Magnetic resonance imaging-induced forces on video capsule endoscopes: First systematic in vitro assessment

doi:10.3748/wjg.122550

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Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2027. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jan 7, 2027; 33(1): 122550
Published online Jan 7, 2027. doi: 10.3748/wjg.122550

Magnetic resonance imaging-induced forces on video capsule endoscopes: First systematic in vitro assessment

Maximilian J Beck, Martin Keuchel, Julia Paschen, Robin M Laser, Jens Roling, Dirk Bandorski, Anita C Windhorst, Niehls Kurniawan, Peter Baltes

Maximilian J Beck, Martin Keuchel, Niehls Kurniawan, Peter Baltes, Department of Internal Medicine, Agaplesion Bethesda Hospital Bergedorf, Hamburg 21029, Germany

Julia Paschen, Robin M Laser, Jens Roling, Department of MR Medical Device Testing, MR: comp GmbH, Gelsenkirchen 45894, North Rhine-Westphalia, Germany

Dirk Bandorski, Department of Intensive Care Medicine and Internal Diagnostics, Asklepios Neurological Clinic Bad Salzhausen, Nidda 63667, Hesse, Germany

Dirk Bandorski, Faculty of Medicine, Justus Liebig University, Giessen 35392, Hesse, Germany

Anita C Windhorst, Institute for Medical Informatics, Justus Liebig University, Giessen 35392, Hesse, Germany

Co-first authors: Maximilian J Beck and Martin Keuchel.

Author contributions: Beck MJ and Keuchel M designed the research study; Beck MJ, Paschen J, Laser RM, Roling J, and Kurniawan N performed the research; Beck MJ, Keuchel M, Paschen J, Roling J, and Windhorst AC analyzed the data; Windhorst AC critically reviewed the statistical methodology; Beck MJ and Keuchel M wrote the manuscript; Paschen J, Laser RM, Roling J, Bandorski D, Kurniawan N, and Baltes P critically revised the manuscript; Baltes P supervised the study; all authors have read and approved the final manuscript; Beck MJ and Keuchel M contributed equally to this work as co-first authors; The designation of co-first authorship reflects their equal contributions to the conception and design of the study, the execution of the experimental work, and the drafting of the manuscript.

AI contribution statement: While preparing this manuscript, the authors used the AI-based assistive tools Claude (Anthropic) and ChatGPT (OpenAI) for language refinement, formatting, and editorial suggestions. AI tools were not used to generate original scientific data, to perform statistical analyses, to draw scientific conclusions, or to write substantive portions of the scientific content. All AI-assisted outputs were carefully reviewed, verified, and approved by the authors. The authors take full responsibility and accountability for the integrity, accuracy, originality, and scientific validity of the manuscript.

Institutional review board statement: This study did not involve human subjects, animals, patient data, or biological material of human origin. The study was performed entirely in vitro, using commercially available video capsule endoscopes as test objects in a 3-Tesla magnetic resonance imaging scanner environment. No personal data were collected or processed. Therefore, approval from an Institutional Review Board was not required and was not obtained.

Informed consent statement: This study did not involve human subjects, patient data, or biological material of human origin. No personal or identifiable data were collected or processed. Therefore, informed consent was not required and was not obtained.

Conflict-of-interest statement: Keuchel M has received lecture fees and consultancy fees from Medtronic; lecture fees and study support from Jinshan; study support from AnX Robotics; and consultancy fees from CapsoVision; Kurniawan N has received lecture fees from Medtronic; Baltes P has received lecture fees from Medtronic and study support from AnX Robotics; Beck MJ, Paschen J, Laser RM, Roling J, Bandorski D and Windhorst AC declare no conflicts of interest related to this work.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Maximilian J Beck, MD, Doctor, Department of Internal Medicine, Agaplesion Bethesda Hospital Bergedorf, Glindersweg 80, Hamburg 21029, Germany. maximilian.beck@posteo.de

Received: April 24, 2026
Revised: July 15, 2026
Accepted: September 17, 2026
Published online: January 7, 2027
Processing time: 199 Days and 5.9 Hours

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) is contraindicated in patients with an ingested video capsule endoscopy (VCE) due to the theoretical risk of mechanical and thermal harm. However, isolated cases of inadvertent scanning have not shown clear harm. Manufacturers advise against performing VCE in patients with an MRI scheduled within the next 14 days, yet asymptomatic retention for up to 12 years has been reported. With the increasing use of VCEs, the likelihood of incidental MRI exposure is rising. To date, no systematic data have been published on the forces exerted on VCEs in an MRI environment.

AIM

To quantify magnetically induced forces on VCEs in a 3-Tesla (3-T) scanner to assess clinical safety risks.

METHODS

Displacement forces on 11 commercially available VCE models were measured in a 3-T MRI scanner according to the American Society of Testing Materials (ASTM) F2052-21. Following ASTM F2213-17, torque was measured by the pulley method for eight VCEs and calculated for three magnet-containing gastric capsules with high displacement forces. The lengths of internal metallic components of the VCEs, as indicators of potential thermal effects, were determined using X-ray images.

RESULTS

VCEs containing magnets showed significantly higher median displacement forces than those without magnets (2366 mN vs 293.92 mN, P = 0.012). Magnetically induced displacement forces were 50.7-fold higher than the individual gravitational force for magnet-containing devices (2366 mN vs 46.66 mN), compared to a 9.7-fold excess for capsules without a magnet (293.92 mN vs 30.20 mN). Median torque was 19.2 mNm for capsules without integrated magnets vs 289.02 mNm with magnets (P = 0.017). For all but one VCE, the forces exceeded the safety threshold defined by the capsule’s gravitational force. The mean length of internal metallic components was 21.3 mm (range: 18.2-25.4 mm); only two capsules slightly exceeded the 24-mm threshold for possible thermal effects.

CONCLUSION

In a 3-T MRI, all but one VCE, particularly magnet-containing capsules, exceeded accepted safety thresholds for displacement force and torque but remained below perforation-relevant levels.

Keywords: Video capsule endoscopy; Magnetic resonance imaging; Capsule retention; Displacement force; Torque; Magnetic resonance imaging safety; Inadvertent imaging; Medical device safety

Core Tip: With the increasing use of video capsule endoscopes (VCEs), accidental magnetic resonance imaging (MRI) in patients with an incorporated VCE is a growing risk. To date, no systematic data have been published on MRI-induced forces on VCEs. This in vitro study is the first to systematically quantify displacement forces and torque on 11 commercially available VCEs in a 3-Tesla MRI scanner. All but one VCE exceeded accepted safety thresholds, with magnet-containing capsules showing forces up to 50-fold above gravitational force. These findings highlight a potential safety concern relevant to both clinicians and engineers.