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dc.contributor.authorPhelps, DLen_US
dc.contributor.authorBalog, Jen_US
dc.contributor.authorGildea, LFen_US
dc.contributor.authorBodai, Zen_US
dc.contributor.authorSavage, Aen_US
dc.contributor.authorEl-Bahrawy, MAen_US
dc.contributor.authorSpeller, AVen_US
dc.contributor.authorRosini, Fen_US
dc.contributor.authorKudo, Hen_US
dc.contributor.authorMcKenzie, JSen_US
dc.contributor.authorBrown, Ren_US
dc.contributor.authorTakáts, Zen_US
dc.contributor.authorGhaem-Maghami, Sen_US
dc.date.accessioned2019-03-04T15:38:42Z
dc.date.issued2018-05
dc.identifier.citationBritish journal of cancer, 2018, 118 (10), pp. 1349 - 1358
dc.identifier.issn0007-0920
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3127
dc.identifier.eissn1532-1827
dc.identifier.doi10.1038/s41416-018-0048-3
dc.description.abstractBACKGROUND:Survival from ovarian cancer (OC) is improved with surgery, but surgery can be complex and tumour identification, especially for borderline ovarian tumours (BOT), is challenging. The Rapid Evaporative Ionisation Mass Spectrometric (REIMS) technique reports tissue histology in real-time by analysing aerosolised tissue during electrosurgical dissection. METHODS:Aerosol produced during diathermy of tissues was sampled with the REIMS interface. Histological diagnosis and mass spectra featuring complex lipid species populated a reference database on which principal component, linear discriminant and leave-one-patient-out cross-validation analyses were performed. RESULTS:A total of 198 patients provided 335 tissue samples, yielding 3384 spectra. Cross-validated OC classification vs separate normal tissues was high (97·4% sensitivity, 100% specificity). BOT were readily distinguishable from OC (sensitivity 90.5%, specificity 89.7%). Validation with fresh tissue lead to excellent OC detection (100% accuracy). Histological agreement between iKnife and histopathologist was very good (kappa 0.84, P < 0.001, z = 3.3). Five predominantly phosphatidic acid (PA(36:2)) and phosphatidyl-ethanolamine (PE(34:2)) lipid species were identified as being significantly more abundant in OC compared to normal tissue or BOT (P < 0.001, q < 0.001). CONCLUSIONS:The REIMS iKnife distinguishes gynaecological tissues by analysing mass-spectrometry-derived lipidomes from tissue diathermy aerosols. Rapid intra-operative gynaecological tissue diagnosis may improve surgical care when histology is unknown, leading to personalised operations tailored to the individual.
dc.formatPrint-Electronic
dc.format.extent1349 - 1358
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectOvarian Neoplasms
dc.subjectLipids
dc.subjectMonitoring, Intraoperative
dc.subjectElectrosurgery
dc.subjectSpectrometry, Mass, Electrospray Ionization
dc.subjectPrincipal Component Analysis
dc.subjectFemale
dc.subjectLipid Metabolism
dc.subjectMetabolomics
dc.subjectMargins of Excision
dc.titleThe surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS).
dc.typeJournal Article
dcterms.dateAccepted2018-02-06
rioxxterms.versionofrecord10.1038/s41416-018-0048-3
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-05
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBritish journal of cancer
pubs.issue10
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Medicine (Brown Epigenetic Therapy)
pubs.publication-statusPublished
pubs.volume118
pubs.embargo.termsNot known
icr.researchteamMedicine (Brown Epigenetic Therapy)en_US
dc.contributor.icrauthorBrown, Roberten


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