Early diagnosis of brain tumours using a novel spectroscopic liquid biopsy

Author:

Brennan Paul M1ORCID,Butler Holly J2ORCID,Christie Loren2ORCID,Hegarty Mark G2,Jenkinson Michael D3,Keerie Catriona4,Norrie John4,O’Brien Rachel5,Palmer David S26,Smith Benjamin R2,Baker Matthew J2

Affiliation:

1. Translational Neurosurgery, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH4 2XU, UK

2. ClinSpec Diagnostics Limited, Royal College Building, Glasgow G1 1XW, UK

3. Institute of Translational Medicine, University of Liverpool & The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK

4. Edinburgh Clinical Trials Unit, Usher Institute—University of Edinburgh, Edinburgh EH16 4UX, UK

5. Emergency Medicine Research Group (EMERGE), Royal Infirmiry of Edinburgh, Edinburgh EH16 4SA, UK

6. Department of Pure and Applied Chemistry, Thomas Graham Building, University of Strathclyde, Glasgow G11XL, UK

Abstract

Abstract Early diagnosis of brain tumours is challenging and a major unmet need. Patients with brain tumours most often present with non-specific symptoms more commonly associated with less serious diagnoses, making it difficult to determine which patients to prioritize for brain imaging. Delays in diagnosis affect timely access to treatment, with potential impacts on quality of life and survival. A test to help identify which patients with non-specific symptoms are most likely to have a brain tumour at an earlier stage would dramatically impact on patients by prioritizing demand on diagnostic imaging facilities. This clinical feasibility study of brain tumour early diagnosis was aimed at determining the accuracy of our novel spectroscopic liquid biopsy test for the triage of patients with non-specific symptoms that might be indicative of a brain tumour, for brain imaging. Patients with a suspected brain tumour based on assessment of their symptoms in primary care can be referred for open access CT scanning. Blood samples were prospectively obtained from 385 of such patients, or patients with a new brain tumour diagnosis. Samples were analysed using our spectroscopic liquid biopsy test to predict presence of disease, blinded to the brain imaging findings. The results were compared to the patient’s index brain imaging delivered as per standard care. Our test predicted the presence of glioblastoma, the most common and aggressive brain tumour, with 91% sensitivity, and all brain tumours with 81% sensitivity, and 80% specificity. Negative predictive value was 95% and positive predictive value 45%. The reported levels of diagnostic accuracy presented here have the potential to improve current symptom-based referral guidelines, and streamline assessment and diagnosis of symptomatic patients with a suspected brain tumour.

Funder

Scottish Enterprise High Growth Spinout Programme

Innovate UK Precision Medicine Accelerator Grant

Publisher

Oxford University Press (OUP)

Subject

General Earth and Planetary Sciences,General Environmental Science

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