Imperial College London
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DrAnitaMitra

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Lecturer
 
 
 
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a.mitra

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tzafetas:2020:10.1073/pnas.1916960117,
author = {Tzafetas, M and Mitra, A and Paraskevaidi, M and Bodai, Z and Kalliala, I and Bowden, S and Lathouras, K and Rosini, F and Szasz, M and Savage, A and Balog, J and McKenzie, J and Lyons, D and Bennett, P and MacIntyre, D and Ghaem-Maghami, S and Takats, Z and Kyrgiou, M},
doi = {10.1073/pnas.1916960117},
journal = {Proceedings of the National Academy of Sciences of USA},
pages = {7338--7346},
title = {The intelligent-Knife (i-Knife) and its intraoperative diagnostic advantage for the treatment of cervical disease},
url = {http://dx.doi.org/10.1073/pnas.1916960117},
volume = {117},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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.
AU  - Tzafetas,M
AU  - Mitra,A
AU  - Paraskevaidi,M
AU  - Bodai,Z
AU  - Kalliala,I
AU  - Bowden,S
AU  - Lathouras,K
AU  - Rosini,F
AU  - Szasz,M
AU  - Savage,A
AU  - Balog,J
AU  - McKenzie,J
AU  - Lyons,D
AU  - Bennett,P
AU  - MacIntyre,D
AU  - Ghaem-Maghami,S
AU  - Takats,Z
AU  - Kyrgiou,M
DO  - 10.1073/pnas.1916960117
EP  - 7346
PY  - 2020///
SN  - 0027-8424
SP  - 7338
TI  - The intelligent-Knife (i-Knife) and its intraoperative diagnostic advantage for the treatment of cervical disease
T2  - Proceedings of the National Academy of Sciences of USA
UR  - http://dx.doi.org/10.1073/pnas.1916960117
UR  - https://www.pnas.org/content/117/13/7338
UR  - http://hdl.handle.net/10044/1/77657
VL  - 117
ER  -
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