Brain surgeons have long relied on a pathology analysis to determine if they have completely removed a tumor. This can be a time-consuming and inaccurate process. Results from a study of a new imaging system that detects a molecular biomarker found in brain gliomas suggest it could improve upon that surgical practice.
The imaging system is known as desorption electrospray ionization mass spectrometry (DESI MS), developed by R. Graham Cooks at Purdue University. The study was performed in collaboration with Harvard Medical School and the Dana Farber Cancer Institute and was funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), which is part of the U.S. National Institutes of Health (NIH).
Gliomas are tumors of the brain glial cells; they account for 80% of all malignant brain tumors. Brain gliomas produce large amounts of tumor metabolite 2-hydroxyglutarate (2-HG), a product of the mutant form of a gene known as IDH, which is associated with tumor formation.
The imaging system is designed to detect levels of 2-HG in samples via mass spectrometry during surgery, to ensure that a tumor has been removed entirely. Researchers first tested the DESI MS system on glioma specimens from 35 patients; 21 of these samples contained high levels of 2-HG.
The researchers then equipped an operating room at Brigham and Women's Hospital with the DESI MS system. They reported that in two surgeries the DESI MS accurately detected the presence of 2-HG as confirmed by a postoperative analysis.
The DESI MS system was installed as part of the Advanced Multimodality Image Guided Operating suite; the suite has built-in imaging devices such as MRI so that the surgeon can map the tumor preoperatively.
The researchers concluded that the DESI MS identified the tumors with "high sensitivity and specificity within minutes." They added that metabolite-imaging mass spectrometry "could transform many aspects of surgical care."
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