Scientists and medics have developed an ultra-rapid method of genetically diagnosing brain tumours that will cut the time it takes to classify them from weeks, to as little as two hours, improving the care for thousands of patients each year.
The groundbreaking method, which is detailed in a new study published today in Neuro-Oncology, has been developed by scientists at the University of Nottingham (UoN) along with clinicians at Nottingham University Hospitals NHS Trust (NUH).
The new approach has been used during 50 brain tumour surgeries with a 100% success rate of providing diagnostic results in under two hours from surgery and detailed tumour classifications within minutes of sequencing. This new ultra-rapid method could mean diagnostic results are sent to the surgeon during the operation to inform surgical decision making.
Clinicians currently have to send samples away for analysis which can take six to eight weeks or more to get full results to be able to inform patients what type of tumour they have and their prognosis. This can be a long and anxious wait for patients and can delay the start of radiotherapy and chemotherapy which may reduce the chances of treatment being successful.
Charles Trigg is 45 and from Leicestershire. He was diagnosed with a stage 4 aggressive glioblastoma in April. Instead of having to wait 8 weeks for the results of his genetic tests his wait time was reduced to just one week,
“From my point of view – to have knowledge is power and it could be the worst knowledge you have, but it gives you certainty and having that certainty actually makes life a hell of a lot easier. “The fact they’ve been able to get back data very quickly that allows an extensive team of people to conduct detailed reviews feels like an amazing blend of science and medicine.”
Dr Stuart Smith, NUH Neurosurgeon, said: “Traditionally, the process of diagnosing brain tumours has been slow and expensive. Now, with this new technology we can do more for patients because we can get answers so much more quickly which will have a much bigger influence on clinical decision making, in as little as two hours. Patients find waiting many weeks for results extremely difficult and this adds to the anxiety and worry at what is already a very difficult time.
“This type of operation can be quite long, so potentially, a surgeon could be informed during surgery of the accurate diagnosis, which would then impact on the surgical strategy.”
Professor Matt Loose, a biologist from the School of Life Sciences at UoN developed a method to sequence specific parts of human DNA at higher depth. This method allows relevant parts of the human genome to be examined much more quickly, and multiple regions of DNA sequenced at the same time, speeding up the whole process,
“When we first were able to sequence an entire human genome in 2018, it took around five labs and six months to do, which obviously isn’t ideal when time is of the essence for a patient. This new method now allows us to choose the bits of DNA that we need to look at in order to answer specific questions, such as what type of tumour and how can it be treated.
“Once we have a sample from a patient, we can now quickly extract the DNA and look at the different properties to give us the information we need. Methylation is the one we are most interested in early on in this instance because that defines the tumour type.”
Once a sample has been removed during surgery, it can now be sent to a local pathology lab, where they would extract DNA before it being sent to the team to sequence.
Dr Simon Paine, Consultant Neuropathologist at NUH said: “This new method of diagnosing brain tumours is going to be a game changer, it really is revolutionary. It not only increases the speed at which the results will be available, but the degree of accuracy of the diagnosis as well is incredible.”
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This new ultra-rapid method is part of the East Midlands Neuro-Oncology service, and the team behind it have recently been awarded a Tessa Jowell Centre of Excellence for the care provided to patients with brain tumours in Nottinghamshire, Leicestershire, Derbyshire and Lincolnshire. The team are now looking to get the new testing rolled out at NHS Trusts across the UK.
