Smart Knife Detects Cancer in Seconds

A smart surgical knife can sniff out cancer almost instantly in the smoke of vaporized flesh

2 min read
Smart Knife Detects Cancer in Seconds

A new smart knife puts the pathology lab in surgeons' hands by sniffing out cancer cells as it cuts flesh. The  so-called intelligent knife, also known as "iKnife," could allow surgeons to work more swiftly and efficiently to remove cancerous tumors without leaving behind traces of cancer cells.

The iKnife works by detecting cancer cells in the smoke left behind by the electrosurgical knife's act of cutting flesh, according to Science Magazine. When the iKnife sucks up the smoke, it pipes the sample to a mass spectrometer capable of almost instantly analyzing the chemistry of the biological tissue to detect the presence of cancer. That translates into near-instant feedback for surgeons rather than having to wait on sample analysis by a pathology lab.

Chemists at the Imperial College London showed that their iKnife could accurately identify both normal and cancerous tissue from 3000 tissue samples taken during 300 cancer patient surgeries, as reported in the journal Science Translational Medicine. The iKnife could tell the difference between different biological tissues, such as liver or brain, as well as determine if a tumor represented a secondary growth originating from a primary tumor elsewhere.

The iKnife results matched well with pathology lab results in both testing samples and during 91 cancer surgeries. Surgeons received feedback from the iKnife with just a 1- to 3-second delay. The knife's developers eventually envision a display similar to a traffic light that shows a red light to indicate the presence of cancer, a green light for healthy tissue, and a yellow light for an in-between mix.

Zoltan Takats, a chemist at Imperial College London, hit upon the idea of the iKnife when he realized that electrosurgical knives—also known as "flesh vaporizers"—already represented the ideal tools for ionizing tissue in a way that's perfect for mass spectrometry. Such electric wands have been used by surgeons since 1925, according to National Geographic's Only Human blog. 

Whether or not the iKnife actually improves health outcomes for cancer surgery patients remains to be seen. But the knife appears to take yet another step in the evolution of a centuries-old surgical tool that has changed from simple blade to a relatively bloodless cutting instrument—and now to a real-time diagnostic tool. It combines all the promises of technological advancement that have previously applied separately to cancer diagnosiscancer extraction, and treatment.

Photo: Luke MacGregor/Reuters

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This CAD Program Can Design New Organisms

Genetic engineers have a powerful new tool to write and edit DNA code

11 min read
A photo showing machinery in a lab

Foundries such as the Edinburgh Genome Foundry assemble fragments of synthetic DNA and send them to labs for testing in cells.

Edinburgh Genome Foundry, University of Edinburgh

In the next decade, medical science may finally advance cures for some of the most complex diseases that plague humanity. Many diseases are caused by mutations in the human genome, which can either be inherited from our parents (such as in cystic fibrosis), or acquired during life, such as most types of cancer. For some of these conditions, medical researchers have identified the exact mutations that lead to disease; but in many more, they're still seeking answers. And without understanding the cause of a problem, it's pretty tough to find a cure.

We believe that a key enabling technology in this quest is a computer-aided design (CAD) program for genome editing, which our organization is launching this week at the Genome Project-write (GP-write) conference.

With this CAD program, medical researchers will be able to quickly design hundreds of different genomes with any combination of mutations and send the genetic code to a company that manufactures strings of DNA. Those fragments of synthesized DNA can then be sent to a foundry for assembly, and finally to a lab where the designed genomes can be tested in cells. Based on how the cells grow, researchers can use the CAD program to iterate with a new batch of redesigned genomes, sharing data for collaborative efforts. Enabling fast redesign of thousands of variants can only be achieved through automation; at that scale, researchers just might identify the combinations of mutations that are causing genetic diseases. This is the first critical R&D step toward finding cures.

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