Researchers Develop Pen Tool for Quickly Identifying Cancer Tissue During Surgery

“Is the pen mightier than the scalpel?” A new study aims to answer that question by presenting research on a handheld pen-sized device that can rapidly determine cancer tissue borders during surgery.

The research, published in Science Translational Medicine, explains that the conventional method of diagnosing cancer and identifying tumorous tissue in surgery is time-consuming and not always accurate. Each sample taken for the Frozen Section Analysis technique requires upwards of 30 minutes to prepare and interpret, although this interpretation is incorrect 10% to 20% of the time.

With these shortcomings in mind, researchers from the University of Texas at Austin set out to develop a handheld mass spectrometry device that can quickly and safely identify whether a tissue is cancerous. The tool, called the MasSpec Pen, was tested on tissue samples from 253 patients with cancer. It returned a diagnosis in about 10 seconds and was over 96% accurate, both in sensitivity (96.4%) and specificity (96.2%).

According to the researchers, the pen-sized tool delivers a droplet of water to the tissue, which extracts biomolecules. This molecular signature is then instantly compared to a database of potential cancer biomarkers using machine learning software. Upon completing the analysis, the words “Normal” or “Cancer” flash on a screen, along with the subtype for some cancers.

The study highlights the device’s ability to make accurate diagnoses even on tissues with marginal borders between normal and cancer tissues with mixed histologic composition. Although it has not yet been used in surgery on human patients, tests on mice have shown that the MasSpec Pen can be used without causing observable tissue damage or stress to the animal.

“Because the metabolites in cancer and normal cells are so different, we extract and analyze them with the MasSpec Pen to obtain a molecular fingerprint of the tissue,” explained lead author Livia Schiavinato Eberlin, PhD, in a press release from the University of Texas at Austin. “What is incredible is that through this simple and gentle chemical process, the MasSpec Pen rapidly provides diagnostic molecular information without causing tissue damage.”

The team of researchers hoped that the device would help oncologic surgeons quickly and accurately determine tumor borders, thus enabling them to strike a better balance between excising as much of the tumor as possible and preserving enough of the patient’s healthy tissue.

“Any time we can offer the patient a more precise surgery, a quicker surgery or a safer surgery, that’s something we want to do,” said co-author James Suliburk, MD, in the press release. “This technology does all three. It allows us to be much more precise in what tissue we remove and what we leave behind.”

If supported in further studies and approved by the FDA, adoption of the tool could help improve clinical outcomes as well as provide more peace of mind for patients and families.

“If you talk to cancer patients after surgery, one of the first things many will say is ‘I hope the surgeon got all the cancer out,’” said Schiavinato Eberlin. “It’s just heartbreaking when that’s not the case. But our technology could vastly improve the odds that surgeons really do remove every last trace of cancer during surgery.”