Related Experiment Video
Updated: Sep 23, 2025
Image-Guided Resection of Glioblastoma and Intracranial Implantation of Therapeutic Stem Cell-seeded Scaffolds
Published on: July 16, 2018
Towards real-time intraoperative tissue interrogation for REIMS-guided glioma surgery
Laura Van Hese1,2, Steven De Vleeschouwer3, Tom Theys3
1Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, 6229 ER Maastricht, The Netherlands.
Introduction:
The main goal of brain tumour surgery is to maximize tumour resection while avoiding neurological deficits. Accurate characterization of tissue and delineation of resection margins are, therefore, essential to achieve optimal surgical results.
Objectives:
The primary objective of this study was to develop and validate a mass spectrometry- based technique for the molecular characterization of high- and low-grade glioma tissue during surgery.
Methods:
An electrosurgical knife is connected to a mass spectrometer (iKnife). Using this system, an aerosol created during electrosurgical resection is aspirated to a mass spectrometer to determine the molecular profile of the tissue within seconds. This rapid evaporative ionization mass spectrometry (REIMS) technique is used to create a chemical profile database and develop a real-time tissue recognition system based on machine learning.
Results:
Classification models were built by analysing biopsies from 36 patients who underwent brain tumour resection. Our multivariate statistical model could differentiate between astrocytoma grade II and III, glioblastoma, oligodendroglioma grade II and III, and normal brain tissue with an 88% overall accuracy. Astrocytoma and oligodendroglioma grade II were separated from normal brain with a 96% correct classification rate. REIMS could differentiate between different percentages of GBM with 99.2% sensitivity and different percentages of astrocytoma grade II with 97.5% sensitivity.
Conclusion:
Real-time information during electrosurgical dissection can improve intra-operative decision-making, leading to a more accurate tumour removal for different glioma subtypes.
Insights
This study introduces a mass spectrometry technique to rapidly identify glioma tissue during surgery. The rapid evaporative ionization mass spectrometry (REIMS) system accurately differentiates various glioma subtypes, improving surgical precision.
Area of Science:
- Neuro-oncology
- Analytical Chemistry
- Machine Learning
Background:
- Accurate tissue characterization and margin delineation are crucial for optimal brain tumor surgery outcomes.
- Maximizing tumor resection while preserving neurological function is the primary surgical goal.
Purpose of the Study:
- To develop and validate a mass spectrometry-based technique for molecular characterization of high- and low-grade glioma tissue during surgery.
- To enable real-time tissue recognition for improved intra-operative decision-making.
Main Methods:
- Utilized an electrosurgical knife connected to a mass spectrometer (iKnife) for rapid evaporative ionization mass spectrometry (REIMS).
- Aerosolized tissue during resection was aspirated for immediate molecular profiling.
- Developed a machine learning-based real-time tissue recognition system using a chemical profile database.
Main Results:
- The REIMS technique achieved 88% overall accuracy in differentiating glioma subtypes (astrocytoma II/III, glioblastoma, oligodendroglioma II/III) and normal brain tissue.
- Achieved 96% accuracy in separating astrocytoma and oligodendroglioma grade II from normal brain tissue.
- Demonstrated high sensitivity in differentiating GBM (99.2%) and astrocytoma grade II (97.5%).
Conclusions:
- Real-time molecular information during electrosurgical dissection enhances intra-operative decision-making.
- This technique can lead to more accurate tumor removal for various glioma subtypes.
- The REIMS system shows promise for improving surgical outcomes in neuro-oncology.
More Related Videos
13:12Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
09:17Longitudinal Intravital Imaging of Brain Tumor Cell Behavior in Response to an Invasive Surgical Biopsy
Published on: May 3, 2019