Klin Onkol 2016; 29(Suppl 4): 88-94. DOI: 10.14735/amko20164S88.
Background: The treatment of oncological diseases is based on the combination of surgery, representing the key step for the removal of the tumor tissue, radiotherapy, chemotherapy, and hormone therapy. However, the surgery is often accompanied by issue of determining the boundaries of the tumor. Prior the operation, the surgeon has information on preoperative findings, which indicate the location and extent of the tumor, but does not specify a clear boundary between the tumor and healthy tissue. This area cannot be recognized visually or by touch in most cases and when the tumor is not removed completely the patient has to undergo reoperation. Aim: Therefore, a number of research centers began to deal with the development of technology that would provide information about the state of the tissue in real time directly during surgery and would not require the collection or storage of tissue samples. These include MarginProbe, Spectropen tissue and spectroscopic scanner devices. Another group consists of imaging techniques using mass spectrometry approaches to determine the tissue specificity. Recently, the intraoperative mass spectrometry (REIMS) technique has undergone tremendous development. It uses an electronic scalpel using by the surgeon for cutting the tissue, when the resulting aerosol is discharged into the mass spectrometer that in tenths of seconds measures mass spectra of phospholipids, which are specific to the operated tissue (tumor or healthy). In the Czech Republic this technology has been already used for research purposes for the detection of drug deposited in the tumor and healthy tissue of mice suffering from melanoma. The obtained results show that with this apparatus it would be possible fundamentally affect the treatment and its efficacy in oncology as well. We will inform you about these new technologies and elucidate their principles and utilization.