HealthDay News — For patients undergoing tumor resection, a study has validated the coupling of rapid evaporative ionization mass spectrometry (REIMS) with electrosurgery in an approach known as the intelligent knife (iKnife).

The technique, which allows near-real-time characterization of human tissue by analysis of the aerosol released during electrosurgical dissection, was applied to tissue samples from 302 patients, resulting in a database comprising 1,624 cancerous and 1,309 non-cancerous entries. During 81 resections, the device was coupled to existing electrosurgical equipment and was used to collect data in the operating theater.

Zoltán Takáts of Imperial College London and colleagues reported the findings in Science Translational Medicine

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The researchers found that the REIMS approach accurately distinguished between discrete histological and histopathological tissue types. Chemical characteristics that were specific to their histopathological subtypes were identified in malignant tissues.

In all cases studied, tissue identification via intraoperative REIMS matched the postoperative histologic diagnosis. Lipidomic profiles were reflected in the mass spectra that varied between distinct histological tumor types, and between primary and metastatic tumors.

“Thus, in addition to real-time diagnostic information, the spectra provided additional information on divergent tumor biochemistry that may have mechanistic importance in cancer,” the researchers wrote.


  1. Balog J et al. Sci Transl Med. 2013;5(194):194ra93.