Iknife In Neurosurgery: Intraoperative Real-Time, In Vivo Biochemical Characterization Of Brain Tumors With High Spatial Resolution

Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PAThe purpose of this study was to prove that rapid intraoperative tissue identification of brain tumours using Rapid Evaporative Ionization Mass Spectrometry (REIMS, used surgically as the iKnife) with high spatial resolution is possible in order to help establish a tissue diagnosis and to maximise the extent of tumour resection.A single centre prospective observational study was designed involving a consecutive series of patients undergoing craniotomy and resection of WHO grade II, III and IV tumours. A neuronavigation system was used to register iKnife readings for the first time during surgery for brain tumour resection. Precise intraoperative readings from different tumour zones were taken and compared to matched core biopsy samples verified by routine histopathology.This protocol worked well, allowing in-vivo mass spectrometry readings to be taken with accurate histology. Analysis of data from the first 6 cases shows distinct phospholipid spectral patterns for Grade II and IV tumours. An increased intensity of sulfatides were observed in the white matter of the grade II tumours.Our neuronavigational platform for the iKnife has revealed unique in-vivo spectra for different intrinsic brain tumours. As more cases are added to our spectral database we hope to describe in-vivo intra-tumoural variations which may shed important light into intrinsic brain tumour biology.Citation Format: Babar Vaqas, Julia Balog, Federico Roncaroli, Zoltan Takats, Kevin Ou0027Neill. iKnife in neurosurgery: intraoperative real-time, in vivo biochemical characterization of brain tumors with high spatial resolution. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-287. doi:10.1158/1538-7445.AM2015-LB-287