous USCEs on 2 fronts: We successfully developed the first swallowable USCE that contained dual modalities of white-light and US imaging, and we presented the first in-human study of USCE, which demonstrated a high technical success rate.

However, our study has limitations. Feasibility, safety, and clinical efficacy of USCE in human patients need to be further validated in a multicenter study with a large sample size. Secondly, technical refinement of USCE, including a smaller capsule size, deeper depth of US penetration, and precise measurements, is necessary for wider clinical adoption.

In conclusion, our study demonstrated that the novel USCE device is feasible and safe to observe the esophagus in the optical mode and acquire submucosal information under US scanning. The USCE procedure is comfortable, and the device is easy to operate and cost-effective, offering the potential for wide use in the clinic. Further multicenter studies to validate the performance of this capsule are warranted.

US capsule endoscopy (USCE) system and procedure. A, Computer workstation with installed UltraCapsule software and imaging platform. B, The capsule. C, Overall design of the capsule. D, USCE procedure. The capsule was swallowed to inspect the esophagus under the guidance of real-time optical viewing. When the lesion was detected, the capsule was switched to the US mode to scan the lesion for submucosal information. The UltraCapsule software on the computer can be switched between different interfaces to display optical images, US images, or both. CMOS, Complementary metal oxide semiconductor; LED, light-emitting diode; SEL, subepithelial lesion.

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