A surgical knife that “smells tumours” can detect endometrial cancer in mere seconds, reported The Guardian. The instrument in question is the “intelligent knife” or iKnife that has already proved its mettle in identifying different tissue types such as those taken from the lung, colon and liver and is being used to treat breast and brain cancers. Now, researchers say that the iKnife’s newly discovered ability to detect the presence of womb cancer in women can drastically minimize diagnostic and treatment delays.
The device works on the basis of electrosurgery, where it uses an electric current to heat tissue, vaporizing it in the process of cutting through it. This emits smoke which contains biological information that could help diagnose the state of the tissue. An electrosurgical knife was connected to a mass spectrometer — a device that analyzes what types and concentrations of chemicals are present in a tissue sample. Thus was born the iKnife.
Researchers at Imperial College London conducted a prospective pilot study to test the diagnostic accuracy of the iKnife. In their paper, published in the journal Cancers, they wrote, “The iKnife reliably diagnosed endometrial cancer in seconds, with a diagnostic accuracy of 89%, minimising the current delays for women whilst awaiting a histopathological diagnosis. The findings presented in this study can pave the way for new diagnostic pathways.”
The iKnife was created to help surgeons identify whether the tissue they are carving out is cancerous or not. The first study that tested this instrument in the operating theater took place in 2013, where the iKnife diagnosed tissue samples from 91 patients with 100% accuracy, all in real time. Usually, such information is revealed post laboratory tests that could take up to half an hour, or more.
Seeing the results, Dr. Zoltan Takats of Imperial College London, who invented the iKnife stated at the time, “These results provide compelling evidence that the iKnife can be applied in a wide range of cancer surgery procedures… It provides a result almost instantly, allowing surgeons to carry out procedures with a level of accuracy that hasn’t been possible before. We believe it has the potential to reduce tumour recurrence rates and enable more patients to survive.”
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While the instrument has been used in the past to differentiate between healthy and malignant samples of the colon, breast, cervical and ovarian tissues, the recent study is the first to use the iKnife to detect cancer in endometrial biopsy samples taken from 150 women. The results were then compared with those obtained from current diagnosis methods. The iKnife’s high level of accuracy suggests that the instrument could be used in clinics to provide a point-of-care diagnosis, researchers said. According to The Guardian, the research team now plans to launch a large-scale clinical trial that may eventually lead to its widespread use.
Endometrial cancer, that affects the lining of the uterus, is a common cancer in women. In the West especially, it is the most prevalent gynecological cancer. Still, The Guardian reports that it is detected in only 10% of those with symptoms. Postmenopausal bleeding is one such symptom that could be indicative of womb cancer. But abnormal vaginal bleeding post menopause could occur due to several other reasons as well, explained Athena Lamnisos of the Eve Appeal cancer charity, which funded the research. “…[T]he ability to provide a diagnostic test that rules cancer in or out immediately, and with accuracy, could make such a positive difference,” Lamnisos told The Guardian.
Obtaining a diagnosis can take up to two weeks – during which time the anxiety of having to wait for the results to confirm whether one has cancer or not can cause immense distress. Endometrial cancer is treatable, with hysterectomy or the removal of the uterus being the primary method of treatment. However, there is a possibility of side effects such as clotting and infections developing post surgery. Thus, delays in the diagnosis and treatment of endometrial cancer can negatively impact patient survival, the researchers noted, adding that there are no ways to provide a point-of-care diagnosis for womb cancer as of now.
Receiving a diagnosis within seconds, on the other hand, can not only alleviate stress for women who are healthy, but also enable doctors to expedite treatment for those who are diagnosed with womb cancer.
As professor Sadaf Ghaem-Maghami, who led the research team, told The Guardian, “The iKnife has the potential to completely revolutionise the way we manage people seen in the rapid-access clinics with significant abnormal vaginal bleeding who have been referred for potential diagnosis of endometrial cancer.”
