Mass spectrometry-based intraoperative tumor diagnostics

Abstract

In surgical oncology, decisions regarding the amount of tissue to be removed can have important consequences: the decision between preserving sufficient healthy tissue and eliminating all tumor cells is one to be made intraoperatively. This review discusses the latest technical innovations for a more accurate tumor margin localization based on mass spectrometry. Highlighting the latest mass spectrometric inventions, real-time diagnosis seems to be within reach; focusing on the intelligent knife, desorption electrospray ionization, picosecond infrared laser and MasSpec pen, the current technical status is evaluated critically concerning its scientific and medical practice. The correct assessment of tumor margins is a key challenge during surgical excision. Latest developments in research strive for the invention of a method to detect the tumor spread intraoperatively, enhancing the therapeutic outcome. Techniques coupling potential or established surgical instruments to mass spectrometric analysis are of great importance in the upcoming market. Methods using electrospray (desorption electrospray ionization), an electrocautery knife (intelligent knife), a surgical laser (picosecond infrared laser) and a drop of water (MasSpecPen) applied on the tissue surface are discussed in this review as new sampling methods.