‘Cancer pen’ distinguishes tumor from healthy tissue during surgery

Thomas E. Milner

Scientists and engineers at The University of Texas at Austin have invented a handheld device called the MasSpec Pen designed to rapidly and accurately identify cancerous tissue during surgery.

“This is a good example of a tool that empowers our transition to precision medicine where the treatment can be done with much higher levels of confidence,” Thomas E. Milner, MD, professor of biomedical engineering at University of Texas Austin Cockrell School of Engineering, said in a press release. “Treatment can be planned and given where the outcomes are known. This is one tool along that path.”

Current methods used for histopathologic tissue diagnoses are laborious and time intensive, thus delaying decision-making during diagnostic and therapeutic procedures, according to researchers.

Milner and colleagues developed the MasSpec Pen. The biocompatible handheld mass spectrometry device does not require specific labeling or imaging during surgery to distinguish between healthy tissue and cancerous tumor.

The researchers analyzed 253 human tissue samples from lung, ovary, thyroid and breast cancer tumors and compared them to samples of healthy tissue.

The device demonstrated a 96.4% sensitivity and 96.2% specificity. Additionally, the device successfully differentiated between histologic subtypes of lung cancer.

“Notably, our classifier allowed accurate diagnosis of cancer in marginal tumor regions presenting mixed histologic composition,” Milner and colleagues wrote. “Our results provide evidence that the MasSpec Pen could potentially be used as a clinical and intraoperative technology for ex vivo and in vivo cancer diagnosis.”

HemOnc Today spoke with Milner about the device, how it works and what still needs to be confirmed before it is ready for mainstream use.

 

Question: Can you describe the technology?

Answer: The MasSpec Pen is to be used by a surgeon who places the pen against tissue to be interrogated. The pen functions by placing a droplet of water onto the tissue site where the pen is placed. There is a transfer of biomolecules from the tissue to the droplet of water, and then the droplet of water is moved from the pen to a device known as a mass spectrometer. The mass spectrometer characterizes the biomolecules, and there is machine-learning software that analyzes the molecular signature of the molecules and makes the determination of whether the tissue is cancerous. The pen is disposable, so surgeons would replace it with each surgery.

 

Q: How well does this technology work?

A: Our study, published in Science Translational Medicine, indicated a 96% accuracy of the pen. Accuracy is composed of sensitivity and specificity, and this pen has very high accuracy.

 

Q: What still needs to be confirmed?

A: There are a number of activities that need to be completed before moving the technology forward. One of the next activities is to conduct testing in the actual operating room with actual cancer surgeries and verify the operation in situ. Of note, different cancer types will require a different type of pen so, depending on the types of surgeries that are being done, the pen will look different. The device will eventually be commercialized and there is an entire pathway for this.

 

Q: How close is it to potential mainstream use?

A: In terms of the technology, it is close to mainstream use. The parts that we cannot predict very well are the investment side and the regulatory approval. However, I do not foresee any major technical problems with the device. I think it is pretty straightforward other than the differences in the look and feel of the pen for the different cancer surgeries.

 

Q: Is there anything else that you would like to mention ?

A: Hopefully this is a device that is propelling medicine from intuitive-type medicine to precision practice. Cancer surgeries are now practiced to do this similar type of thing where cancer biopsies are sent to the pathologist and the pathologist has to look under the microscope, slice the tumor into many thin slices and look at it under the microscope, all while the surgery is taking place. The pathologist has to go back and tell the surgeon whether there is cancer or not. This device will hopefully transform medicine to more of a precise procedure where the tumors can be taken out with more accuracy and higher confidence that the margins are correct and proper. Much of the biomedical research that is being done today is trying to move medicine from an intuitive practice to more of a precision practice and this is hopefully one device that will help us to do this. – by Jennifer Southall

 

Reference:

Zhang J, et al. Science Trans Med. 2017;doi:10.1126/scitranslmed.aan3968.

 

For more information:

Thomas E. Milner, MD, can be reached at The University of Texas at Austin Cockrell School of Engineering, 204 E. Dean Keeton St., Stop C2201, Austin, TX 78712-1591; email: milner@mail.utexas.edu.

 

Disclosure: Milner reports no relevant financial disclosures.

Thomas E. Milner

Scientists and engineers at The University of Texas at Austin have invented a handheld device called the MasSpec Pen designed to rapidly and accurately identify cancerous tissue during surgery.

“This is a good example of a tool that empowers our transition to precision medicine where the treatment can be done with much higher levels of confidence,” Thomas E. Milner, MD, professor of biomedical engineering at University of Texas Austin Cockrell School of Engineering, said in a press release. “Treatment can be planned and given where the outcomes are known. This is one tool along that path.”

Current methods used for histopathologic tissue diagnoses are laborious and time intensive, thus delaying decision-making during diagnostic and therapeutic procedures, according to researchers.

Milner and colleagues developed the MasSpec Pen. The biocompatible handheld mass spectrometry device does not require specific labeling or imaging during surgery to distinguish between healthy tissue and cancerous tumor.

The researchers analyzed 253 human tissue samples from lung, ovary, thyroid and breast cancer tumors and compared them to samples of healthy tissue.

The device demonstrated a 96.4% sensitivity and 96.2% specificity. Additionally, the device successfully differentiated between histologic subtypes of lung cancer.

“Notably, our classifier allowed accurate diagnosis of cancer in marginal tumor regions presenting mixed histologic composition,” Milner and colleagues wrote. “Our results provide evidence that the MasSpec Pen could potentially be used as a clinical and intraoperative technology for ex vivo and in vivo cancer diagnosis.”

HemOnc Today spoke with Milner about the device, how it works and what still needs to be confirmed before it is ready for mainstream use.

 

Question: Can you describe the technology?

Answer: The MasSpec Pen is to be used by a surgeon who places the pen against tissue to be interrogated. The pen functions by placing a droplet of water onto the tissue site where the pen is placed. There is a transfer of biomolecules from the tissue to the droplet of water, and then the droplet of water is moved from the pen to a device known as a mass spectrometer. The mass spectrometer characterizes the biomolecules, and there is machine-learning software that analyzes the molecular signature of the molecules and makes the determination of whether the tissue is cancerous. The pen is disposable, so surgeons would replace it with each surgery.

 

Q: How well does this technology work?

A: Our study, published in Science Translational Medicine, indicated a 96% accuracy of the pen. Accuracy is composed of sensitivity and specificity, and this pen has very high accuracy.

 

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Q: What still needs to be confirmed?

A: There are a number of activities that need to be completed before moving the technology forward. One of the next activities is to conduct testing in the actual operating room with actual cancer surgeries and verify the operation in situ. Of note, different cancer types will require a different type of pen so, depending on the types of surgeries that are being done, the pen will look different. The device will eventually be commercialized and there is an entire pathway for this.

 

Q: How close is it to potential mainstream use?

A: In terms of the technology, it is close to mainstream use. The parts that we cannot predict very well are the investment side and the regulatory approval. However, I do not foresee any major technical problems with the device. I think it is pretty straightforward other than the differences in the look and feel of the pen for the different cancer surgeries.

 

Q: Is there anything else that you would like to mention ?

A: Hopefully this is a device that is propelling medicine from intuitive-type medicine to precision practice. Cancer surgeries are now practiced to do this similar type of thing where cancer biopsies are sent to the pathologist and the pathologist has to look under the microscope, slice the tumor into many thin slices and look at it under the microscope, all while the surgery is taking place. The pathologist has to go back and tell the surgeon whether there is cancer or not. This device will hopefully transform medicine to more of a precise procedure where the tumors can be taken out with more accuracy and higher confidence that the margins are correct and proper. Much of the biomedical research that is being done today is trying to move medicine from an intuitive practice to more of a precision practice and this is hopefully one device that will help us to do this. – by Jennifer Southall

 

Reference:

Zhang J, et al. Science Trans Med. 2017;doi:10.1126/scitranslmed.aan3968.

 

For more information:

Thomas E. Milner, MD, can be reached at The University of Texas at Austin Cockrell School of Engineering, 204 E. Dean Keeton St., Stop C2201, Austin, TX 78712-1591; email: milner@mail.utexas.edu.

 

Disclosure: Milner reports no relevant financial disclosures.