“Revolutionary” surgical knife could detect womb cancer within seconds, say experts

A surgical knife that “smells tumours” can diagnose womb cancer within seconds, researchers at Imperial College London have revealed.

Around 9,400 women are diagnosed with endometrial cancer, also known as uterine or womb cancer, in the UK each year. This makes it the country’s fourth most common cancer in women and the sixth most common globally.

However, only about 10 per cent of those with suspected symptoms who undergo a biopsy are found to have it.

Researchers have now found that the iKnife, a device that is already used to treat breast and brain cancers, can detect the presence of endometrial cancer with nearly 90 per cent accuracy.

Writing in the journal Cancers, the research team said: “The iKnife reliably diagnosed endometrial cancer in seconds, with a diagnostic accuracy of 89 per cent, minimising the current delays for women whilst awaiting a histopathological diagnosis. The findings presented in this study can pave the way for new diagnostic pathways.”

According to Imperial College London, the iKnife is based on electrosurgery, a technique invented in the 1920s often used in surgery to control bleeding and to rapidly dissect soft tissue in surgery.

Electrosurgical knives use an electrical current to heat tissue, cutting through it while minimising blood loss. In doing so, they vaporise the tissue, creating smoke that is normally sucked away by extraction systems.

The iKnife’s inventor, Dr Zoltan Takats of Imperial College London, connected an electrosurgical knife to a mass spectrometer, an analytical instrument used to identify chemicals in a sample.

The device can tell the difference between cancerous and healthy tissue by analysing the smoke produced when tissue is vaporised.

The experts said its effectiveness was proved using biopsy tissue samples from 150 women with suspected womb cancer, and the results compared with current diagnosis methods.

Athena Lamnisos, chief executive of the Eve Appeal cancer charity which funded the research, told the Guardian: “Waiting for test results is stressful – especially if that test is to find out whether or not you have cancer. When you hear that the ‘c’ word is even a possibility, the days can’t pass quickly enough until a clinician gives you the all clear.

“Womb cancer has one ‘red flag’ symptom of postmenopausal bleeding that should always get checked out on a two-week referral from your GP. To wait a further two weeks for the results can be really hard for patients.

“There are many reasons for abnormal vaginal bleeding after the menopause – womb cancer is just one of them – the ability to provide a diagnostic test that rules cancer in or out immediately, and with accuracy, could make such a positive difference.

“This Eve-supported research has the potential to create a step change in faster diagnosis, and for the 90 per cent of women with postmenopausal bleeding that isn’t cancer, a really effective way to put their minds at ease. We know how important this is for patients.”

Prof Sadaf Ghaem-Maghami, who led the research, told the newspaper the iKnife has the potential to completely revolutionise the way healthcare professionals manage people seen in the rapid-access clinics with significant abnormal vaginal bleeding who have been referred for potential diagnosis of endometrial cancer.

“With its high diagnostic accuracy of 89 per cent and positive predictive value of 94 per cent, one could immediately reassure the person of the very low likelihood of having cancer if the iKnife result is negative and expedite further tests and scans and treatment for people whose biopsies indicate presence of cancer.

“This could happen whilst awaiting confirmation from standard pathology, which can take up to two weeks,” he added.