In a remarkable leap forward for neuro-oncology, scientists in the UK have unveiled a pioneering diagnostic tool that dramatically cuts the waiting time for brain tumour classification — from the current six to eight weeks down to just two hours. This new test, called ROBIN (Rapid Nanopore Brain Intraoperative Classification), promises to transform both surgical decision-making and patient care.

Developed by a collaborative team at the University of Nottingham and Nottingham University Hospitals NHS Trust (NUH), ROBIN harnesses cutting-edge nanopore sequencing technology to deliver real-time, intraoperative tumour analysis. The findings, recently published in the journal Neuro-Oncology, demonstrate that the tool is not only ultra-fast but also 90% concordant with current gold-standard diagnostic pathways.

A Technological Breakthrough in Neurosurgery

Traditionally, determining the molecular subtype of a brain tumour requires sending tissue samples to centralised labs, with results trickling back over many weeks. This delay can postpone critical treatment decisions and add emotional strain to an already distressing diagnosis.

With ROBIN, however, results are available within minutes of sequencing, and a robust diagnostic classification can be delivered before the patient even leaves the operating theatre. The test also provides next-day comprehensive molecular profiling, offering unparalleled insight into the tumour’s genetic landscape.

“Not only is the test more accurate and quicker, but it is also cheaper than current methods. Most importantly, it delivers results to the patients when they need them.”
— Professor Matt Loose, University of Nottingham

Helping Surgeons in Real Time

The implications for intraoperative neurosurgical care are profound. According to Dr Stuart Smith, Consultant Neurosurgeon at NUH, the tool could directly influence surgical decisions by guiding the extent of resection based on tumour type.

“This new technology allows us to make informed choices during surgery — it truly changes how we manage brain tumours.”
— Dr Stuart Smith, University of Nottingham & NUH

Moreover, Dr Simon Paine, Consultant Neuropathologist, praised the test’s ability to deliver both speed and precision.

“It really is revolutionary. The level of diagnostic accuracy we can achieve so quickly is a game changer.”
— Dr Simon Paine, NUH

What Makes ROBIN Unique?

• Single Assay Workflow: Simultaneously delivers intraoperative methylome classification and next-day full molecular profiling.
• High-Speed Sequencing: Diagnostic turnaround time under two hours, with classifications within minutes of sequencing start.
• Integrated Analysis: Uses three separate methylation classifiers for enhanced diagnostic confidence.
• Real-Time Insights: Capable of detecting single nucleotide variants, copy number variants, and structural variants on the fly.
• Cost-Effective: At approximately £450 per case, it is potentially more affordable than existing pathways — especially when scaled.

Clinical Validation

In a prospective study involving 50 intraoperative cases:

• 90% concordance with standard diagnostic results was achieved.
• Full integrated diagnosis was available within 24 hours.
• Classifications were accurate enough to inform surgical strategy mid-operation.

The Future of CNS Tumour Diagnosis

This innovation comes at a time when the field is rapidly embracing genomic and epigenomic classification systems for central nervous system (CNS) tumours. ROBIN stands at the frontier of this transformation, combining speed, accuracy, and cost-efficiency in one compact platform.

It addresses a critical clinical gap: the need for high-yield, long-read DNA sequencing during surgery, without the delays of traditional ligation-based methods. And unlike prior tools that focused only on methylation profiles, ROBIN integrates multiple analytic layers, setting a new benchmark in diagnostic confidence and clinical utility.

ROBIN represents a seismic shift in brain tumour diagnosis — one that could dramatically improve outcomes by allowing clinicians to act faster and with greater certainty. For patients and their families, it means fewer weeks of agonising uncertainty and faster access to personalised care. For neurosurgeons, it means sharper tools and smarter strategies in the operating theatre.

Further reading: Simon Deacon, Inswasti Cahyani, Nadine Holmes, et al., ROBIN: A unified nanopore-based assay integrating intraoperative methylome classification and next-day comprehensive profiling for ultra-rapid tumor diagnosis, Neuro-Oncology, 2025;, noaf103, https://doi.org/10.1093/neuonc/noaf103