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Mass Spectrometry Imaging as a Tool for Surgical Decision-making

1Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3Department of Chemistry and Center for Analytical Instrumentation Development, Purdue University, West Lafayette, IN, USA.
4Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
John Wiley & Sons, Inc.
Publication Date:
J Mass Spectrom
Volume Number:
Issue Number:
J Mass Spectrom. 2013 Nov;48(11):1178-87.
PubMed ID:
DESI-MSI, brain tumors, real-time diagnosis, surgery, image-guided therapy
Appears in Collections:
DP2 OD007383/OD/NIH HHS/United States
R21 EB009459/EB/NIBIB NIH HHS/United States
K08 NS064168/NS/NINDS NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
P41 RR019703/RR/NCRR NIH HHS/United States
Generated Citation:
Calligaris D., Norton I., Feldman D.R., Ide J.L., Dunn I.F., Eberlin L.S., Cooks R.G., Jolesz F.A., Golby A.J., Santagata S., Agar N.Y. Mass Spectrometry Imaging as a Tool for Surgical Decision-making. J Mass Spectrom. 2013 Nov;48(11):1178-87. PMID: 24259206. PMCID: PMC3957233.
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Despite significant advances in image-guided therapy, surgeons are still too often left with uncertainty when deciding to remove tissue. This binary decision between removing and leaving tissue during surgery implies that the surgeon should be able to distinguish tumor from healthy tissue. In neurosurgery, current image-guidance approaches such as magnetic resonance imaging (MRI) combined with neuronavigation offer a map as to where the tumor should be, but the only definitive method to characterize the tissue at stake is histopathology. Although extremely valuable information is derived from this gold standard approach, it is limited to very few samples during surgery and is not practically used for the delineation of tumor margins. The development and implementation of faster, comprehensive, and complementary approaches for tissue characterization are required to support surgical decision-making an incremental and iterative process with tumor removed in multiple and often minute biopsies. The development of atmospheric pressure ionization sources makes it possible to analyze tissue specimens with little to no sample preparation. Here, we highlight the value of desorption electrospray ionization as one of many available approaches for the analysis of surgical tissue. Twelve surgical samples resected from a patient during surgery were analyzed and diagnosed as glioblastoma tumor or necrotic tissue by standard histopathology, and mass spectrometry results were further correlated to histopathology for critical validation of the approach. The use of a robust statistical approach reiterated results from the qualitative detection of potential biomarkers of these tissue types. The correlation of the mass spectrometry and histopathology results to MRI brings significant insight into tumor presentation that could not only serve to guide tumor resection, but that is also worthy of more detailed studies on our understanding of tumor presentation on MRI.

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