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    'Pill-Cam' Beats X-Ray in Finding Tumors

    Camera You Swallow Takes Pictures as It Tumbles Through Intestines

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    "The bottom line is that the camera did better than either barium or CT," said Hara.

    But as good as it is, the camera isn't perfect.

    One of the problems with the camera is that it only works in an empty intestine. Patients have to fast for eight hours before swallowing the camera pill, and in "some patients that isn't long enough to empty the intestine," she says. Another shortcoming is the lack of control over camera angles and direction. "The camera is literally tumbling through the intestine, so we only get pictures of what it is pointed at," she said.

    The greatest problem, however, is "pinpointing the image shown by the camera." For eight hours after the patient swallows the camera, it sends out digital images at the rate of two pictures per second. The image has a time line so the doctor knows when it enters the stomach, leaves the stomach, and enters the intestine. The doctor uses these time coordinates to estimate the progress of the camera and the location of the images. Not an easy task, says Hara, because "the intestine is actually 23 feet long and folded in on itself."

    But she says that one way to better pinpoint location is to use "CT images to help us localize the image." Hara says that as the endoscopy camera technology evolves it will probably be regularly used in conjunction with CT scans.

    The procedure, which Hara says is the ultimate outpatient test because "you come in, swallow a pill, go to work, come back in eight hours to drop off the recorder" costs about $2,500, although only $500 of that goes for the one-use camera. Hara says the test is covered by Medicare and other insurers.

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