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 diagnosis, cancer extraction, and treatment.
Photo: Luke MacGregor/Reuters
Jeremy Hsu has been working as a science and technology journalist in New York City since 2008. He has written on subjects as diverse as supercomputing and wearable electronics for IEEE Spectrum. When he’s not trying to wrap his head around the latest quantum computing news for Spectrum, he also contributes to a variety of publications such as Scientific American, Discover, Popular Science, and others. He is a graduate of New York University’s Science, Health & Environmental Reporting Program.