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mHealth Israel Conference & Business Contest: Given Imaging- Capsule Communication Challenges, October 7, 2013
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mHealth Israel Conference & Business Contest: Given Imaging- Capsule Communication Challenges, October 7, 2013


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Rafi Nave, VP R&D, Given Imaging, presents at mHealth Israel Conference & Business Contest, October 7, 2013. Title is Given Imaging- Capsule Communication Challenges

Rafi Nave, VP R&D, Given Imaging, presents at mHealth Israel Conference & Business Contest, October 7, 2013. Title is Given Imaging- Capsule Communication Challenges

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  • 1. Capsule Communication Challenges October 2013
  • 2. Given Imaging - Recognized Industry Leader World Leader in Minimally-Invasive GI Diagnostics >85% Market share globally [ >95% share in the U.S. ] One of the largest GI sales and marketing organizations in North America (nearly 100 sales and marketing professionals in the US alone) ~5,500 active PillCam customers: 2,750 Americas, 1,000 APJ, 1750 EMEA Over 2 Million capsules ingested to date Thousands of lives saved due to the CE [ Capsule Endoscope ] More than 2,000 PillCam peer-reviewed publications Strong IP: ~350 registered patents, ~230 pending patents 2
  • 3. Demonstrated Revenue Growth and Profitability Revenue ($ in millions) $178 Non-GAAP Operating Margin Gross Margin $181 $195-205* $158 $142 $125 $113 73.3% 1.1% 2007 73.6% 4.6% 2008 76.6% 77.4% 77.2% 77.2% 12.7% 12.0% 12.1% 12.8% 2009 2010 2011 2012 2013 *Guidance 3
  • 4. Given Imaging’s Comprehensive GI Diagnostic and Monitoring Solutions  The only capsule-based pH test for GERD  PillCam ESO 2  Capsule endoscopy procedure for  Ambulatory pH testing gold standard visualization of the esophagus Complete reflux diagnostic solution for both capsule and catheter-based testing  PillCam SB 2  Most widely used capsule endoscope for visualization of the entire small bowel  The standard of care in numerous countries  PillCam COLON 2  Safe, minimally invasive, sedation- free, patient-friendly modality to visualize the colon and rectum PillCam COLON 2 not cleared for use in U.S. 4 High-Resolution Manometry with physiology visualization and data analysis software for identification of motility disorders Ingestible, wireless motility capsule using sensor technology to measure pH, pressure and temperature from within the entire GI tract
  • 5. Capsule implementation evolution SB1 [ 2003 ] Optical Head One lens LEDs Optical head 4 lenses C2 [ 2009 ] LEDs Transmitter Chip Batteries Imager
  • 6. The main technical challenges of Capsule Endoscopy Power Management Miniaturization  Fit within capsule form factor  Completion of medical procedure within allotted time  Battery operation & shelf life Reading Time Diagnostic Yield   Facilitation of effective detection of pathologies by physicians Patient-Friendly Data Transmission   A narrow ‘pipe’ to xfer the video  Ensuring timely conclusions by the physician Two-way data transmission 2 Patient comfort before (prep), during and after procedure The Gold Standard in Capsule Endoscopy
  • 7. The Capsule Communication Challenges  High volume data:  up to 35 Frames/sec  Frame/image size: now at ~100K pixels. Next generation may need much more!  Confined carrier Frequency choice  Very high attenuation in the human body above 1GHz  But… our high bandwidth necessitates high frequency  The lower the frequency the worse is a given size antenna’s effectiveness  We should use ISM [ Industrial, Scientific, Medical ] frequency bands  Attempt to fit within narrow bandwidth  Regulatory constraints  Noise immunity  Consume very low power  Battery operated. Needs to last a 10-12 hours procedure  Need cost-effective, medium volume, reliable solution 7 10/14/2013
  • 8. The frequency range  There are several sub-1GHz ISM bands.  Since we need to support high-bandwidth – the higher the frequency – the better  The capsule size implies antenna that is smaller than 1 cm. It is apparent that we lose most of the transmission power due to antenna frequency mismatch. Still, the higher the frequency – the better the transmission  In the 750 – 900MHz domain there are ISM bands. However, they vary from region to region [ US, EMEA, Japan, China… ]. It will complicate substantially the implementation if we need to devise a dedicated transmitter/frequency per region!  The most suitable ISM band that we found, under the above constraints, is around 434MHz 8 10/14/2013
  • 9. Coping with the bandwidth challenge  The consumer world migrates to ever-increasing image quality:  HD TV and PC/Internet quality  Digital Cameras growing M-Pixels count  The GI Physicians migrate to HD Endoscopes and start expecting HD image quality from Capsule Endoscopy  But… the ‘pipe’ of our communication is narrow [ circa 13MHz ] due to both Regulation and Noise constraints  So… we must employ every trick in the book to squeeze the utmost of the given ‘pipe’: Modern modulation and, especially, compression solutions  The capsule is limited in its power budget. Hence, we seek for asymmetrical compression solutions that do not exhaust extensive power on the transmitting side 9 10/14/2013
  • 10. Coping with the low power constraint  As mentioned – wherever possible, the solution is tuned so that the burden is on the Receiver side and the transmitting capsule has less power-exhausting tasks to perform.  Since capsule movement in the bowels is intermittent [ it parks for a while and then speeds up ] – we do not want to take photos at high rate all the time, but, on the other hand, do not want to miss pathologies while traveling fast.  Hence: We developed AFR [ Adaptive Frame Rate ] that detects fast movement and temporarily switches to a Very High Rate [ 10X ]  All common tricks of power-saving [ turning off modules while not being used, using low-power manufacturing process & circuit solutions ] 10 10/14/2013
  • 11. In summary  The Video Capsule attains effective clinical performance by making the best out of a highly constrained environment:  Correct selection of the carrier frequency/band  Careful selection of the working-point  Application of asymmetrical compression  Adaptive Frame Rate  Careful low-power design All the above lead to a Market Leading highly popular product! 11 10/14/2013
  • 12. Thank You!