Scientists at Imperial College London, in partnership with clinicians at Imperial College Healthcare NHS Trust, have installed a highresolution solid state nuclear magnetic resonance (NMR) spectrometer in St Mary’s Hospital.
Researchers will use the machine to analyse intact tissue samples from patients taking part in studies, to investigate whether it can, ultimately, give surgeons detailed diagnostic information while their patients are under the knife. Metabolic profiling of tissue samples could transform the way surgeons make decisions in the operating theatre, say researchers at the new laboratory. The Surgical Metabonomics Laboratory will be led by the surgical innovator, Professor Lord Ara Darzi and Professor Jeremy Nicholson, a leading researcher in biomolecular medicine and Head of the Department of Surgery and Cancer. The science of metabonomics, which involves comprehensively measuring the metabolic changes in a person’s body, has been pioneered by the Imperial team over the last 20 years. Techniques from analytical chemistry, such as NMR spectroscopy and mass spectrometry, can allow researchers to simultaneously measure all of the chemicals produced by the body’s metabolism. With knowledge of which molecules correspond to which conditions in the body, this “metabolic fingerprint” can provide information about the state of a person’s health. Metabonomics has previously been applied to samples of bodily fluids, such as blood and urine, to look for indicators of disease or of how a person might respond to a particular drug. The acquisitions of the NMR machine will allow the team to analyse solid tissue samples from patients undergoing surgery with Imperial College Healthcare. Surgeons will be able to take tissue samples and have them loaded straight into the NMR machine without the need to prepare them. The research team think it will be possible to give the surgeon a readily interpretable readout from the analysis within 20 minutes, which would provide information such as whether the tissue is infected or how good its blood supply is. Surgeons might also use the technology to determine exactly which areas of tissue are cancerous. One project that the team will undertake at the new laboratory is to develop an “intelligent knife”, used in conjunction with electrocautery technology, which seals blood vessels by burning them with a hot iron. By analysing the smoke produced in this procedure in a mass spectrometer, researchers believe they will be able to tell the surgeon whether the tissue they are burning is healthy, cancerous or infected. To help realise the vision of the new centre to enhance surgical safety and patient care, Imperial has partnered with two spectroscopic instrument manufacturers, Bruker BioSpin and the Waters Corporation, who will help to develop, optimise and implement NMR and mass spectrometric technologies for real time diagnostics and prognostic modelling.
