Friday, September 8, 2017

This is seriously exciting medical science


I was excited to read about a new diagnostic device for use during surgery.

A cancer patient can spend hours in surgery, only to discover afterwards that a small piece of the tumour was left behind – and that means a second arduous procedure. It’s a common, distressing outcome for the patient.

. . .

“My idea with the MasSpec Pen was to develop a fully automated medical device that was also completely biocompatible and non-destructive to tissue samples,” says Livia Schiavinato Eberlin, an assistant professor of chemistry at the University of Texas at Austin. “The result is a device that has a very elegant but simple design and operation, in a way that can be handled by any medical professional.”

As the name suggests, the pen uses mass spectrometry to make diagnoses. It consists of a handheld probe with a plastic tip that is used to touch the tissue sample mid-surgery. A pump system then sends a single drop of water to the pen tip, which sits on the tissue for three seconds.

“During this time, molecules that are soluble in water like small metabolites including sugars, lipids, amino acids, and even some proteins are extracted from the tissue,” Eberlin says. “This is a very gentle chemical process, and what is incredible and exciting is that it causes no obvious harm to the tissue. You can think about it in the same way that water extracts caffeine from coffee powder, we use water to extract molecules from tissue."

The droplet passes from the pen down a 1.5 metre tube attached to a mass spectrometer that analyses the molecules on the spot to get what Eberlin refers to as a “fingerprint” of the tissue. “We envision the mass spectrometer to be in a cart and go in ORs for use, and the pens are the disposable components that would be used for each procedure,” she says. A wash cycle occurs after each analysis, to get rid of 97 per cent of any potential contamination ahead of a repeat analysis – or the tip of the pen can be replaced.

“We analysed a lot of human normal and cancer tissues, 253 to be exact, so that now we can associate the molecular profiles to a cancer ‘fingerprint’ or a normal ‘fingerprint’ and provide a diagnosis using statistical and software tools,” Eberlin says. The team looked at breast, thyroid, lung and ovarian cancers, but Eberlin says she has used mass spectrometry to identify brain, pancreatic, stomach, bladder, kidney, prostate and liver cancer in the past and has no reason to believe the pen’s abilities can’t extend to all solid cancers eventually.

There's more at the link.

As a pastor, one of the more distressing aspects of my job was to counsel families facing the death of a loved one through cancer - particularly when surgery had at first seemed successful, but then proved inadequate because part of the cancer was left behind.  It was devastating to the patient, and even more so to his or her loved ones.  It's one of the worst aspects of pastoral ministry, because all one can do is offer hope for eternity - not for the here and now.  It doesn't help a kid to be told that, God willing, he'll see his father again one day, when he's facing the loss of his big, strong Daddy right here and now.  He can't understand theological concepts.  He's just feeling the awful, aching hurt inside, and desperate for God or anyone to make it stop, make it go away . . . and one can't.

If this device can be debugged and proved to be accurate, it'll be a huge step forward.  Faster, please!

Peter

4 comments:

  1. Interesting.

    I had my prostate out in 2014, for prostate cancer. Operation was done robotically. The doctor said it had progressed outside the organ but he thought he got it all.

    Well, he didn't. It's elsewhere in my body (known to be in at least one lung), and has a fair chance of killing me at some point. How long? Anyone's guess. Currently very quiet, but that doesn't last forever.

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  2. Do a search for "iKnife" on the web - that system has been in development for a few years now at Imperial College in London and at Waters Corporation. The technology works very well and has been tested on 1000+ patients in the UK. The big challenge is getting the technology refined enough (the instruments required are currently too bulky to be widely used) but even more so is getting the data required for FDA approval for the U.S. market. The non-medical application of the technology is called REIMS and is used for things like food authenticity testing - fast identification of, for example, meat and fish species (remember the issue with horsemeat in ground beef?) or honey (counterfeit honey is a big isuue in places).

    This device from Texas would seem to be a copy of the same approach using slightly different technology details.

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