Thursday, September 07, 2017

Cancer 'pen' developed that can detect a tumour within ten seconds

A cancer 'pen' that can detect a tumour within ten seconds has been developed - bringing immediate diagnosis to a surgeon's fingertips.

The handheld scanner is more than 96% accurate in distinguishing diseased from healthy tissue in real-time while the patient lies on the operating table.

It will enable the removal all traces of malignant masses, reducing the risk of relapses because cancerous cells were left behind.

The technology is expected to start being tested during actual cancer surgeries as soon as next year.
Most pathology labs require several days to evaluate if tumour cells remain in samples taken during surgery.


Study leader, a chemist, said: "If you talk to cancer patients after surgery one of the first things many will say is 'I hope the surgeon got all the cancer out.

"It's just heartbreaking when that's not the case. But our technology could vastly improve the odds that surgeons really do remove every last trace of cancer during surgery."

The revolutionary MasSpec Pen precisely identifies cancer simply by touch - and is more than 150 times quicker than existing technology.

Co-researcher and head of endocrine surgery  said: "Any time we can offer the patient a more precise surgery, a quicker surgery or a safer surgery, that's something we want to do.

"This technology does all three. It allows us to be much more precise in what tissue we remove and what we leave behind."

Tiny amounts of water - 10 microliters or one-fifth the size of a single drop - extract small molecules called metabolites from a patient's tissue during surgery.

This is then drawn through a flexible tube into a mass spectrometer scanner which anlayses the chemical's looking for cancer.

The disposable device described is easy to operate.

It requires simply holding the pen against the patient's tissue, triggering the automated analysis using a foot pedal and waiting a few seconds for a result.

It means surgeons know at once which tissue to cut out and which to leave alone, making the procedure much safer and effective.


After analysing samples from lung, ovary, thyroid and breast tumours from 253 patients, as well as healthy tissues, the scientists developed a 'molecular profile' that could identify cancers with 96.4% sensitivity, 96.2% specificity and 96.3% accuracy.

The pen was even able to detect cancer in marginal regions between normal and cancerous tissues that presented mixed cellular composition.

Experiments also reliably identified tumours in living mice. Importantly it did not cause any damage to healthy tissues.

Maximising cancer removal is critical to improve patient survival but removing too much healthy tissue can also have profound negative consequences.

For example, breast cancer patients could experience higher risk of painful side effects and nerve damage, in addition to aesthetic impacts.

 Thyroid cancer patients could lose speech ability or the ability to regulate the body's calcium levels in ways that are important for muscle and nerve function.

Other mass spectrometry tools require harsh solvents, pressurised gasses or high voltages.

The MasSpec Pen gathers molecules for analysis using only water. Additionally its tip was 3D printed with a safe and biocompatible material called PDMS.

Each type of cancer produces a unique set of metabolites and other biomarkers that act as fingerprints.
Prof. explained: "Cancer cells have disregulated metabolism as they're growing out of control.

"Because the metabolites in cancer and normal cells are so different we extract and analyse them with the MasSpec Pen to obtain a molecular fingerprint of the tissue.

"What is incredible is that through this simple and gentle chemical process, the MasSpec Pen rapidly provides diagnostic molecular information without causing tissue damage."

When the pen completes the analysis the words "Normal" or "Cancer" automatically appear on a computer screen. For certain cancers, such as lung cancer, the name of a subtype might also appear.

Dr. who led the experiments in the lab, said: "When designing the MasSpec Pen we made sure the tissue remains intact by coming into contact only with water and the plastic tip of the MasSpec Pen during the procedure.
 
"The result is a bio-compatible and automated medical device that we are so excited to translate to the clinic very soon."

The current state-of-the-art method for diagnosing cancers during surgery, called Frozen Section 
Analysis, is slow and sometimes inaccurate.
 
Each sample can take 30 minutes or more to prepare and interpret by a pathologist which increases the risk to the patient of infection and reactions to anaesthesia.

And for some types of cancers, frozen section interpretation can be difficult, yielding unreliable results in as many as 10 to 20% of cases.

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