European Associated Laboratory (EAL) LANCET
In 2017, Inserm and Imperial College of London have labialized a European Associated Laboratory (EAL), named LANCET. LANCET EAL is based on two groups, PRISM and the Department of Surgery and Cancer of ICL. LANCET EAL project will consist in the development of a tight collaboration for a minimally invasive tissue identification approaches using ambient mass spectrometry. This EAL is deriving from a tight collaboration since 2014 with Pr. Z. Takats on novel guide surgery instrument. In fact, Pr Z. Takats has developed a MS based technology (Intelligent Knife or i’Knife system) allowing for real time monitoring during surgery by collecting aerosol (smokes) liberated during tissue excision with an electric scalpel (Balog et al., 2013). This pioneer work has demonstrated the high potential of MS for providing signature MS spectra of the various areas of the tissues with possible distinction of normal and cancerous parts of tissues and the intermediate parts corresponding to the excision margins (Takats et al., 2012). Dr. Takats has settled a first prototype installed in a surgery room at Saint Mary Hospital in London (Balog et al., 2010; Schäfer et al., 2011). For diagnosis the system operates a collection of the molecular profiles and comparison of the molecular profiles to reference profiles implemented into a database of the various stages and grades of one cancer pathology. In parallel, PRISM has developed a novel instrument for in vivo real time and non-invasive diagnosis, the SPIDERMASS. This instrument consists in an innovative sampling probe based on laser ablation coupled to analytical instrument to perform real-time analysis (Fatou et al., 2016, Patent FR1458925). The instrument will aim to be used by surgeons in the operating room so as to improve the decision making. The system is based on tissue sampling correlated with a real-time analysis. LANCET EAL is based on the development of new methods lies in their minimally invasive nature, which is achieved in two, markedly different ways. In case of solid tumours deeply embedded into healthy tissue environment, a special sampling device will be developed and used which extracts only the molecules of interest from the tissues without removing any cellular component. This is achieved by using the so-called Solid Phase Microextraction method for the rapid extraction of hydrophobic (mostly lipid-type) tissue constituents. A metal fibber coated with solid phase extraction medium is inserted into the tumour and the extraction medium is exposed to the tissue. The fibre is retracted and subsequently analysed by Desorption Electrospray Ionization Mass Spectrometry (DESI-MS) to provide longitudinally resolved information on the tissue environment. In case of luminal (e.g. ovarian cancers, sarcoma) tumours we are planning to develop a sampling solution that will be compatible with endoscopic instrumentation. Atmospheric Pressure Laser Ablation (APLA) based desorption/ionization is the technology of choice for tissue sampling in this case. APLA has various advantages including i) possible miniaturization through the use of fibres for both laser light guiding to the tissue and material collection, ii) low damage to patient’s tissues with optimized laser energy and wavelength and iii) possible use of the laser light to destroy the cells for treatment perspectives. This means that APLA using fibered laser should provide a good solution for including it in an endoscopic device. This also means that the system can potentially be combined with a surgical robot and be used for robotic surgery, even for brain pathologies such as Epilepsy. Through LANCET, PRISM and Pr. Z. Takats have started to publish a common paper in Cancer Cell, and have applied to ANR, but also in H2020.