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Brief Title: Real Time Tissue Characterisation Using Mass Spectrometry REI-EXCISE iKnife Study
Official Title: Rapid Evaporative Ionisation Mass Spectrometry for Examination of Circumferential Surgical Excision Margins
Study ID: NCT03432429
Brief Summary: REI-EXCISE is a multicentre, prospective, non-randomised feasibility study, aimed to evaluate the diagnostic accuracy of rapid ionisation mass spectroscopy using an iKnife device. The iKnife will collect vapour, a by-product of surgery, which will pass through the mass spectrometer machine for analysis in order to evaluate what is "normal" and what is "cancerous" breast tissue.
Detailed Description: There is an urgent need to address high rates of close or positive margins and re-operative breast cancer surgery, which commonly results from the inability of the surgeon to rapidly and reliably evaluate resection margin status intra-operatively. This study therefore seeks to address this problem by aiming to develop a method for near real time, in vivo intra-operative tissue classification that may be used by breast surgeons as an intelligent knife (or "iKnife") to better guide oncological margin control. The method known as Rapid Evaporative Ionisation Mass Spectrometry (REIMS) technology uses mass spectrometric and chemometric analysis of the tissue specific ionic content of the surgical diathermy smoke plume for the rapid identification of dissected breast tissues. There are no additional treatment interventions as part of REI-EXCISE. The main study procedures are breast conserving surgery using the REIMS iKnife for mass spectral analysis of each surgical margin and correlation between the results of a software recognition algorithm that capitalised on the spectral data (i.e. iKnife margin = positive / negative) with conventional histopathological assessment. False positive iKnife data will be further interrogated with digital droplet polymerase chain reaction and imprint cytology assessment.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Royal Marsden NHS Foundation Trust (Chelsea), London, , United Kingdom
Imperial College NHS Foundation Trust, Charing Cross Hospital, London, , United Kingdom
The Royal Marsden NHS Foundation Trust (Sutton), Sutton, , United Kingdom
Name: Daniel Leff
Affiliation: Department of Surgery & Cancer, Imperial College London
Role: PRINCIPAL_INVESTIGATOR
Name: Zoltan Takats
Affiliation: Department of Metabolism, Digestion and Reproduction, Imperial College London
Role: PRINCIPAL_INVESTIGATOR