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'Nose Knows' Devices Not Ready for Clinic

Ƶ MedicalToday
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BARCELONA -- Within a decade, doctors may be able to diagnose cancer, asthma, and tuberculosis simply by having an electronic nose analyze a person's breath, researchers reported here.

In a presentation at the European Respiratory Society congress, Maris Bukovskis, MD, lecturer in medicine at the , Riga, described preliminary findings in which the electronic nose was able to correctly identify 128 of 140 cases of lung cancer in nonsmokers -- a positive predictive value of 91.4% -- and was able to determine there was no cancer in 120 of 125 healthy volunteers, a negative predictive value of 96%.

Action Points

  • Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  • Several preliminary studies suggest that an electronic nose may be able to provide clinically useful data in detection of cancer and phenotyping of severe asthma.

In smokers, the experimental electronic nose picked up 114 lung cancers and missed seven for a positive predictive value of 94.2% and ruled out cancer in 84 of 89 healthy individuals for a negative predictive value of 94.4%.

"These are good findings," Bukovskis said at an ERS press briefing," but we need to improve on them."

"We still have work to do with this device to prevent false positives and false negatives," Immanuels Taivans, MD, professor of medicine at the University of Latvia, told Ƶ at poster presentations describing the studies.

"We are teaching the electronic nose to pick up the pattern of chemicals given off by cancers and other diseases," said Elisabeth Bel, MD, PhD, professor of medicine at the Amsterdam, who moderated the press briefing.

"I think we will have an electronic nose that can pick up tuberculosis in maybe 2 years," she told Ƶ. "Asthma and cancer detection may take longer."

Paul Brinkman, MSc, a biomedical engineer at the Academic Medical Centre, told Ƶ that the electronic nose is a development that has spun off from military applications where organizations such as the U.S. (DARPA) worked to create a device similar to the fictional which allowed that series' Captain Kirk and his fellow space travelers to assess the habitability of planets.

The DARPA project was designed to sample air for signatures of chemical weapons or bombs. Brinkman said he and others are using offshoots of the technology to look for signatures of volatile organic compounds in a person's breath that can be tied to disease states.

In his report, he suggested that compounds could be identified that fell into various clusters of severity of asthma. He said the clusters make it possible to identify severe asthma patients with respect to inflammation and lung function.

Another researcher, Niki Fens, MD, PhD, a post-doctoral clinical researcher at the Academic Medical Centre, described at her poster presentation how "breath prints" correlated with eosinophils, lymphocytes, and macrophages in patients with asthma.

"We believe our work suggests that peripheral airway inflammation in asthma can be assessed noninvasively. We believe we have shown proof-of-principle with our electronic nose," she told Ƶ. "It is our version of the tricorder."

Disclosures

Bel, Fens, Bukovskis, Taivans and Brinkman had no disclosures.

Primary Source

European Respiratory Society

Source Reference: Bukovskis M, et al "Detection of early stage lung cancer by electronic nose" ERS 2013; Abstract P2888.

Secondary Source

European Respiratory Society

Source Reference: Brinkman P, et al "Unbiased cluster analysis of severe asthma based on metabolomics by the U-BIOPRED electronic nose platform" ERS 2013; Abstract 3041.

Additional Source

European Respiratory Society

Source Reference: Fens N, et at "Electronic nose breathprints reflect BALF inflammatory cell counts in asthma" ERS 2013; Abstract P850.