Imperial College London
Alternate

ProfessorZoltanTakats

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Analytical Chemistry
 
 
 
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Contact

 

+44 (0)20 7594 2760z.takats

 
 
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Location

 

Sir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mason:2019:10.1007/s00464-019-07140-y,
author = {Mason, S and Manoli, E and Poynter, L and Alexander, J and Paizs, P and Adebesin, A and Goldin, R and Darzi, A and Takats, Z and Kinross, J},
doi = {10.1007/s00464-019-07140-y},
journal = {Surgical Endoscopy: surgical and interventional techniques},
pages = {3618--3625},
title = {Mass spectrometry transanal minimally invasive surgery (MS-TAMIS) to promote organ preservation in rectal cancer},
url = {http://dx.doi.org/10.1007/s00464-019-07140-y},
volume = {34},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Transanal minimally invasive surgery (TAMIS) is deployed for organ preservation in early rectal cancer and significant rectal polyps. Rapid evaporative ionisation mass spectrometry (REIMS) provides biochemical tissue analysis, which could be applied intraoperatively to give real-time tissue feedback to the surgeon and decrease the risk of an involved margin. However, the accuracy and feasibility of this approach have not been established. METHODS: In this prospective observational study, patients undergoing resection of rectal adenomas or carcinomas were recruited. An electrosurgical handpiece analysed tissues ex vivo using diathermy, with the aerosol aspirated into a Xevo G2-S ToF mass spectrometer. The relative abundance of lipids underwent predictive statistical modelling and leave-one-patient-out cross-validation. The outcomes of interest were the ability of REIMS to differentiate normal, adenomatous and cancerous tissue, or any disease subtype from normal. REIMS was coupled with TAMIS for in vivo sampling, assessing the accuracy of tissue recognition and distinguishing bowel wall layers. RESULTS: Forty-seven patients were included, yielding 266 spectra (121 normal, 109 tumour and 36 adenoma). REIMS differentiates normal, adenomatous and cancerous rectal tissues with 86.8% accuracy, and normal and adenomatous tissue with 92.4% accuracy and 91.4% accuracy when differentiating disease from normal. We have performed the first five in-man mass spectrometry augmented TAMIS (MS-TAMIS). In real time, MS-TAMIS can differentiate rectal mucosa and submucosa based on their relative abundance of triglycerides and glycerophospholipids. The ex vivo accuracy distinguishing diseased and normal tissues is maintained in vivo at 90%, with negative predictive value of 95%. The system identified a deep and lateral involved tumour margin during TAMIS. CONCLUSIONS: REIMS distinguishes rectal tissue types based on underlying lipid biology, and this can be translated in vivo
AU  - Mason,S
AU  - Manoli,E
AU  - Poynter,L
AU  - Alexander,J
AU  - Paizs,P
AU  - Adebesin,A
AU  - Goldin,R
AU  - Darzi,A
AU  - Takats,Z
AU  - Kinross,J
DO  - 10.1007/s00464-019-07140-y
EP  - 3625
PY  - 2019///
SN  - 0930-2794
SP  - 3618
TI  - Mass spectrometry transanal minimally invasive surgery (MS-TAMIS) to promote organ preservation in rectal cancer
T2  - Surgical Endoscopy: surgical and interventional techniques
UR  - http://dx.doi.org/10.1007/s00464-019-07140-y
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31617102
UR  - https://link.springer.com/article/10.1007%2Fs00464-019-07140-y
UR  - http://hdl.handle.net/10044/1/74244
VL  - 34
ER  -
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