Abstract: Intestinal motility assessment with video capsule endoscopy arises as a novel and challenging clinical fieldwork. This technique is based on the analysis of the patterns of intestinal contractions shown in a video provided by an ingestible capsule with a wireless micro-camera. The manual labeling of all the motility events requires large amount of time for offline screening in search of findings with low prevalence, which turns this procedure currently unpractical. In this paper, we propose a machine learning system to automatically detect the phasic intestinal contractions in video capsule endoscopy, driving a useful but not feasible clinical routine into a feasible clinical procedure. Our proposal is based on a sequential design which involves the analysis of textural, color, and blob features together with SVM classifiers. Our approach tackles the reduction of the imbalance rate of data and allows the inclusion of domain knowledge as new stages in the cascade. We present a detailed analysis, both in a quantitative and a qualitative way, by providing several measures of performance and the assessment study of interobserver variability. Our system performs at 70% of sensitivity for individual detection, whilst obtaining equivalent patterns to those of the experts for density of contractions.

Abstract: JCR Impact Factor 2010: 3.349
Background This study aimed to determine the proportion of cases with abnormal intestinal motility among patients with functional bowel disorders. To this end, we applied an original method, previously developed in our laboratory, for analysis of endoluminal images obtained by capsule endoscopy. This novel technology is based on computer vision and machine learning techniques.
 Methods The endoscopic capsule (Pillcam SB1; Given Imaging, Yokneam, Israel) was administered to 80 patients with functional bowel disorders and 70 healthy subjects. Endoluminal image analysis was performed with a computer vision program developed for the evaluation of contractile events (luminal occlusions and radial wrinkles), non-contractile patterns (open tunnel and smooth wall patterns), type of content (secretions, chyme) and motion of wall and contents. Normality range and discrimination of abnormal cases were established by a machine learning technique. Specifically, an iterative classifier (one-class support vector machine) was applied in a random population of 50 healthy subjects as a training set and the remaining subjects (20 healthy subjects and 80 patients) as a test set.
 Key Results The classifier identified as abnormal 29% of patients with functional diseases of the bowel (23 of 80), and as normal 97% of healthy subjects (68 of 70) (P < 0.05 by chi-squared test). Patients identified as abnormal clustered in two groups, which exhibited either a hyper- or a hypodynamic motility pattern. The motor behavior was unrelated to clinical features.
Conclusions &  Inferences With appropriate methodology, abnormal intestinal motility can be demonstrated in a significant proportion of patients with functional bowel disorders, implying a pathologic disturbance of gut physiology.