Smart knife sniffs for cancer

The iKnife sniffs out malignant cancer cells in real-time, so surgeons can avoid cutting healthy tissue, while making sure they don't leave behind stray tumor cells.

To remove all the cancerous tissue, while avoiding unnecessary cuts into the surrounding healthy tissue, researchers have developed a surgical knife that can literally sniff out cancer cells. ScienceNOW reports.

The edges of a tumor aren’t always easy to detect. Ratios of fatty lipids can be used to identify cancerous tissue, but this requires removing and preparing the tissue for a technique that analyzes its structure, called mass spectrometry.

To speed things up, Zoltán Takáts and colleagues at Imperial College London designed an intelligent, electrosurgical knife that can analyze the surgical smoke created when surgeons cut and cauterize blood vessels.

The iKnife sucks that vapor (a byproduct of surgery) into a mass spectrometer, which then indicates whether the cut tissue is cancerous or healthy based on its lipid profile.

  • The team tested the knife using nearly 3,000 tissue samples from about 300 cancer patients’ surgeries. The iKnife could distinguish normal and tumor tissues from different organs (such as breast, liver, and brain) and could even identify the origin of a tumor that had metastasized.
  • When they tried out the iKnife during 81 actual cancer surgeries, the results matched pathology lab results after the surgery for cancerous and normal tissues for nearly all patients.

Also with only a 1- to 3-second delay for a readout, the iKnife offers real-time information -- which minimizes the amount of time the patient needs to be under anesthesia.

The tool is reliable enough, according to the study, to begin widespread use in operating rooms. The next steps include clinical trials to see if using the tool helps patients develop fewer recurring tumors and live longer.

The work was published in Science Translational Medicine last week.

[Via ScienceNOW]

Image: Science Translational Medicine/AAAS

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