Beyond Capture Efficiency: A Multidimensional Framework for Benchmarking Circulating Tumor Cell Isolation Technologies

Metastasis remains the major cause of cancer-related mortality, and circulating tumor cells (CTCs) are both candidate liquid-biopsy biomarkers and plausible intermediates of metastatic dissemination. Because CTCs are extremely rare in peripheral blood, platform comparisons have often focused solely on recovery. That focus is insufficient for applications that depend on the quality of the recovered material, including single-cell profiling, short-term culture, and functional testing. Here, we compared four CTC isolation approaches: TellDx CTC System, Genesis System, RosetteSep, and flow cytometry, using spike-in experiments in human blood. Capture efficiency was evaluated across all four plat