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Lara Heaton and Anna Levy for RN Breakfast

'Intelligent knife' can detect endometrial cancer in seconds

A study by Imperial College London has found a sophisticated tool may be able to detect and diagnose endometrial cancer in just seconds.

The iKnife has been in use for several years, but this research is the first to investigate its diagnostic capabilities.

Researchers hope it will help people with uteruses get diagnosed quicker, reducing the anxiety of waiting for results.

What is endometrial cancer?

Endometrial cancer is the most common cancer type to occur in the uterus.

Around 3,000 cases of uterine cancer were diagnosed in Australia last year, according to government statistics.

The disease occurs when the cells lining the uterus grow in an abnormal and uncontrolled way, often resulting in symptoms such as abnormal bleeding and watery discharge.

While the cause of the disease is unknown, risk factors include obesity, high blood pressure, diabetes and poly-cystic ovary syndrome.

It's usually detected post-menopause, but younger people can develop the cancer, too.

Even so, UK statistics say only around 10 per cent of those presenting with symptoms who undergo a biopsy are diagnosed with the cancer.

Treatment is almost always a hysterectomy, a surgical removal of the uterus, alongside other cancer treatments like radiotherapy or chemotherapy.

So, what exactly is the iKnife?

The iKnife, or "intelligent knife" was developed by Dr Zoltan Takats at Imperial College London in the UK.

It's a modified surgical knife that uses heat to cut through biopsied tissue and analyses the smoke that evaporates to distinguish healthy tissue from cancer.

And it's all in real-time.

Professor Sadaf Ghaem-Maghami is a senior researcher on the study, which was recently published in the journal, cancers.

She told ABC RN Breakfast the research, which uses the iKnife for diagnosis of cancer rather than treatment, is the first of its kind.

"[It's] quite unique. So far, nobody's done this," she said.

The study found the iKnife had an 89 per cent accuracy rate when diagnosing patients.

"That's really pretty good for a diagnostic test," Professor Ghaem-Maghami said.

"It was quite specific and had a very good positive predictive value, which means that if it thinks it's cancer, it is highly likely that the final diagnosis is going to be cancer."

While histopathology — examining tissue under a microscope — is the "gold standard" for diagnosis, Professor Ghaem-Maghami said she hoped the iKnife could be used to make a preliminary diagnosis after a biopsy has been taken from a patient.

"We can actually then fasten their care pathway and hopefully save them weeks of anxiety while they wait for the final histology," she said.

What could this mean for cancer diagnosis in Australia?

A large clinical trial is planned in the UK, and researchers hope this could lead to the technology being adopted more widely.

But in Australia, some experts have expressed concern.

Andreas Obermair, a professor of gynaecological oncology at the University of Queensland, has reservations about the tool's efficacy in diagnosis.

"It would make sense to use it for breast and ovarian cancer, for which this technology was developed," he said.

"For a diagnostic tool, I would expect a much better performance than 89 per cent accuracy."

Professor Obermair said the test's relevance would also be different in an Australian setting.

He said while public hospitals may be slow to communicate results with patients, endometrial cancer in Australia can be diagnosed in around a week or less.

"I think in the UK they have a big issue with diagnostic and surgery waiting times, whereas in Australia, that is not such a big issue," he said.

He said he would like to see more formal research comparing the iKnife to current diagnostic standards before it's used in Australia.

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