The intelligent knife (iKnife) and its intraoperative diagnostic advantage for the treatment of cervical disease

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Tzafetas , M , Mitra , A , Paraskevaidi , M , Bodai , Z , Kalliala , I , Bowden , S , Lathouras , K , Rosini , F , Szasz , M , Savage , A , Balog , J , McKenzie , J , Lyons , D , Bennett , P , MacIntyre , D , Ghaem-Maghami , S , Takats , Z & Kyrgiou , M 2020 , ' The intelligent knife (iKnife) and its intraoperative diagnostic advantage for the treatment of cervical disease ' , Proceedings of the National Academy of Sciences of the United States of America , vol. 117 , no. 13 , pp. 7338-7346 . https://doi.org/10.1073/pnas.1916960117

Title: The intelligent knife (iKnife) and its intraoperative diagnostic advantage for the treatment of cervical disease
Author: Tzafetas, Menelaos; Mitra, Anita; Paraskevaidi, Maria; Bodai, Zsolt; Kalliala, Ilkka; Bowden, Sarah; Lathouras, Konstantinos; Rosini, Francesca; Szasz, Marcell; Savage, Adele; Balog, Julia; McKenzie, James; Lyons, Deirdre; Bennett, Phillip; MacIntyre, David; Ghaem-Maghami, Sadaf; Takats, Zoltan; Kyrgiou, Maria
Contributor organization: Clinicum
Department of Obstetrics and Gynecology
HUS Gynecology and Obstetrics
University of Helsinki
Date: 2020-03-31
Language: eng
Number of pages: 9
Belongs to series: Proceedings of the National Academy of Sciences of the United States of America
ISSN: 0027-8424
DOI: https://doi.org/10.1073/pnas.1916960117
URI: http://hdl.handle.net/10138/314455
Abstract: Clearance of surgical margins in cervical cancer prevents the need for adjuvant chemoradiation and allows fertility preservation. In this study, we determined the capacity of the rapid evaporative ionization mass spectrometry (REIMS), also known as intelligent knife (iKnife), to discriminate between healthy, preinvasive, and invasive cervical tissue. Cervical tissue samples were collected from women with healthy, human papilloma virus (HPV) +/- cervical intraepithelial neoplasia (CIN), or cervical cancer. A handheld diathermy device generated surgical aerosol, which was transferred into a mass spectrometer for subsequent chemical analysis. Combination of principal component and linear discriminant analysis and least absolute shrinkage and selection operator was employed to study the spectral differences between groups. Significance of discriminatory m/z features was tested using univariate statistics and tandem MS performed to elucidate the structure of the significant peaks allowing separation of the two classes. We analyzed 87 samples (normal = 16, HPV +/- CIN = 50, cancer = 21 patients). The iKnife discriminated with 100% accuracy normal (100%) vs. HPV +/- CIN (100%) vs. cancer (100%) when compared to histology as the gold standard. When comparing normal vs. cancer samples, the accuracy was 100% with a sensitivity of 100% (95% CI 83.9 to 100) and specificity 100% (79.4 to 100). Univariate analysis revealed significant MS peaks in the cancer-to-normal separation belonging to various classes of complex lipids. The iKnife discriminates healthy from premalignant and invasive cervical lesions with high accuracy and can improve oncological outcomes and fertility preservation of women treated surgically for cervical cancer. Larger in vivo research cohorts are required to validate these findings.
Description: Correction: Volume: 117 Issue: 31 Pages: 18892-18892 DOI: 10.1073/pnas.2013655117 Published: AUG 4 2020
Subject: REIMS
cervical cancer
mass spectrometry
iKnife
fertility preservation
REAL-TIME ANALYSIS
RADICAL TRACHELECTOMY
TRANSFORMATION ZONE
BIOLOGICAL TISSUES
LOOP EXCISION
IN-VIVO
CANCER
IDENTIFICATION
RADIOTHERAPY
SURGERY
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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