Imperial College London

Emeritus ProfessorJeremyNicholson

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Emeritus Professor of Biological Chemistry



+44 (0)20 7594 3195j.nicholson Website




Ms Wendy Torto +44 (0)20 7594 3225




Office no. 665Sir Alexander Fleming BuildingSouth Kensington Campus






BibTex format

author = {Alexander, J and Gildea, L and Balog, J and Speller, A and McKenzie, J and Muirhead, L and Scott, A and Kontovounisios, C and Rasheed, S and Teare, J and Hoare, J and Veselkov, K and Goldin, R and Tekkis, P and Darzi, A and Nicholson, J and Kinross, J and Takats, Z},
doi = {10.1007/s00464-016-5121-5},
journal = {Surgical Endoscopy and Other Interventional Techniques},
pages = {1361--1370},
title = {A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife},
url = {},
volume = {31},
year = {2016}

RIS format (EndNote, RefMan)

AB - Background:This pilot study assessed the diagnostic accuracy of rapid evaporative ionization mass spectrometry (REIMS) in colorectal cancer (CRC) and colonic adenomas.Methods:Patients undergoing elective surgical resection for CRC were recruited at St. Mary’s Hospital London and The Royal Marsden Hospital, UK. Ex vivo analysis was performed using a standard electrosurgery handpiece with aspiration of the electrosurgical aerosol to a Xevo G2-S iKnife QTof mass spectrometer (Waters Corporation). Histological examination was performed for validation purposes. Multivariate analysis was performed using principal component analysis and linear discriminant analysis in Matlab 2015a (Mathworks, Natick, MA). A modified REIMS endoscopic snare was developed (Medwork) and used prospectively in five patients to assess its feasibility during hot snare polypectomy.Results:Twenty-eight patients were recruited (12 males, median age 71, range 35–89). REIMS was able to reliably distinguish between cancer and normal adjacent mucosa (NAM) (AUC 0.96) and between NAM and adenoma (AUC 0.99). It had an overall accuracy of 94.4 % for the detection of cancer versus adenoma and an adenoma sensitivity of 78.6 % and specificity of 97.3 % (AUC 0.99) versus cancer. Long-chain phosphatidylserines (e.g., PS 22:0) and bacterial phosphatidylglycerols were over-expressed on cancer samples, while NAM was defined by raised plasmalogens and triacylglycerols expression and adenomas demonstrated an over-expression of ceramides. REIMS was able to classify samples according to tumor differentiation, tumor budding, lymphovascular invasion, extramural vascular invasion and lymph node micrometastases (AUC’s 0.88, 0.87, 0.83, 0.81 and 0.81, respectively). During endoscopic deployment, colonoscopic REIMS was able to detect target lipid species such as ceramides during hot snare polypectomy.Conclusion:REIMS demonstrates high diagnostic accuracy for tumor type and for established histological featur
AU - Alexander,J
AU - Gildea,L
AU - Balog,J
AU - Speller,A
AU - McKenzie,J
AU - Muirhead,L
AU - Scott,A
AU - Kontovounisios,C
AU - Rasheed,S
AU - Teare,J
AU - Hoare,J
AU - Veselkov,K
AU - Goldin,R
AU - Tekkis,P
AU - Darzi,A
AU - Nicholson,J
AU - Kinross,J
AU - Takats,Z
DO - 10.1007/s00464-016-5121-5
EP - 1370
PY - 2016///
SN - 1432-2218
SP - 1361
TI - A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife
T2 - Surgical Endoscopy and Other Interventional Techniques
UR -
UR -
VL - 31
ER -