Laser-assisted rapid evaporative ionisation mass spectrometry (LA-REIMS) as a metabolomics platform in cervical cancer screening

Abstract

Background The introduction of high-risk human papillomavirus (hrHPV) testing as part of primary cervical screening is anticipated to improve sensitivity, but also the number of women who will screen positive. Reflex cytology is the preferred triage test in most settings but has limitations including moderate diagnostic accuracy, lack of automation, inter-observer variability and the need for clinician-collected sample. Novel, objective and cost-effective approaches are needed. Methods In this study, we assessed the potential use of an automated metabolomic robotic platform, employing the principle of laser-assisted Rapid Evaporative Ionisation Mass Spectrometry (LA-REIMS) in cervical cancer screening. Findings In a population of 130 women, LA-REIMS achieved 94% sensitivity and 83% specificity (AUC: 91.6%) in distinguishing women testing positive ( n = 65) or negative ( n = 65) for hrHPV. We performed further analysis according to disease severity with LA-REIMS achieving sensitivity and specificity of 91% and 73% respectively (AUC: 86.7%) in discriminating normal from high-grade pre-invasive disease. Interpretation This automated high-throughput technology holds promise as a low-cost and rapid test for cervical cancer screening and triage. The use of platforms like LA-REIMS has the potential to further improve the accuracy and efficiency of the current national screening programme. Funding Work was funded by the MRC Imperial Confidence in Concept Scheme, Imperial College Healthcare Charity, British Society for Colposcopy and Cervical Pathology, National Research Development and Innovation Office of Hungary, Waters corporation and NIHR BRC.

Rapid evaporative ionisation mass spectrometry (REIMS): A potential and rapid tool for the identification of insecticide resistance in mosquito larvae

“…The speed at which samples can be analysed allows for high sample turnover which therefore reduces cost, 100 mosquito larvae could be analysed, and an answer generated in as little as 2-3 hours. In other applications including cancer diagnostic REIMS has been identified to be a more cost-effective method than other molecular techniques with costs around £1.60 per sample (Paraskevaidi et al 2020). The REIMS method identifies differences in the lipid/metabolite profile of samples however specific molecule detection is not the objective of this method, which is designed instead to detect unique patterns in mass spectrum that enable classification (Wagner et al 2020).…”

Understanding Cervical Cancer through Proteomics

“…LA-REIMS achieved 94% sensitivity and 83% specificity in the detection of high-risk HPV positive women. Therefore, the authors conclude that the use of platforms such as LA-REIMS can further improve the accuracy and efficiency of the current national detection program [158].…”

“…Paraskevaidi et al [158] evaluated a novel method for CC screening. Using an automated metabolomic robotic platform and the principle of laser-assisted rapid evaporative ionization mass spectrometry (LA-REIMS), a population of 130 women was analyzed.…”

Molecular markers for cervical cancer screening

“…REIMS was developed for the analysis of aerosols generated during electrosurgery and combined with tandem high-resolution MS was tested on histology samples showing excellent accuracy for discriminating normal, CIN and cancer tissues [65]. A similar approach with LA-REIMS led to the development of a high-throughput screening procedure in cell pellets from LBC samples to discriminate hrHPV positive from negative samples and normal from CIN2+ [66]. Discrimination was most likely based on differences in lipid patterns and analysis used a neural network-based approach.…”