Intelligent knife can diagnose cancerous tissue
Scientists at Imperial College London have developed an ‘intelligent knife’ that can tell surgeons immediately whether the tissue they are cutting is cancerous or not.
In the first study to test the invention in the operating theatre, the ‘iKnife’ diagnosed tissue samples from 91 patients with 100% accuracy, immediately providing information that typically takes up to half an hour to reveal using laboratory tests.
The study was funded by the European Research Council, the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre, and the Hungarian National Office for Research and Technology.
In cancers involving solid tumours, removal of the cancer in surgery is generally the best hope for treatment. The surgeon normally takes out the tumour with a margin of healthy tissue. However, it is often impossible to tell by sight which tissue is cancerous. One in five breast cancer patients who have surgery require a second operation to fully remove the cancer. In cases of uncertainty, the removed tissue is sent to a lab for examination while the patient remains under general anaesthetic.
The iKnife is based on electrosurgery, a technology invented in the 1920s that is commonly used today. Electrosurgical knives use an electrical current to rapidly heat tissue, cutting through it while minimising blood loss. In doing so, they vaporise the tissue, creating smoke that is normally sucked away by extraction systems.
The inventor of the iKnife, Dr Zoltan Takats, realised that this smoke would be a rich source of biological information. To create the iKnife, he connected an electrosurgical knife to a mass spectrometer, an analytical instrument used to identify what chemicals are present in a sample. Different types of cell produce thousands of metabolites in different concentrations, so the profile of chemicals in a biological sample can reveal information about the state of that tissue.
The findings have been published in the journal Science Translational Medicine.
