Device, system and method for motility measurement and analysis

Previous application data The present application states that "Devices, Systems and Methods for Motility Measurement and Analysis (Device, Claims the priority and interests of US Provisional Patent Application No. 60 / 673,803 filed on April 22, 2005, entitled "System and Method for Motility Measurement and Analysis)", all of which are in this application. Incorporated by citation. In addition, the application was filed on August 11, 2005, entitled "Motility Analysis Within a Gastrointestinal Tract," and was filed on December 22, 2005, US Patent Application Publication No. 2005. A partial continuation of US Patent Application No. 11 / 201,217 published as / 0281446, claiming its priorities and interests, the entire of which is incorporated by reference in this application. "Motility Analysis Within a Gastrointestinal It is a continuation application of US Patent Application No. 10 / 175,148, filed on June 20, 2002 and issued on September 13, 2005 as US Patent No. 6,944,316, entitled "Tract)". The whole is incorporated by reference in this application, which is entitled "Motility Analysis Within a Gastrointestinal Tract" and was filed on May 19, 2002 and December 27, 2002. This is a domestic stage application of International Patent Application No. PCT / IL02 / 00386 published as International Application Publication No. WO 02/102223, the entire of which is incorporated by reference in this application, which is "in the gastrointestinal tract". "Motility Analysis Within a Gastrointestinal Tract", claiming the priority and interests of US Provisional Patent Application No. 60 / 299,178, filed June 20, 2001, in its entirety. Incorporated in the application by citation.

Field of invention The present invention relates to the field of in-vivo sensing, and more specifically to the field of in-vivo imaging.

Background of the invention Peristalsis in the gastrointestinal (GI) tract carries swallowed food and also aids digestion and final excretion. Peristalsis results in a pressure pulse wave or contraction that moves along the gastrointestinal tract, resulting in the motility of a bolus or other object within the gastrointestinal tract.

Some medical conditions can alter normal motility in the gastrointestinal tract. For example, obstacles, obstructions or other medical conditions cause hypokinesia. Coordination disorder is caused, for example, by neuropathy and is not always visible.

Some in-vivo sensing systems may include, for example, an in-vivo imager capable of capturing and transmitting an image of the gastrointestinal tract as the in-vivo imager passes through the gastrointestinal lumen.

Other devices, systems and methods for in vivo sensing of passages or cavities in the body for sensing and accumulating information (eg image information, pH information, temperature information, electrical impedance information, pressure information, etc.) Is known in.

<p> Outline of the invention</p>

<p> Some embodiments of the invention may include, for example, devices, systems and methods for the measurement and analysis of gastrointestinal motility and / or contractile activity.</p><p> Some embodiments may include, for example, a system having a processor that determines, calculates, and / or analyzes intraluminal motility and / or contractile activity based on data analysis received from an in vivo device. ..</p><p> Some examples may include, for example, determining the motility and / or contractile activity based on the analysis of the position measurement data of the in vivo device.</p><p> Some embodiments may include, for example, calculating the displacement of the in vivo device within a predetermined period of time to determine the motility and / or contractile activity based on the displacement.</p><p> Some embodiments may include, for example, determining the magnitude of motility and / or contractile activity based on the magnitude of displacement of the in vivo device during the predetermined period.</p><p> Some embodiments may include determining, for example, the smallness of motility and / or contractile activity based on the small displacement of the in vivo device during the predetermined period.</p><p> Some examples may include, for example, identifying patterns in the position measurement data and determining the motility and / or contractile activity based on the patterns.</p><p> Some embodiments may include, for example, calculating the position measurement data based on the radio frequency signal received from the in vivo device.</p><p> Some embodiments may include, for example, calculating the velocity of the in vivo device during a predetermined period and determining the motility and / or contractile activity based on the velocity.</p><p> Some examples may include, for example, determining the motility and / or contractile activity based on the change in velocity during the predetermined period.</p><p> Some examples may include, for example, identifying patterns at multiple calculated velocities and determining the motility and / or contractile activity based on the patterns.</p><p> Some examples may include determining motility, contraction and / or contractile activity, for example, based on image analysis of images obtained by an in vivo imager. For example, light intensity analysis of multiple images obtained by an in vivo device may be used to determine the contractile activity of the gastrointestinal tract.</p><p> Some examples may include determining motility, contraction and / or contractile activity, for example, based on the brightness levels of multiple images obtained by an in vivo device.</p><p> In some embodiments, the in-vivo device includes, for example, an in-vivo imager, an in-vivo sensor, an autonomous in-vivo device and / or a swallowable capsule.</p>

<p> The embodiments of the present invention may have various other benefits or advantages. The subject matter of invention is specifically pointed out and articulated in the conclusions of the specification. However, the present invention will be best understood by reference to the detailed description below, along with the accompanying drawings, with respect to both the mechanism and method of operation as well as the content, features and advantages.</p><p> It is recognized that for the sake of simplicity and clarity of the illustration, the elements shown in the figure are not necessarily drawn to scale. For example, some dimensions of an element may be exaggerated compared to other elements for clarity. In addition, reference numbers may be repeated in the figure to indicate corresponding or similar elements, where appropriate.</p><p> Detailed description of the invention In the detailed description below, many specific details are given to provide a complete understanding of the present invention. However, it will be appreciated by those skilled in the art that the present invention can be practiced without these specific details. In other examples, well-known methods, procedures, elements and circuits are not described in detail so as not to obscure the invention.</p><p> Although some of the discussion may relate to in-vivo imaging devices, systems and methods, the invention is not limited to this, and examples of the present invention, along with various other in-vivo sensing devices, systems and methods. May be used. For example, some embodiments of the present invention include, for example, in vivo pH sensing, in vivo temperature sensing, in vivo pressure sensing, in vivo electrical impedance sensing, in vivo detection of substances or materials, in vivo detection of medical conditions or pathologies, It may be used with in vivo data collection or analysis and / or with various other in vivo sensing devices, systems and methods.</p><p> Some embodiments of the invention are typically directed to single-use or partially disposable detection and / or analyzers. Some examples are directed to typically swallowable in-vivo devices that can be pushed by natural peristalsis into a lumen, such as the gastrointestinal (GI) tract, and can proceed passively or actively. Some examples are directed to in vivo sensing devices that can pass through other lumens such as blood vessels, genitals, urethra. The in-vivo device may be, for example, a sensing device, an imaging device, a diagnostic device, a detection device, an analyzer, a treatment device, or a combination thereof. In some embodiments, the in vivo device may include an image sensor or an image sensor. Other sensors such as pH sensors, temperature sensors, pressure sensors, sensors for other in vivo parameters, sensors for various in vivo substances or compounds, and the like may be included.</p><p> Devices, systems and methods according to some embodiments of the invention, including, for example, in-vivo sensing devices, receiving systems and / or display systems, are entitled "In-vivo Video Camera System". U.S. Patent No. 5,604,531 by Iddan et al. And / or U.S. Patent No. No. 1, issued March 7, 2006, entitled "Device for In-Vivo Imaging." No. 7,009,634, and / or "System and Method for Wide Field Imaging of Body Lumens", filed on 16 January 2002 and 15 August 2002. US Patent Application No. 10 / 046,541, published as US Patent Application Publication No. 2002/0109774, and / or "System and Method for Determining In-vivo" Body Lumen Conditions) , US Patent Application No. 10 / 046,540, filed on January 16, 2002 and published as US Patent Application Publication No. 2002/0111544 on August 15, 2002, and / Or, entitled "System and Method for Presentation of Data Streams," as described in US Patent Application No. 11 / 226,350, filed September 15, 2005. It may resemble examples, all of which are incorporated herein by reference in their entirety. The devices and systems described herein have other configurations and / or It may have a set of elements. For example, external receiver / recorder devices, processors and monitors in workstations, such as those described in the above publications, may be suitable for use in some embodiments of the present invention. For example, the present invention can be performed using endoscopes, needles, stents, catheters and the like. Some in vivo devices may be in capsule shape or other shape, such as peanut shape or tubular, spherical, conical, or other suitable shape.</p><p> Some embodiments of the invention may include, for example, a typically swallowable in vivo device. In other embodiments, the in vivo device need not be swallowable and / or autonomous and may have other shapes or configurations. Some examples may be used in various lumens, such as the gastrointestinal tract, blood vessels, urethra, genitals and the like. In some embodiments, the in vivo device may optionally include sensors, image sensors and / or other suitable elements.</p><p> Examples of in vivo devices are typically autonomous and typically self-sufficient. For example, an in-vivo device may be a capsule or other unit in which all of its elements are substantially contained within a container, housing or shell, or may include such a capsule or other unit, in which the in-vivo device. Does not require wires or cables to receive power or transmit information, for example. The in-vivo device may communicate with an external receiving and displaying system to provide data display, control or other functions. For example, power may be supplied by an internal battery or an internal power source, or a wired or wireless power receiving system may be used. Other embodiments may have other configurations and functions. For example, elements may be distributed across multiple sites or units, and control information or other information may be received from external sources.</p><p> Examples of the present invention are not limited to this point, and the term "motility" as used herein may relate to, and may include, for example, in vivo movement or in vivo displacement of an in vivo device. Good.</p><p> Examples of the present invention are not limited to this point, and the term "great motility" as used herein may relate, for example, to relatively large displacements and / or relatively fast movements of in vivo devices. On the other hand, the term "small motility" as used herein may be associated with, for example, relatively small displacements and / or relatively slow movements of in vivo devices. It may be included.</p><p> Examples of the present invention are not limited to this point, and for example, the term "contraction activity" as used herein may relate to or includes, for example, the movement or contraction of a lumen such as the gastrointestinal tract. But it may be.</p>

FIG. 1 schematically shows an in-vivo sensing system according to an embodiment of the present invention. In some embodiments, the system may include, for example, an image sensor 846, an illumination source 842, and an in vivo device 840 having a power source 845 and a transmitter 841. In some embodiments, device 840 may be implemented using swallowable capsules, but other types of devices or suitable embodiments may be used. Outside the patient's body may be, for example, an image receiver 812 (including, for example, an antenna, an antenna belt or an antenna array, or operably connected to them), a storage device 819, a data processor 814 and a monitor 818. .. In one embodiment, for example, the storage device 819, the data processor 814 and / or the monitor 818 may optionally be implemented as a workstation 899, which may include, for example, a multipurpose or dedicated computer or computing platform.

The transmitter 841 may operate wirelessly, for example by the use of radio waves, but in embodiments where there is device 840 or it is contained within the endoscope, the transmitter 841 may be, for example, a wire. Data may be transmitted via fiber optics and / or other suitable methods.

The device 840 may typically be an autonomous swallowable capsule and may include it, but the device 840 may have other shapes and is swallowable or autonomous. No need. Examples of device 840 are typically autonomous and typically self-sufficient. For example, device 840 may be a capsule or other unit in which all of its elements are substantially contained within a container or shell, where device 840 is a wire for receiving power and transmitting information. Or you don't need a cable.

In some embodiments, device 840 may communicate with external receiving and display systems (eg, via receiver 812) to provide data display, control or other functionality. For example, power may be supplied to device 840 using an internal battery, an internal power source, or a wireless system to receive power. Other embodiments may have other configurations and functions. For example, the elements may be distributed across multiple sites or units, and control information may be received from external sources.

In one embodiment, the device 840 may include an in vivo video camera, eg, an image sensor 846, which captures and transmits an image of the gastrointestinal tract while the device 840 is passing through, for example, the gastrointestinal tract. Can be done. Other cavities and / or internal cavities are imaged or sensed by device 840. In some embodiments, the imaging element 846 is, for example, a charge coupling element (CCD) camera or imaging element, a complementary metal oxide semiconductor (CMOS) camera or imaging element, a digital camera, a still camera, a video camera or other. It may include a suitable imaging element, camera, or imaging element.

In one embodiment, the image sensor 846 in device 840 may be operationally connected to transmitter 841. The transmitter 841 may transmit the image to, for example, the image receiver 812, which may send the data to the data processor 814 and / or the storage device 819. The transmitter 841 may further include a control function, but the control function may be included in a separate element. Transmitter 841 may include any suitable transmitter capable of transmitting image data, other sensed data and / or other data (eg, control data) to the receiver. For example, transmitter 841 may include an ultra-low power high frequency (RF) high band transmitter, probably provided in a chip scale package (CSP). Transmitter 841 may transmit via antenna 848. Another unit within the transmitter 841 and / or device 840, such as the controller or processor 847, controls the device 840, controls the operating mode or settings of the device 840, and / or controls within the device 840. Control capabilities, such as one or more control modules, processing modules, circuits and / or functions, may be included to perform processing operations.

The power supply 845 may include one or more batteries or power cells. For example, the power supply 845 may include a silver oxide battery, a lithium battery, other suitable electrochemical cells with high energy density, and the like. Other suitable power supplies may be used. For example, the power source 845 may receive power or energy from an external power source (eg, a power transmitter), which may be used to transmit power or energy to device 840.

In some embodiments, the power source 845 may be inside the device 840 and / or may not require coupling to an external power source, eg, to receive power. The power supply 845 may be one of devices 840, for example, in a continuous, substantially continuous, or non-discrete manner or timing, or in a periodic, intermittent, or other non-continuous manner. It can power more than one element. In some embodiments, the power supply 845 is, for example, one or more of devices 840, not necessarily in response to, for example, a request, or necessarily in response to a triggering event or external actuation or external excitation. Can power the element.

In one embodiment, the transmitter 841 may optionally include a processor or processor or controller to process, for example, the signal and / or data generated by the image sensor 846. In another embodiment, the processing device may be implemented using a separate element within device 840, such as a controller or processor 847, or an integrated image sensor 846, transmitter 841 or another element. It may or may not be needed as a part. Any processing unit can be, for example, a central processing unit (CPU), digital signal processor (DSP), microprocessor, controller, chip, microchip, controller, circuit, integrated circuit (IC), application-specific integrated circuit (ASIC) or Other suitable multipurpose or specific processors, controllers, circuit devices or circuits may be included. In one embodiment, for example, the processor or controller may be embedded or integrated in transmitter 841, and may be implemented using, for example, an ASIC.

In some embodiments, the image sensor 846 is, for example, in a continuous, substantially continuous, or non-discrete manner, eg, not necessarily on demand, or necessarily a triggering event or external actuation or In vivo images may be captured in a periodic, intermittent, or other discontinuous manner, not necessarily in response to external excitation.

In some embodiments, the transmitter 841 is continuous, substantially continuous, eg, not necessarily on demand, or necessarily in response to a triggering event or external actuation or external excitation. Image data may be transmitted instead, or in a periodic, intermittent, or other non-contiguous manner.

In some embodiments, device 840 may include one or more light sources 842, such as one or more light emitting diodes (LEDs), "white LEDs", organic LEDs (OLEDs), or other suitable light sources. .. The illumination source 842 may illuminate, for example, an imaged and / or sensed cavity or cavity. Any optical system 850 that includes one or more optical elements, such as one or more lenses or composite lens assemblies, one or more suitable optical filters or other suitable optical elements, is optionally included in device 840. It may help converge the reflected light on the image pickup element 846 and / or perform other optical processing operations.

The data processor 814 can analyze the data received from the device 840 via the receiver 812, and may communicate with the storage device 819, for example, by passing frame data to and from the storage device 819. The data processor 814 also supplies the analyzed data to the monitor 818, where users (eg doctors) can view data including, for example, image data, sensing data, position data, motility data or other information. , Or other methods. In one embodiment, the data processor 814 may be configured for real-time processing and / or for performing post-processing and / or for review later. If the control function (eg delay, timing, etc.) is outside of device 840, a suitable external device (eg, data processor 814 or image receiver 812) may send one or more control signals to device 840.

The monitor 818 may include, for example, one or more screens, monitors or suitable display devices. Monitor 818 may display, for example, one or more images or image streams captured or transmitted by device 840, such as an image of the gastrointestinal tract or another image of a cavity or lumen. Additional or alternative, monitor 818 describes, for example, control data, location or location data (eg, the location or relative location of device 840). , Or the data shown), orientation data, motility information and / or other suitable data may be displayed. In one embodiment, for example, both the image and its location or location are shown using monitor 818 and / or stored using storage device 819. Other systems and methods of storing and / or displaying the collected image data and / or other data may be used.

In some embodiments, in addition to or instead of revealing the pathological or other conditions of the gastrointestinal tract or other cavities, the system provides information about the location of these conditions. Can be done. Suitable tracking devices and methods are described herein, as well as US Pat. No. 5,604,531, and / or "Array System for Locating," as described above. an In-Vivo "Signal Source)" of U.S. Patent Application No. 10 / 150,018, filed May 20, 2002 and published as U.S. Patent Application Publication No. 2002/0173718 on November 21, 2002. Also described in Examples, both have been transferred to a transferee common to the present invention, the full text of which is incorporated herein by reference. Other suitable location identification systems and methods may be used according to the examples of the present invention.

Typically, the device 840 may transmit the image information as separate parts. Each part may typically correspond to an image or frame. Other suitable transmission methods may be used. For example, in some embodiments, device 840 may capture and / or capture an image every half second and may transmit image data to receiver 812. Other constant and / or variable capture and / or transmission rates may be used.

Typically, the image data recorded and transmitted may include digital color image data. In alternative embodiments, other image formats (eg, monochrome image data) may be used. In some embodiments, each frame of the image data may include 256 rows, each row may contain 256 pixels, and each pixel may contain color and brightness data by known methods. According to another embodiment, a 320 × 320 pixel image sensor may be used, or another image sensor with an appropriate pixel size may be used. The pixel size may be, for example, 5 to 6 microns. Other suitable sizes may be used. According to some embodiments, each pixel can be individually adapted to a microlens. For example, Bayer color filters may be applied. Other suitable data formats may be used, and other suitable numbers or types of rows, columns, arrays, pixels, sub-pixels, boxes, super-pixels and / or colors may be used.

Optionally, device 840 may include one or more sensors 843 in place of or in addition to sensors such as image sensor 846. The sensor 843 may, for example, sense, detect, determine and / or measure one or more values of the physical properties or characteristics of the ambient environment of the device 840. For example, sensor 843 may include a pH sensor, temperature sensor, conductivity sensor, pressure sensor or any other known suitable in vivo sensor.

In some embodiments, the device 840 is capable of one-way or two-way communication. For example, device 840 may be able to use transmitter 841 to transmit data (eg, sensed data, image data, position measurement data, etc.) to an external receiver / recorder 812. Optionally, the device 840 may be able to receive data (eg, control data, instructions, commands, parameter values, settings or parameter modifications, activation instructions, non-operation instructions, etc.) from an external transmitter or transceiver. .. For example, in one embodiment, device 840 may optionally include a receiver capable of receiving signals (eg, transmitter 841 can optionally be implemented as a transceiver or transmitter / receiver). The receiver / recorder 812 is also optionally realized as a transceiver or transceiver capable of transmitting signals to device 840. May be good. Other suitable one-way or two-way communication mechanisms may be used.

According to some embodiments of the invention, the position measurement data uses, for example, data collected or transmitted by an in vivo device (eg, device 840 or another signal source) separate from the position data itself. Will be decided. For example, the position measurement data may be specific to the signal sent by the in-vivo device 840 or the beacon sent by the in-vivo device 840, but the position measurement data may be sensitive data (eg, image data, pH data, etc.). Other data and additional data may be sent separately. In one embodiment, the sensed data can be considered non-positional measurement data collected by the in vivo device 840. In some embodiments, the position measurement data may be unique to the data signal, which primarily includes the sensed data.

In some embodiments, image data and other collected data can be stored for short or long periods of time and can be moved to another location or device for processing, and / or analysis. Medical professionals can use images to diagnose pathologies of the gastrointestinal tract or other parts of the body, and the system provides information about the location of these pathologies. In one embodiment, the data processor storage device 819 first collects the data and then transfers the data to the data processor 14, so that the image data is not seen in real time. In alternative embodiments, other configurations may allow real-time display, and motility data and / or contractile activity data may be calculated and displayed in substantially real time.

The monitor 818 may preferably show image data in still and / or moving form, and may also show other information. For example, in one embodiment, the monitor is the absolute time elapsed for the image currently shown, the relative or absolute motility, contractile activity data of the device 840 over the stroke while the device 840 passes through the gastrointestinal tract. Alternatively, the indicator and / or the time corresponding to the current image or other data displayed may be indicated. The absolute time elapsed for the currently shown image is, for example, the moment device 840 is first activated and the image receiver 812 begins receiving transmissions from device 840, and the moment the currently displayed image is captured. It can be the amount of time that has elapsed between and. Various methods can be used to display the motility and / or contractile activity of the device 840, for example as manifested herein. In some embodiments, various types of information are displayed in windows or other screen areas, and / or multiple monitors are used to image data, motility data, contractile activity data, position measurement data and /. Alternatively, other data may be displayed.

Information collection, storage and processing are preferably carried out by a unit, but the systems and methods of the present invention may be performed in alternative configurations. For example, elements that enable motility and / or contractile activity analysis are located within the device 840 (eg, a swallowable capsule) or, as an alternative, within a portable device worn by the patient (eg, receiver 812). May be good. In addition, the elements that collect image information do not have to be encapsulated, but are included in other means of transport suitable for passing through the lumen of the human body, such as endoscopes, stents, catheters, needles, etc. May be good.

While the device 840 can take several hours to pass through the gastrointestinal tract, the in-vivo sensing system can collect large amounts of data and record images at speeds such as two images per second, tens of thousands of images. Will result in recording. The series of still images collected may later be shown as still images or moving images across the gastrointestinal tract. The image recording speed (or the speed at which the frame is captured) may be constant or variable, for example the image recording speed may vary based on the motility of the device 840.

While in the gastrointestinal tract, device 840 performs intermittent movements with relatively long residence times at several locations or locations. These relatively long residence periods may be normal or may be due to pathology such as obstruction in the gastrointestinal tract. The embodiments of the present invention help, for example, a medical professional to monitor the movement of the device 840 and diagnose and find, for example, an obstruction or other pathological area. Further changes in motility can indicate normal conditions, for example the passage of device 840 from one part of the gastrointestinal tract to another, so the embodiments of the present invention are the location or position of device 840 or other diagnostic device. Motility data can be used to determine location. In some embodiments, the motility data may indicate contractile activity and allow the generation of contractile activity data.

In one embodiment, substantially each image Pi in the data stream of an image can be compared to the immediately preceding image Pi-1 (or any other previous image Pi-n), eg, that comparison. Determine the motility and / or contractile activity of the device 840 during the capture of the two images. According to an embodiment of the invention, one or more methods may be used to determine motility and / or contractile activity based on image comparison or image analysis. In some embodiments, for example, image similarities or image differences may be determined and analyzed to obtain measurements or indications of motility and / or contractile activity. In one embodiment, for example, it is possible to take advantage of the assumption that the device 840 moves slowly while the two images are captured so that the two images are similar. According to one embodiment, if the two compared images are determined to be substantially identical, it can be determined that the device 840 did not move while the two images were captured. According to some examples, if the two compared images are very different, it can be determined that the device 840 moved relatively fast while capturing the compared images.

In some embodiments, the image comparison may be pixel-pixel and / or pixel cluster based. In an alternative embodiment, the images are compared without being divided into sections such as pixels or clusters. In one embodiment, the 256x256 pixel grid of each image is divided into a grid of 32x32 pixel clusters to form 1,032 clusters. In alternative embodiments, other methods of dividing the image may be used, and other pixel counts or dimensions may be used.

For example, based on the comparison of two or more images, the data processor 814 can calculate the contractile activity between capturing the two images and / or the relative motility of the in-vivo imager 840 that captured the images. it can. In one embodiment, the resulting motility value at one point is a relative value on the scale and is raw relative to another point during traversal of the gastrointestinal tract or other parts of the body of device 840. It can show the motility of the in-vivo imager 840 and / or the magnitude of contractile activity. In alternative embodiments, absolute motility may be calculated.

In some embodiments, the contractile activity and / or motility calculation may be repeated for virtually any image or a set of images in a series of images, thereby causing a series of contractile activity and / or Generate motility values. The resulting contractile activity and / or motility values can be presented to the user in various ways. In one embodiment, the monitor 818 displays a first window for displaying an image frame or video and a second window that displays the continuous elapsed absolute time (or current time in the video) of the images in the displayed frame. A third window that displays a chart of contractile activity or relative motility of the in-vivo imager 840, plotted against time and / or distance traveled along a lumen such as the gastrointestinal tract with two windows. May include windows and. A contractile activity and / or motility value or pattern (eg, a region with low motility or contractile activity, a region with high motility or contractile activity, or a region with a certain motility or contractile activity pattern) in the image or video part. A display to be linked may be given on the display unit of the monitor 818. The user can click with the mouse or use another input device, for example. Can point to a contractile activity or motility value, or a portion of a contractile activity or motility chart or plot, and the system can display the corresponding still image or video.

In some embodiments, additional windows may display other data. For example, the position of the in vivo imager 840 while traversing the gastrointestinal tract may be graphed as a two-dimensional rendering of a three-dimensional path, such data as image data, contractile activity data and / or motility. It may be combined or linked with the data. Areas with low motility or contractile activity, areas with high motility or contractile activity, or areas where the pattern of motility or contractile activity is altered or abnormal are, for example, color changes or color changes on such path indications. It may be indicated using a color label.

In one embodiment, spectral analysis of contractile activity or motility data may be performed and the spectral analysis may be presented to the user or used for diagnostic or other purposes. For example, in a substantially normal human gastrointestinal tract, peristaltic waves are typically produced with some repetition. Spectral analysis of peristaltic waves in different periods or parts of a series of contractile activity or motility data may be performed and presented to the user. Such spectral analysis may indicate, for example, the frequency of peristaltic wave repetition at different times or locations in the course of transport through the gastrointestinal tract. In alternative embodiments, other visual representations of contractile activity and / or motility may be provided.

In some examples, contractile activity data and / or motility data are examined or analyzed to determine at least one parameter or measurement, which is, for example, a particular in spectral analysis of contractile activity or motility data. It can be shown as a pattern of, a pattern of spectral analysis of contractile activity or motility data, a particular iteration of the peristaltic wave, or a representation of the peristaltic wave iteration. The parameters that can be displayed by a pattern or a particular pattern may be compared to criteria such as, for example, parameter values of a normal or healthy individual, or may be compared to a particular pattern typical of gastrointestinal pathology. .. The comparative results provide a diagnostic tool for identifying the condition of the gastrointestinal tract, for example by showing the dilated state of the gastrointestinal tract. Spectral analysis can be performed, for example, on contractile activity or motility data of the in vivo device 840. For example, spectral analysis is represented as a motion wave graph over time. Other methods of representing spectral analysis may be used. A pattern matching module (implemented using, for example, a processor 814 that operates according to a software application) attempts to match a spectral analysis corresponding to various conditions with a recorded spectral analysis and determines a match or a close match. Can be reported to the user.

In some embodiments, one or more methods of analyzing image data may be used to generate motility and / or contractile activity data. For example, contractile activity and / or motility analysis is continuous or non-continuous, calculation of differences for a given property between two or more frames, images or corresponding pixels of an image portion, continuous or non-continuous. , Calculation of cross-correlation functions between two or more frames, images or image parts, continuous or non-continuous, calculation of changes in local statistical distribution in two or more frames, images or image parts, or continuous It can be done based on the calculation of changes between two or more frames, images, or corresponding local statistical distributions that are or are not contiguous. The local statistical distribution can include, for example, the mean, variation or standard deviation of one or more pixel clusters.

In some embodiments, image analysis is performed to determine the location of the device 40 in vivo (eg, by identifying imaging parameters typical of a particular region of the gastrointestinal tract or other lumen). May be used. In some embodiments, position or location information and other factors (eg, the time elapsed during the transposition of the device 840, or the velocity of the device 840 along its path) to calculate motility and / or contractile activity. ) May be used. Similarly, the position of device 840 may be determined by other methods and location information may be used to calculate motility and / or contractile activity.

Some examples may use one or more non-image analysis based methods for measuring motility and / or contractile activity. For example, device 840 may include an accelerometer, which can measure the instantaneous acceleration of device 840 as it moves through the gastrointestinal tract. The integrator can convert the acceleration data to velocity data, and the velocity data may be used by the data processor 814 to determine motility and / or contraction activity.

In some embodiments, a pressure sensor or shear gauge may be attached to or included in the device 840, allowing detection of pressure due to peristalsis or movement of the intestinal wall. According to some embodiments, the relationship between pressure and velocity is empirically determined and then utilized to determine the velocity or relative velocity of device 840.

In some embodiments, the sensor of device 840 detects motion relative to an artificially induced magnetic field that can be generated in the patient's gastrointestinal tract region. The magnetic field can induce an electric current in the coil of the sensor, the magnitude of which can be a function of the velocity of the coil through the magnetic field. The data on the induced current is analyzed and converted into motility and / or contraction activity information.

In some embodiments, an external sensor that continuously tracks the device 840, such as a Doppler ultrasonic unit, may be used. Additional or alternative, according to one embodiment, the strength of the transmitted signal can be monitored with a receiver 812 adapted to receive the RF signal from transmitter 841 of device 840. A signal of invariant intensity indicates that the transmitter 841 (hence device 840) is not moving, and a signal of different intensity indicates that the transmitter 841 (hence device 840) is moving. One or more of these methods and / or other suitable methods may be combined to provide a measurement of the motility and / or luminal contraction activity of the device 840.

In some embodiments, contractile activity and / or motility is raw, eg, based on measured displacement of the in vivo device 840 over time, over a predetermined period of time, or at time intervals. It may be determined based on the position measurement of the body device 840.

FIG. 2 is a flow chart of a method of determining contractile activity and / or motility based on position measurement data according to some embodiments of the invention.

As shown in frame 1310, the method comprises determining, for example, the position L1 of the in vivo device at the first time point T1. For example, the receiver 812 and / or the data processor 814 may determine the position L1 of the in vivo device 840 at the first time point T1 based on signal strength or other received signal analysis.

As shown in frame 1320, optionally, a wait period or delay period elapses between the operation of frame 1310 and the operation of frame 1310. In one embodiment, time intervals such as, for example, about 1 second, 5 seconds, 10 seconds, etc. may elapse. In alternative embodiments, other appropriate time intervals may elapse, or substantially no delay period may elapse.

As shown in frame 1330, this method comprises, for example, an in vivo device at another time point T2. Includes determining the position L2 of. The receiver 812 and / or the data processor 814 may determine the position L2 of the in vivo device 840 at another time point T2, for example based on signal strength or other received signal analysis.

As shown in frame 1340, this method involves, for example, determining the velocity V of the in vivo device between the first and second time points. For example, in one embodiment, the difference or absolute difference between L1 and L2 may be calculated and may be divided by the difference or absolute difference between T1 and T2. In some embodiments, the following formula may be used: V = | (L2-L1) / (T2-T1) | Equation 1 Other suitable formulas or calculations may be used.

As indicated by arrow 1350, motility and / or contractile activity data are determined based on analysis of velocity and / or position measurement data (eg, substantially real-time analysis). In one embodiment, for example, the calculated velocity V is compared to the velocity threshold. If the calculated velocity V is greater than the threshold, it can be determined that the in vivo device has relatively high motility during the period between T1 and T2, and / or the patient's contractile activity during the period between T1 and T2. It can be determined that (eg, multiple contractions per minute) is relatively large. If the calculated velocity V is less than the threshold, it can be determined that the in vivo device has relatively little or virtually no motility during the period between T1 and T2, and / or T1 and T2. It can be determined that the contractile activity performed by the patient during the interim period (eg, multiple contractions per minute) is relatively small or no contractile activity. In one embodiment, the threshold may be pre-defined or pre-calculated, eg, based on pre-obtained position measurement data from healthy and / or unhealthy patients, in another embodiment. The threshold may be calculated in substantially real time, for example, based on analysis of the speed of the in vivo device or calculation of an average value.

As indicated by arrow 1360, the operation of frame 1310-1350 may be repeated, for example, periodically or substantially continuously.

In some embodiments, the measured velocity or position measurement data may be analyzed to identify patterns or data that indicate the magnitude of motility or the magnitude of contractile activity. For example, the position measurement data and / or the velocity value may be charted using a graph, and a pattern on the graph may be specified to indicate the magnitude of motility or the magnitude of contraction activity.

In some embodiments, a graph of measured velocity values can be prepared and analyzed, allowing measurements of, for example, motility or contractile activity. Reference is made to FIG. 3, which schematically illustrates the measured velocity value graph 1400 of the in vivo device according to some embodiments of the invention. In graph 1400, the vertical axis 1410 may represent the velocity (V) value and the horizontal axis 1420 may represent the time (T) value. In other embodiments, the vertical axis 1410 may represent the velocity (V) value and the horizontal axis 1420 may represent the distance and / or location along the lumen, eg, the gastrointestinal tract.

In some embodiments, a relatively rapid increase in velocity can be identified, for example, as indicated by pattern 1430 or other suitable pattern or data. The identified pattern makes it possible to determine whether there was significant motility, significant contractile activity, or one or more contractions at the corresponding time points (eg, time points T10, T20 and T30). Can be.

In some embodiments, a relatively sharp decrease in velocity can be identified, for example, as indicated by pattern 1440 or other suitable pattern or data. Identified pa The turn may allow the determination that small motility or small contractile activity has occurred at the corresponding time points (eg, time points T15, T25 and T35).

In some embodiments, relatively unchanged velocities can be identified, for example, as indicated by pattern 1450 or other suitable pattern or data. According to the identified pattern, at one or more corresponding time points (eg, time points T27 and T28) there was little motility, little contraction activity, or virtually no contraction. Can make a judgment.

Other appropriate decisions regarding motility and / or contractile activity may be made based on the analysis of velocity and / or position measurement data.

In some embodiments, contractile activity may be determined based on one or more indicators. In one embodiment, for example, a relatively large contractile activity based on identifying a relatively large displacement of an in vivo device (eg, measured using position measurement data) over a predetermined relatively short period of time. Can be determined, and relatively small contractile activity is determined based on identifying relatively small displacements of the in vivo device (eg, measured using position measurement data) over a predetermined relatively long period of time. obtain. In another embodiment, relatively large or relatively small contractile activity can be determined, for example, based on analysis of in vivo device motility data, velocity data, displacement data and / or position measurement data.

In some embodiments, multiple images captured by the in vivo device may be compared to allow determination of contractile activity. In one embodiment, for example, an image comparison (or cluster comparison) can show that the later image is very different from the previous image, thereby between the times when the compared images were captured. It becomes possible to judge that a relatively large contractile activity has occurred. In another embodiment, for example, an image comparison (or cluster comparison) may show that the later image is not very different from the previous image, and the compared images are relatively small between times captured. It is possible to determine that contractile activity has occurred or that there has been virtually no contractile activity.

In some examples, pathology, possible medical diagnoses, medical conditions and / or medical diagnoses can be determined and suggested, for example, based on motility and / or contractile activity data. In one embodiment, for example, by using relatively small motility and / or relatively small contractile activity, the patient's intestinal motility may be dysfunctional or dysfunctional, or a portion of the intestine may be dysfunctional or dysfunctional. It may be decided by suggesting that it may have.

In some embodiments, one or more data items, data patterns, measurements or other analysis results may be used to identify or determine contraction, or to identify or determine contraction activity. You may. In one embodiment, for example, a relatively abrupt change or decrease in illumination (eg, global illumination) in one or more images may be used to determine contraction or contraction activity. In another embodiment, for example, a relatively rapid change or increase in the velocity, position and / or location of the in vivo device may be used to determine contraction or contraction activity.

In yet another embodiment, movement or displacement of the in-vivo device, eg, "reverse" or upstream, which does not follow the general direction of travel of the in-vivo device, is used to determine contraction or contractile activity. Be done. This results in, for example, a contraction that engages only a portion of the in-vivo device (eg, the anterior or tip of the in-vivo device), or a downstream contraction that causes fluid above the contraction region. Can be pushed upstream.

In one example, the motility and / or contractile activity data show motility and / or contractile activity data such as a typical healthy person, a typical sick person, a person with one or more illnesses or medical conditions. It can be compared to or related to the corresponding data. By such comparison or analysis, for example, whether the patient is healthy or unhealthy, or has one or more illnesses or medical conditions, based on motility and / or contractile activity data collected from a patient, etc. Can be suggested or judged to indicate (or perhaps indicate) about.

Some examples, kinetic data, position measurement data, position data, velocity data, acceleration data, lighting data, image comparison results or other data may be substantially continuous over time, eg, periodically. Etc., may be analyzed and determined over a predetermined period of time or according to a predetermined time interval or time slot.

In some embodiments, motility, contraction and / or contractile activity can be determined based on lighting data, such as changes in the illumination intensity of one or more images captured by an in vivo device. In some embodiments, for example, contraction or contractile activity changes the distance between the in vivo device and the lumen that can surround it, thereby reflecting light from the lumen to the image sensor of the in vivo device. Modulate the amount or intensity of. In some examples, photomodulation can correlate with motility, contractile activity or contraction. In some embodiments, the in-vivo imager can capture an image of a relatively small cavity located between the in-vivo imager and the lumen. Therefore, photomodulation that may be associated with contraction or contraction activity within the cavity may be used to determine contraction, contraction activity or motility.

According to one embodiment, an autonomous capsule imaging device is used to obtain an image of the gastrointestinal lumen, which may have a circular field of view that is substantially perpendicular to the long axis of the capsule device. In some embodiments, the device may have a peanut-like shape because some areas of the imaging device are concave, tapered, narrowed or "pinched". Such concave areas may include, for example, a transparent ring, portion, or viewing window through which light may enter or may be reflected from a reflective surface (eg, part of the gastrointestinal tract wall) onto the image sensor. May be good. The device may include one or more illuminators that illuminate the inner wall or area of the lumen from, for example, one or several directions. The light rays reflected from the inner wall of the lumen hit the reflecting surface of the device and are reflected on the image sensor. In some embodiments, the reflective surface may be parabolic, so that light rays that hit the reflective surface from various directions, for example, are reflected toward the image sensor. Typically, in a tubular cavity, the capsule-shaped device can be aligned with the lumen axis by contraction. Thus, according to one embodiment, imaging capsules that move along the gastrointestinal tract, such as the small intestine, and have a substantially right-angled field of view are sensitive to contraction of the gastrointestinal tract. This is because these contractions can cause the lumen wall to collapse or contract in the longitudinal wall of the imaging capsule that obtains the image, blocking and / or altering the view and / or illumination of the view of the capsule. The image obtained from such an imaging capsule device may resemble the exemplary frame shown in FIG. For example, as shown in FIG. 4 and detailed herein, an in vivo image sensor may include an image sensor capable of capturing a panoramic (eg, ring) image. Thus, for example, in one embodiment, one or more in vivo images that are dark or relatively darker may indicate that contraction occurred when the image was captured. In another embodiment, one or more images that are bright or relatively bright may indicate that no shrinkage occurred when the image was captured. .. For example, contraction of the lumen or its portion can cause contraction of the lumen wall in the external portion of the in-vivo device from which the panoramic in-vivo image is captured, thereby blocking the panoramic view of the in-vivo image sensor. As a result, a dark panoramic (for example, ring-shaped) in-vivo image is produced. Thus, a dark or relatively dark panoramic image corresponds to the contraction of the lumen around or near an in-vivo imager, eg, an in-vivo imager capable of capturing a panoramic image. obtain.

For example, in alternative embodiments, a substantially opposite judgment may be used, so that, for example, a bright image may indicate contraction and a dark image may indicate no or less contractile activity. According to one embodiment, a capsule-type imaging device that looks forward or backward may be used, where the lumen tissue can be illuminated and imaged through a dome-shaped window. The capsule-shaped device may be aligned with the longitudinal axis of the tubular cavity, typically during contraction. According to one embodiment, the luminal tissue that is nearly parallel to the capsule wall during the relaxed state of the lumen is more or less perpendicular to the capsule wall during the contraction phase, typically closer to the capsule dome. Be made. Since the dome covers the illumination source and the image sensor, the tissue is not so close that it obstructs the field of view, so that the light reflected from the now-approaching tissue wall is more in the image obtained for that tissue. It will be bright. Therefore, according to one example, the image of the contracting tissue will typically be brighter than the image obtained during the relaxation stage of the lumen. For example, an in vivo device capable of capturing an image using the front view may have a first illumination level when the lumen contracts and when the view of the image sensor has a first size or depth due to the contraction. A first image (eg, a relatively bright image) can be captured, while the in vivo device has a second different size or a second different size of view of the image sensor when the lumen does not contract and because there is no contraction. It is possible to capture a second image (eg, a relatively dark image) with a second different illumination level when it has depth. For example, the content of the field of view of the in-vivo image sensor can be changed depending on the presence or absence of contraction, and it is captured by, for example, whether the lumen or a part thereof is closer to or farther from the in-vivo image sensor. It is possible to change the illumination level (eg, brightness or darkness) of an in-vivo image to determine the occurrence or non-occurrence of contraction based on the illumination level of the captured image.

In another embodiment, for example, one or more patterns of dark and bright images can be identified and substantially each such pattern (eg, having a series of dark and bright images, or its). It can be determined that (reverse) indicates contraction. Other suitable analytical methods and judgments may be used.

See FIG. 4 showing six exemplary frames 1501-1506 captured by an in-vivo imager used to determine motility, contraction and / or contractile activity, according to some embodiments of the invention. .. Six exemplary frames 1501-1506 are shown, but other frames or images may be captured, used and analyzed by the embodiments of the present invention.

Frame 1501 shows an exemplary image captured by the in-vivo imager when a substantially complete contraction occurs near the in-vivo imager. Frame 1502 shows an exemplary image captured by the in-vivo imager when the contraction occurs near the in-vivo imager. Shrinkage resulted in a relatively dark image, as shown in frames 1501 and 1502.

Frames 1503, 1504 and 1505 are exemplary captured by an in vivo imager during the "return" period, for example when the lumen returns from a contracting state to a "playing" state with virtually no contractile activity. Image is shown. As shown in frame 1503-1505, the image captured by the in vivo device during this period is relatively brighter or less dark than the image in frame 1501-1502.

Frame 1506 shows an exemplary image captured by an in-vivo imager when the lumen is in a "playing" state with virtually no contraction activity. As shown in frame 1506, the image captured by the in vivo device during this period is not significantly brighter or significantly darker than the image in frame 1501-1502. Also, the image of frame 1503-1505 Relatively brighter or less dark than the statue.

Note that the image of frames 1501-1506 is shown for exemplary purposes only. The embodiments of the present invention generate and / or use other images having varying degrees of brightness, darkness, relative brightness, relative darkness, light intensity, illumination intensity, and the like. Also, such images may be used to generate other judgments regarding motility, contraction or contractile activity.

In some embodiments, the in-vivo image of frame 1501-1506 is an in-vivo image pickup capable of capturing a panoramic (eg, ring-shaped) in-vivo image using an in-vivo image sensor having a panoramic field of view. It can be obtained by using an element.

See FIG. 5, which schematically illustrates the six exemplary stages 1601-1606 of the in vivo device 1640 passing through the lumen 1650, according to some embodiments of the present invention. Stage 1601 shows no contraction, but stage 1602-1606 shows that contraction has propagated to lumen 1650 (as indicated by arrow 1660). Six exemplary stages 1601-1606 are shown, but other numbers or types of stages may be used according to the embodiments of the present invention.

As shown in FIG. 5, at each stage 1601-1606, a cavity (with reference number 1611-1616, respectively) may exist between the in vivo device 1640 and the lumen 1650. For example, the size or volume of cavity 1611-1616 can vary while contraction propagates to lumen 1650. In some embodiments, the light reflected by the lumen 1650 onto the image sensor of the in vivo device 1640 can vary (eg, in relation to or vice versa) with respect to the size or volume of the cavity 1611-1616.

In some embodiments, the contraction propagating through the lumen 1650 can resize or modulate the cavity 1611-1616, thereby reflecting off the image sensor of in vivo device 1640. The intensity of the light produced can be changed or modulated. In some embodiments, the photomodulation is such that the average intensity of the image captured by the in vivo imager 1640 (eg, without or before applying the gain correction technique) is modulated by the contraction of the lumen 1650. May be periodic.

See FIG. 6, which schematically shows a graph 1700 of the average image light intensity of an image captured by an in-vivo imager according to some embodiments of the present invention. The vertical axis 1701 may indicate the average image light intensity and the horizontal axis 1702 may indicate the time (or, in some embodiments, an image or a collection of images). Bars 1711-1721 may indicate the average light intensity of an image captured by an in vivo device.

As shown in Graph 1700, the average image light intensity can increase and decrease over time and can be used, for example, as a contraction activity or a modulation signal associated with contraction. In one embodiment, the modulated signal strength is relatively weak and the signal-to-noise ratio (SNR) is relatively low, but the modulated signal may be periodic and has one or more measurable parameters. May be good. For example, in some embodiments, the amplitude or frequency of the modulated signal may be determined and optionally determined to correlate with the amplitude or frequency of contractile activity. In some embodiments, the amplitude and / or frequency of the modulated signal may be compared to the amplitude or frequency of the modulated signal, such as, for example, a healthy person, an unhealthy person, a person with one or more illnesses or medical conditions. .. In one embodiment, the conditioning signal may be further analyzed or processed to generate a judgment about motility, contraction or contractile activity, eg, using one or more filters.

In one embodiment, the "peak" of the modulated signal 1750 or the increased average image light intensity pattern can indicate shrinkage. In alternative embodiments, a fall of modulated signal 1760 or a pattern of reduced average image light intensity may indicate contraction. In some embodiments, the peak 1750 and the decline 1760 may be used to determine one contractile activity for the period corresponding to the peak 1750 and the decline 1760. In some embodiments, other patterns or portions of Graph 1700 may exhibit contractile activity and / or may be identified, used and analyzed.

In some embodiments, the in-vivo imager may illuminate at a certain (eg, constant or variable) illumination pulse frequency and / or capture the image at a certain (eg, constant or variable) frame capture rate. You may. In one embodiment, the illumination pulse frequency and / or frame capture rate is relatively high compared to, for example, the rate of contraction propagation within the lumen. In another embodiment, the length of the contracted portion may be relatively large. This makes it possible, for example, to capture an image that can be used for light intensity modulation analysis with relatively high accuracy. For example, in some embodiments, the relatively large size of the contractile portion can have a more significant effect on the size or shape of the cavity or lumen there, further in the photointensity modulation used for contraction activity analysis or determination. It can have a significant effect.

In some examples, modulation of the mean image light intensity can be used to determine the frequency of contractions or no contractile activity, and parameters for generating decisions about motility, contractile activity or pathological conditions associated with motility or contractile activity. Can be used as.

In some examples, the frequency, amplitude and / or cycle of contractile activity may be used to determine motility or to make a diagnosis with motility information. In one embodiment, such parameters of contractile activity frequency, amplitude and / or period are light intensity modulated signals (eg in Graph 1700), or other suitable data, such as in vivo device speed, in vivo. It can be derived from changes in device speed, displacement of in vivo devices, position measurement data, position data, acceleration data or other data). In one embodiment, the frequency, amplitude and / or period of contractile activity is, for example, the velocity of the in-vivo device, the change in the velocity of the in-vivo device, the displacement of the in-vivo device, the position measurement data, the position data, the acceleration data or the like. Correlate or relate to the data in.

In some embodiments, one or more images captured by the in vivo device may be analyzed to allow determination of contractile activity. In one embodiment, for example, analysis of one or more images may show a sudden and / or short-term change in the brightness level of one or more images, thereby the identified change in brightness level. It is possible to determine that a relatively large contractile activity (eg, one or more contractions) occurred during the period associated with.

Some parts of the discussion herein may relate to light intensity, illumination intensity, brightness level and / or darkness level for illustrative purposes, but embodiments of the present invention are not limiting in this regard. Some embodiments may include motility information, contractile activity information and / or contraction determination, which may include other data or parameters such as contrast, color, saturation, color tone, one or more color channels, etc. The value is based on parameters or values that may be used before or after the enhancement or gain process is applied.

Some embodiments of the invention may include, for example, an in-vivo image sensor having a plurality of image sensors or image sensors, such as two or three image sensors. For example, in one embodiment, the in vivo device may include a first imaging device having a first field of view and a second imaging device having a second field of view. In some embodiments, the plurality of imaging devices may be oriented in different directions, for example at angles of about 45 degrees, about 90 degrees, about 180 degrees, and so on. In some embodiments, the in vivo device having multiple image sensors has motility data, contraction data or It may be used to collect data used for the generation or analysis of contractile activity data. For example, multiple image sensors in an in vivo device may capture images that can be used for image comparison and / or light intensity modulation analysis, thereby allowing determination of motility, contraction or contraction activity. In one embodiment, the captured data may be accumulated by multiple image sensors, and in another embodiment, the data captured from each image sensor is processed separately and the results are compared or further analyzed. May be done. Other suitable processes may be used.

The devices, systems and methods according to some embodiments of the present invention may be used, for example, with devices that are inserted into or swallowed by the human body. However, the embodiments of the invention are not limited in this regard and may be used, for example, with a device that is inserted or swallowed into a non-human or animal body.

While certain features of the invention have been illustrated and described herein, many modifications, substitutions, modifications and equivalents will be recalled to those skilled in the art. Therefore, it is understood that the appended claims are intended to include all these modifications and modifications in the true spirit of the invention.

<figref num="1">FIG. 6 is a schematic block diagram of an in vivo sensing system according to some embodiments of the present invention.</figref><figref num="2">FIG. 5 is a flow chart of a method of determining motility and / or contractile activity based on position measurement data according to some embodiments of the present invention.</figref><figref num="3">FIG. 5 is a schematic diagram of a graph of measured velocity values of an in vivo device according to some embodiments of the present invention.</figref><figref num="4">FIG. 6 is a diagram of six exemplary frames captured by an in-vivo imager that can be used to determine motility, contraction and / or contractile activity, according to some embodiments of the invention.</figref><figref num="5">FIG. 6 is a schematic representation of six exemplary stages of an in vivo device passing through a lumen according to some embodiments of the present invention.</figref><figref num="6">It is a schematic diagram of the average image light intensity graph of the image captured by the in-vivo image pickup apparatus according to some examples of this invention.</figref>