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Heers H, Chwilka O, Huber J, Vogelmeier C, Koczulla AR, Baumbach JI, Boeselt T. VOC-based detection of prostate cancer using an electronic nose and ion mobility spectrometry: A novel urine-based approach. Prostate 2024. [PMID: 38497426 DOI: 10.1002/pros.24692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Many diseases leave behind specific metabolites which can be detected from breath and urine as volatile organic compounds (VOC). Our group previously described VOC-based methods for the detection of bladder cancer and urinary tract infections. This study investigated whether prostate cancer can be diagnosed from VOCs in urine headspace. METHODS For this pilot study, mid-stream urine samples were collected from 56 patients with histologically confirmed prostate cancer. A control group was formed with 53 healthy male volunteers matched for age who had recently undergone a negative screening by prostate-specific antigen (PSA) and digital rectal exam. Headspace measurements were performed with the electronic nose Cyranose 320TM . Statistical comparison was performed using principal component analysis, calculating Mahalanobis distance, and linear discriminant analysis. Further measurements were carried out with ion mobility spectrometry (IMS) to compare detection accuracy and to identify potential individual analytes. Bonferroni correction was applied for multiple testing. RESULTS The electronic nose yielded a sensitivity of 77% and specificity of 62%. Mahalanobis distance was 0.964, which is indicative of limited group separation. IMS identified a total of 38 individual analytical peaks, two of which showed significant differences between groups (p < 0.05). To discriminate between tumor and controls, a decision tree with nine steps was generated. This model led to a sensitivity of 98% and specificity of 100%. CONCLUSIONS VOC-based detection of prostate cancer seems feasible in principle. While the first results with an electronic nose show some limitations, the approach can compete with other urine-based marker systems. However, it seems less reliable than PSA testing. IMS is more accurate than the electronic nose with promising sensitivity and specificity, which warrants further research. The individual relevant metabolites identified by IMS should further be characterized using gas chromatography/mass spectrometry to facilitate potential targeted rapid testing.
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Affiliation(s)
- Hendrik Heers
- Department of Urology, Philipps-Universität Marburg, Marburg, Germany
| | - Oliver Chwilka
- Department of Urology, Philipps-Universität Marburg, Marburg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-Universität Marburg, Marburg, Germany
| | - Claus Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps-Universität Marburg, Marburg, Germany
| | - Andreas Rembert Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps-Universität Marburg, Marburg, Germany
- Department of Pulmonology, Schoen-Kliniken, Berchtesgaden, Germany
| | - Jörg Ingo Baumbach
- Department of Biochemical and Chemical Engineering, Technical University of Dortmund, Dortmund, Germany
| | - Tobias Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps-Universität Marburg, Marburg, Germany
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2
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Angioli R, Santonico M, Pennazza G, Montera R, Luvero D, Gatti A, Zompanti A, Finamore P, Incalzi RA. Use of Sensor Array Analysis to Detect Ovarian Cancer through Breath, Urine, and Blood: A Case-Control Study. Diagnostics (Basel) 2024; 14:561. [PMID: 38473033 DOI: 10.3390/diagnostics14050561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Ovarian cancer (OC) is the eighth most common cancer in women. Since screening programs do not exist, it is often diagnosed in advanced stages. Today, the detection of OC is based on clinical examination, transvaginal ultrasound (US), and serum biomarker (Carbohydrate Antigen 125 (CA 125) and Human Epididymis Protein 4 (HE4)) dosage, with a sensitivity of 88% and 95%, respectively, and a specificity of 84% for US and 76% for biomarkers. These methods are clearly not enough, and OC in its early stages is often missed. Many scientists have recently focused their attention on volatile organic compounds (VOCs). These are gaseous molecules, found in the breath, that could provide interesting information on several diseases, including solid tumors. To detect VOCs, an electronic nose was invented by a group of researchers. A similar device, the e-tongue, was later created to detect specific molecules in liquids. For the first time in the literature, we investigated the potential use of the electronic nose and the electronic tongue to detect ovarian cancer not just from breath but also from urine, blood, and plasma samples.
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Affiliation(s)
- Roberto Angioli
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Marco Santonico
- Unit of Electronics for Sensor Systems, Department of Science and Technology for Sustainable Development and One Health, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Giorgio Pennazza
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Roberto Montera
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Daniela Luvero
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandra Gatti
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandro Zompanti
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Panaiotis Finamore
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
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3
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Vassilenko V, Moura PC, Raposo M. Diagnosis of Carcinogenic Pathologies through Breath Biomarkers: Present and Future Trends. Biomedicines 2023; 11:3029. [PMID: 38002028 PMCID: PMC10669878 DOI: 10.3390/biomedicines11113029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The assessment of volatile breath biomarkers has been targeted with a lot of interest by the scientific and medical communities during the past decades due to their suitability for an accurate, painless, non-invasive, and rapid diagnosis of health states and pathological conditions. This paper reviews the most relevant bibliographic sources aiming to gather the most pertinent volatile organic compounds (VOCs) already identified as putative cancer biomarkers. Here, a total of 265 VOCs and the respective bibliographic sources are addressed regarding their scientifically proven suitability to diagnose a total of six carcinogenic diseases, namely lung, breast, gastric, colorectal, prostate, and squamous cell (oesophageal and laryngeal) cancers. In addition, future trends in the identification of five other forms of cancer, such as bladder, liver, ovarian, pancreatic, and thyroid cancer, through perspective volatile breath biomarkers are equally presented and discussed. All the results already achieved in the detection, identification, and quantification of endogenous metabolites produced by all kinds of normal and abnormal processes in the human body denote a promising and auspicious future for this alternative diagnostic tool, whose future passes by the development and employment of newer and more accurate collection and analysis techniques, and the certification for utilisation in real clinical scenarios.
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Affiliation(s)
- Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
| | - Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
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4
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Warli SM, Firsty NN, Velaro AJ, Tala ZZ. The Olfaction Ability of Medical Detection Canine to Detect Prostate Cancer From Urine Samples: Progress Captured in Systematic Review and Meta-Analysis. World J Oncol 2023; 14:358-370. [PMID: 37869239 PMCID: PMC10588501 DOI: 10.14740/wjon1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/29/2023] [Indexed: 10/24/2023] Open
Abstract
Background To date, early cancer detection is considered vital to reduce the global cancer burden through low-cost, but accurate screening modalities. The anatomical positioning of prostate cancer (PCa) created a potentially distinctive diagnostic method through the identification of volatile organic compounds (VOCs) in urine, which might be detectable not by humans but by canine species. This review aimed to capture the potential of the medical detection canine (MDC) to detect PCa by providing its diagnostic accuracy estimation on urine odor testing. Methods Databases, e.g., MEDLINE, Cochrane, ScienceDirect, and ProQuest, were searched to identify the studies. We focused on accessible original research, comparing the diagnostic utility of trained female MDC and histopathology examination as the gold standard for PCa diagnosis. The statistical analysis was performed in Meta-DiSc 1.4 and presented in diagnostic values, i.e., sensitivity (Sn), specificity (Sp), positive or negative likelihood ratio (LR+ or LR-), diagnostic odd ratio (DOR), and area under the curve (AUC) value, to conclude the Sn-Sp in a single outcome. Results Female German Shepherds were the most commonly utilized MDC from the five studies included in the final analysis. We estimate the pooled diagnostic value of eight different MDCs, with the findings as follows: Sn (0.95 (0.94 - 0.97)), Sp (0.92 (0.90 - 0.93)), LR+ (4.48 (1.90 - 10.58)), LR- (0.12 (0.01 - 1.42)), DOR (35.39 (2.90 - 432.53)), and an AUC value of 0.9232. Conclusions MDC's olfaction ability holds considerable potential on its diagnostic accuracies to distinguish the urine of PCa individuals by identifying its volatilome property.
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Affiliation(s)
- Syah Mirsya Warli
- Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara-Haji Adam Malik General Hospital, Medan, Indonesia
| | - Naufal Nandita Firsty
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Adrian Joshua Velaro
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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5
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Grizzi F, Bax C, Hegazi MAAA, Lotesoriere BJ, Zanoni M, Vota P, Hurle RF, Buffi NM, Lazzeri M, Tidu L, Capelli L, Taverna G. Early Detection of Prostate Cancer: The Role of Scent. CHEMOSENSORS 2023; 11:356. [DOI: 10.3390/chemosensors11070356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Prostate cancer (PCa) represents the cause of the second highest number of cancer-related deaths worldwide, and its clinical presentation can range from slow-growing to rapidly spreading metastatic disease. As the characteristics of most cases of PCa remains incompletely understood, it is crucial to identify new biomarkers that can aid in early detection. Despite the prostate-specific antigen serum (PSA) levels, prostate biopsy, and imaging representing the actual gold-standard for diagnosing PCa, analyzing volatile organic compounds (VOCs) has emerged as a promising new frontier. We and other authors have reported that highly trained dogs can recognize specific VOCs associated with PCa with high accuracy. However, using dogs in clinical practice has several limitations. To exploit the potential of VOCs, an electronic nose (eNose) that mimics the dog olfactory system and can potentially be used in clinical practice was designed. To explore the eNose as an alternative to dogs in diagnosing PCa, we conducted a systematic literature review and meta-analysis of available studies. PRISMA guidelines were used for the identification, screening, eligibility, and selection process. We included six studies that employed trained dogs and found that the pooled diagnostic sensitivity was 0.87 (95% CI 0.86–0.89; I2, 98.6%), the diagnostic specificity was 0.83 (95% CI 0.80–0.85; I2, 98.1%), and the area under the summary receiver operating characteristic curve (sROC) was 0.64 (standard error, 0.25). We also analyzed five studies that used an eNose to diagnose PCa and found that the pooled diagnostic sensitivity was 0.84 (95% CI, 0.80–0.88; I2, 57.1%), the diagnostic specificity was 0.88 (95% CI, 0.84–0.91; I2, 66%), and the area under the sROC was 0.93 (standard error, 0.03). These pooled results suggest that while highly trained dogs have the potentiality to diagnose PCa, the ability is primarily related to olfactory physiology and training methodology. The adoption of advanced analytical techniques, such as eNose, poses a significant challenge in the field of clinical practice due to their growing effectiveness. Nevertheless, the presence of limitations and the requirement for meticulous study design continue to present challenges when employing eNoses for the diagnosis of PCa.
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Affiliation(s)
- Fabio Grizzi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Carmen Bax
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Mohamed A. A. A. Hegazi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Beatrice Julia Lotesoriere
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Matteo Zanoni
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
| | - Paolo Vota
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
| | - Rodolfo Fausto Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Lorenzo Tidu
- Italian Ministry of Defenses, “Vittorio Veneto” Division, 50136 Firenze, Italy
| | - Laura Capelli
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Gianluigi Taverna
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
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6
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P H, Rangarajan M, Pandya HJ. Breath VOC analysis and machine learning approaches for disease screening: a review. J Breath Res 2023; 17. [PMID: 36634360 DOI: 10.1088/1752-7163/acb283] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023]
Abstract
Early disease detection is often correlated with a reduction in mortality rate and improved prognosis. Currently, techniques like biopsy and imaging that are used to screen chronic diseases are invasive, costly or inaccessible to a large population. Thus, a non-invasive disease screening technology is the need of the hour. Existing non-invasive methods like gas chromatography-mass spectrometry, selected-ion flow-tube mass spectrometry, and proton transfer reaction-mass-spectrometry are expensive. These techniques necessitate experienced operators, making them unsuitable for a large population. Various non-invasive sources are available for disease detection, of which exhaled breath is preferred as it contains different volatile organic compounds (VOCs) that reflect the biochemical reactions in the human body. Disease screening by exhaled breath VOC analysis can revolutionize the healthcare industry. This review focuses on exhaled breath VOC biomarkers for screening various diseases with a particular emphasis on liver diseases and head and neck cancer as examples of diseases related to metabolic disorders and diseases unrelated to metabolic disorders, respectively. Single sensor and sensor array-based (Electronic Nose) approaches for exhaled breath VOC detection are briefly described, along with the machine learning techniques used for pattern recognition.
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Affiliation(s)
- Haripriya P
- Department of Electronic Systems Engineering, Indian Institute of Science, Bangalore 560012, India
| | - Madhavan Rangarajan
- Department of Electronic Systems Engineering, Indian Institute of Science, Bangalore 560012, India
| | - Hardik J Pandya
- Department of Electronic Systems Engineering, Indian Institute of Science, Bangalore 560012, India.,Centre for Product Design and Manufacturing, Indian Institute of Science, Bangalore 560012, India
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7
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Than N, Chik Z, Bowers A, Bozano L, Adebiyi A. Quantitation of ethanol in UTI assay for volatile organic compound detection by electronic nose using the validated headspace GC-MS method. PLoS One 2022; 17:e0275517. [PMID: 36201443 PMCID: PMC9536638 DOI: 10.1371/journal.pone.0275517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Disease detection through gas analysis has long been the topic of many studies because of its potential as a rapid diagnostic technique. In particular, the pathogens that cause urinary tract infection (UTI) have been shown to generate different profiles of volatile organic compounds, thus enabling the discrimination of causative agents using an electronic nose. While past studies have performed data collection on either agar culture or jellified urine culture, this study measures the headspace volume of liquid urine culture samples. Evaporation of the liquid and the presence of background compounds during electronic nose (e-nose) device operation could introduce variability to the collected data. Therefore, a headspace gas chromatography-mass spectrometry method was developed and validated for quantitating ethanol in the headspace of the urine samples. By leveraging the new method to characterize the sample stability during e-nose measurement, it was revealed that ethanol concentration dropped more than 15% after only three measurement cycles, which equal 30 minutes for this study. It was further shown that by using only data within the first three cycles, better accuracies for between-day classification were achieved, which was 73.7% and 97.0%, compared to using data from within the first nine cycles, which resulted in 65.0% and 81.1% accuracies. Therefore, the newly developed method provides better quality control for data collection, paving ways for the future establishment of a training data library for UTI.
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Affiliation(s)
- Nam Than
- Department of Biomedical Engineering, San Jose State University, San Jose, California, United States of America
| | - Zamri Chik
- Universiti Malaya Bioequivalence Testing Centre (UBAT), Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amy Bowers
- IBM Almaden Research Center, San Jose, California, United States of America
| | - Luisa Bozano
- IBM Almaden Research Center, San Jose, California, United States of America
| | - Aminat Adebiyi
- IBM Almaden Research Center, San Jose, California, United States of America
- * E-mail:
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8
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Giró Benet J, Seo M, Khine M, Gumà Padró J, Pardo Martnez A, Kurdahi F. Breast cancer detection by analyzing the volatile organic compound (VOC) signature in human urine. Sci Rep 2022; 12:14873. [PMID: 36050339 PMCID: PMC9435419 DOI: 10.1038/s41598-022-17795-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/31/2022] [Indexed: 11/12/2022] Open
Abstract
A rising number of authors are drawing evidence on the diagnostic capacity of specific volatile organic compounds (VOCs) resulting from some body fluids. While cancer incidence in society is on the rise, it becomes clear that the analysis of these VOCs can yield new strategies to mitigate advanced cancer incidence rates. This paper presents the methodology implemented to test whether a device consisting of an electronic nose inspired by a dog’s olfactory system and olfactory neurons is significantly informative to detect breast cancer (BC). To test this device, 90 human urine samples were collected from control subjects and BC patients at a hospital. To test this system, an artificial intelligence-based classification algorithm was developed. The algorithm was firstly trained and tested with data resulting from gas chromatography-mass spectrometry (GC–MS) urine readings, leading to a classification rate of 92.31%, sensitivity of 100.00%, and specificity of 85.71% (N = 90). Secondly, the same algorithm was trained and tested with data obtained with our eNose prototype hardware, and class prediction was achieved with a classification rate of 75%, sensitivity of 100%, and specificity of 50%.
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Affiliation(s)
- Judit Giró Benet
- Center for Embedded Cyber-Physical Systems (CEPS), University of California Irvine (UCI), Irvine, 92697, USA.
| | - Minjun Seo
- Center for Embedded Cyber-Physical Systems (CEPS), University of California Irvine (UCI), Irvine, 92697, USA
| | - Michelle Khine
- Department of Biomedical Engineering, University of California Irvine (UCI), Irvine, 92697, USA
| | - Josep Gumà Padró
- South Catalonia Oncology Institute (IOCS), Sant Joan de Reus University Hospital, IISPV, Rovira i Virgili University, 43204, Reus, Spain
| | - Antonio Pardo Martnez
- Department of Electronic and Biomedical Engineering, Universitat de Barcelona (UB), 08028, Barcelona, Spain
| | - Fadi Kurdahi
- Center for Embedded Cyber-Physical Systems (CEPS), University of California Irvine (UCI), Irvine, 92697, USA
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9
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Gasparri R, Capuano R, Guaglio A, Caminiti V, Canini F, Catini A, Sedda G, Paolesse R, Di Natale C, Spaggiari L. Volatolomic urinary profile analysis for diagnosis of the early stage of lung cancer. J Breath Res 2022; 16. [PMID: 35952625 DOI: 10.1088/1752-7163/ac88ec] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
Nowadays in clinical practice there is a pressing need for potential biomarkers that can identify lung cancer at early stage before becoming symptomatic or detectable by conventional means. Several researchers have independently pointed out that the volatile organic compounds (VOCs) profile can be considered as a lung cancer fingerprint useful for diagnosis. In particular, 16% of volatiles contributing to the human volatilome are found in urine, which is therefore an ideal sample medium. Its analysis through non-invasive, relatively low-cost and straightforward techniques could offer great potential for the early diagnosis of lung cancer. In this study, urinary VOCs were analysed with a gas chromatography-ion mobility spectrometer (GC-IMS) and an electronic nose (e-nose) made by a matrix of twelve quartz microbalances (QMBs) complemented by a photoionization detector (PID). This clinical prospective study involved 127 individuals, divided into two groups: 46 with lung cancer stage I-II-III confirmed by computerized tomography (CT) or positron emission tomography-(PET) imaging techniques and histology (biopsy), and 81 healthy controls. Both instruments provided a multivariate signal which, after being analysed by a machine learning algorithm, identified eight VOCs that could distinguish lung cancer patients from healthy ones. The eight VOCs are 2-pentanone, 2-hexenal, 2-hexen-1-ol, hept-4-en-2-ol, 2-heptanone, 3-octen-2-one, 4-methylpentanol, 4-methyl-octane. Results show that GC-IMS identifies lung cancer with respect to the control group with a diagnostic accuracy of 88%. Sensitivity resulted as being 85%, and specificity was 90% - Area Under the Receiver Operating Characteristics (AUROC): 0.91. The contribution made by the e-nose was also important, even though the results were slightly less sensitive with an accuracy of 71.6%. Moreover, of the eight VOCs identified as potential biomarkers, five VOCs had a high sensitivity (p≤ 0.06) for early stage (stage I) lung cancer.
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Affiliation(s)
- Roberto Gasparri
- Department of Thoracic Surgery, Istituto Europeo di Oncologia, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Rosamaria Capuano
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alessandra Guaglio
- General toracic surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Milano, Lombardia, 20141, ITALY
| | - Valentina Caminiti
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Federico Canini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alexandro Catini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Giulia Sedda
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Roberto Paolesse
- Department of Chemical Science and Technology, Via della Ricerca Scientifica, University of Rome 'Tor Vergata', Rome, Rome, 00133, ITALY
| | - Corrado Di Natale
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, Milano, Lombardia, 20141, ITALY
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10
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Taverna G, Grizzi F, Tidu L, Bax C, Zanoni M, Vota P, Lotesoriere BJ, Prudenza S, Magagnin L, Langfelder G, Buffi N, Casale P, Capelli L. Accuracy of a new electronic nose for prostate cancer diagnosis in urine samples. Int J Urol 2022; 29:890-896. [PMID: 35534435 PMCID: PMC9543199 DOI: 10.1111/iju.14912] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/10/2022] [Indexed: 01/04/2023]
Abstract
Objective To evaluate the accuracy of a new electronic nose to recognize prostate cancer in urine samples. Methods A blind, prospective study on consecutive patients was designed. Overall, 174 subjects were included in the study: 88 (50.6%) in prostate cancer group, and 86 (49.4%) in control group. Electronic nose performance for prostate cancer was assessed using sensitivity and specificity. The diagnostic accuracy of electronic nose was reported as area under the receiver operating characteristic curve. Results The electronic nose in the study population reached a sensitivity 85.2% (95% confidence interval 76.1–91.9; 13 false negatives out of 88), a specificity 79.1% (95% confidence interval 69.0–87.1; 18 false positives out of 86). The accuracy of the electronic nose represented as area under the receiver operating characteristic curve 0.821 (95% confidence interval 0.764–0.879). Conclusions The diagnostic accuracy of electronic nose for recognizing prostate cancer in urine samples is high, promising and susceptible to supplemental improvement. Additionally, further studies will be necessary to design a clinical trial to validate electronic nose application in diagnostic prostate cancer nomograms.
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Affiliation(s)
- Gianluigi Taverna
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Urology, Humanitas Mater Domini Hospital, Varese, Italy
| | - Fabio Grizzi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Lorenzo Tidu
- Italian Ministry of Defenses, "Vittorio Veneto" Division, Florence, Italy
| | - Carmen Bax
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Matteo Zanoni
- Department of Urology, Humanitas Mater Domini Hospital, Varese, Italy
| | - Paolo Vota
- Department of Urology, Humanitas Mater Domini Hospital, Varese, Italy
| | - Beatrice Julia Lotesoriere
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Stefano Prudenza
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Luca Magagnin
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Giacomo Langfelder
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Nicolò Buffi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Laura Capelli
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
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11
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Bax C, Prudenza S, Gaspari G, Capelli L, Grizzi F, Taverna G. Drift compensation on electronic nose data for non-invasive diagnosis of prostate cancer by urine analysis. iScience 2022; 25:103622. [PMID: 35024578 PMCID: PMC8725018 DOI: 10.1016/j.isci.2021.103622] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/07/2021] [Accepted: 12/10/2021] [Indexed: 12/24/2022] Open
Abstract
Diagnostic protocol for prostate cancer (KP) is affected by poor accuracy and high false-positive rate. The most promising innovative approach is based on urine analysis by electronic noses (ENs), highlighting a specific correlation between urine alteration and KP presence. Although EN could be exploited to develop non-invasive KP diagnostic tools, no study has already introduced EN into clinical practice, most probably because of drift issues that hinder EN scaling up from research objects to large-scale diagnostic devices. This study, proposing an EN for non-invasive KP detection, describes the data processing protocol applied to a urine headspace dataset acquired over 9 months, comprising 81 patients with KP and 41 controls, for compensating the drift. It proved effective in mitigating drift on 1-year-old sensors by restoring accuracy from 55% up to 80%, achieved by new sensors not subjected to drift. The model achieved, on double-blind validation, a balanced accuracy of 76.2% (CI95% 51.9–92.3). Urine odor alteration due to prostate cancer can be detected by electronic noses Sensors drift hinders electronic nose scaling up to large-scale diagnostic devices OSC mitigates drift on 1-year-old sensors, restoring accuracy from 55% up to 80%
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Affiliation(s)
- Carmen Bax
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy
| | - Stefano Prudenza
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy
| | - Giulia Gaspari
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy
| | - Laura Capelli
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy
| | - Fabio Grizzi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan 20089, Italy.,Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Gianluigi Taverna
- Department of Urology, Humanitas Mater Domini Hospital, Via Gerenzano, 2, Castellanza, 21053 Varese, Italy.,Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
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12
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Gouzerh F, Bessière JM, Ujvari B, Thomas F, Dujon AM, Dormont L. Odors and cancer: Current status and future directions. Biochim Biophys Acta Rev Cancer 2021; 1877:188644. [PMID: 34737023 DOI: 10.1016/j.bbcan.2021.188644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 02/07/2023]
Abstract
Cancer is the second leading cause of death in the world. Because tumors detected at early stages are easier to treat, the search for biomarkers-especially non-invasive ones-that allow early detection of malignancies remains a central goal to reduce cancer mortality. Cancer, like other pathologies, often alters body odors, and much has been done by scientists over the last few decades to assess the value of volatile organic compounds (VOCs) as signatures of cancers. We present here a quantitative review of 208 studies carried out between 1984 and 2020 that explore VOCs as potential biomarkers of cancers. We analyzed the main findings of these studies, listing and classifying VOCs related to different cancer types while considering both sampling methods and analysis techniques. Considering this synthesis, we discuss several of the challenges and the most promising prospects of this research direction in the war against cancer.
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Affiliation(s)
- Flora Gouzerh
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France.
| | - Jean-Marie Bessière
- Ecole Nationale de Chimie de Montpellier, Laboratoire de Chimie Appliquée, Montpellier, France
| | - Beata Ujvari
- Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Frédéric Thomas
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Antoine M Dujon
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Laurent Dormont
- CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France
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13
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Optimization of training and measurement protocol for eNose analysis of urine headspace aimed at prostate cancer diagnosis. Sci Rep 2021; 11:20898. [PMID: 34686703 PMCID: PMC8536694 DOI: 10.1038/s41598-021-00033-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/27/2021] [Indexed: 01/03/2023] Open
Abstract
More than one million new cases of prostate cancer (PCa) were reported worldwide in 2020, and a significant increase of PCa incidence up to 2040 is estimated. Despite potential treatability in early stages, PCa diagnosis is challenging because of late symptoms' onset and limits of current screening procedures. It has been now accepted that cell transformation leads to release of volatile organic compounds in biologic fluids, including urine. Thus, several studies proposed the possibility to develop new diagnostic tools based on urine analysis. Among these, electronic noses (eNoses) represent one of the most promising devices, because of their potential to provide a non-invasive diagnosis. Here we describe the approach aimed at defining the experimental protocol for eNose application for PCa diagnosis. Our research investigates effects of sample preparation and analysis on eNose responses and repeatability. The dependence of eNose diagnostic performance on urine portion analysed, techniques involved for extracting urine volatiles and conditioning temperature were analysed. 192 subjects (132 PCa patients and 60 controls) were involved. The developed experimental protocol has resulted in accuracy, sensitivity and specificity of 83% (CI95% 77-89), 82% (CI95% 73-88) and 87% (CI95% 75-94), respectively. Our findings define eNoses as valuable diagnostic tool allowing rapid and non-invasive PCa diagnosis.
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14
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Tyagi H, Daulton E, Bannaga AS, Arasaradnam RP, Covington JA. Non-Invasive Detection and Staging of Colorectal Cancer Using a Portable Electronic Nose. SENSORS (BASEL, SWITZERLAND) 2021; 21:5440. [PMID: 34450881 PMCID: PMC8398649 DOI: 10.3390/s21165440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022]
Abstract
Electronic noses (e-nose) offer potential for the detection of cancer in its early stages. The ability to analyse samples in real time, at a low cost, applying easy-to-use and portable equipment, gives e-noses advantages over other technologies, such as Gas Chromatography-Mass Spectrometry (GC-MS). For diseases such as cancer with a high mortality, a technology that can provide fast results for use in routine clinical applications is important. Colorectal cancer (CRC) is among the highest occurring cancers and has high mortality rates, if diagnosed late. In our study, we investigated the use of portable electronic nose (PEN3), with further analysis using GC-TOF-MS, for the analysis of gases and volatile organic compounds (VOCs) to profile the urinary metabolome of colorectal cancer. We also compared the different cancer stages with non-cancers using the PEN3 and GC-TOF-MS. Results obtained from PEN3, and GC-TOF-MS demonstrated high accuracy for the separation of CRC and non-cancer. PEN3 separated CRC from non-cancerous group with 0.81 AUC (Area Under the Curve). We used data from GC-TOF-MS to obtain a VOC profile for CRC, which identified 23 potential biomarker VOCs for CRC. Thus, the PEN3 and GC-TOF-MS were found to successfully separate the cancer group from the non-cancer group.
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Affiliation(s)
- Heena Tyagi
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Ayman S. Bannaga
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Ramesh P. Arasaradnam
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- School of Health Sciences, Coventry University, Coventry CV1 5FB, UK
- Leicester Cancer Centre, University of Leicester, Leicester LE1 7RH, UK
| | - James A. Covington
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
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15
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Bax C, Bernasconi R, Massironi F, Magagnin L, Grizzi F, Capelli L, Taverna G. Inkjet Printed ZnO Sensors for Early Prostate Cancer Detection by Means of Urine Odor Analysis. JOURNAL OF THE ELECTROCHEMICAL SOCIETY 2021; 168:047513. [DOI: 10.1149/1945-7111/abf7e7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
In the second half of the 20th century, inkjet printing has rapidly evolved from a mere digital image reproduction technique into a highly versatile materials deposition technology. Recently, inkjet production of metal oxide-based gas sensors (MOS) has emerged, and inkjet sensors have been proposed for different applications. In this context, this paper proposes the adoption of inkjet MOS sensors for urine analysis for the purpose of developing an innovative tool for the early prostate cancer (KP) diagnosis. Based on the results reported in the scientific literature, proving the correlation between urine color and odor alterations and cancer, the study focuses on the analysis by means of MOS sensor array of odors emanated from urine samples from prostate cancer patients versus healthy donors. The results achieved in terms of diagnostic accuracy, sensitivity, and specificity (i.e., about 80%) proved the potentialities of inkjet MOS sensor for the challenging purpose of detection of prostate cancer in its early stages. Resulting significantly more powerful than current KP diagnostic protocol, the approach here presented might become, after validation, a rapid, non-invasive and low-cost screening tool, capable to provide a solution to the problems of patients’ overtreatment and high health spending associated to procedures currently adopted.
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16
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Aggarwal P, Baker J, Boyd MT, Coyle S, Probert C, Chapman EA. Optimisation of Urine Sample Preparation for Headspace-Solid Phase Microextraction Gas Chromatography-Mass Spectrometry: Altering Sample pH, Sulphuric Acid Concentration and Phase Ratio. Metabolites 2020; 10:metabo10120482. [PMID: 33255680 PMCID: PMC7760603 DOI: 10.3390/metabo10120482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022] Open
Abstract
Headspace-solid phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS) can be used to measure volatile organic compounds (VOCs) in human urine. However, there is no widely adopted standardised protocol for the preparation of urine samples for analysis resulting in an inability to compare studies reliably between laboratories. This paper investigated the effect of altering urine sample pH, volume, and vial size for optimising detection of VOCs when using HS-SPME-GC-MS. This is the first, direct comparison of H2SO4, HCl, and NaOH as treatment techniques prior to HS-SPME-GC-MS analysis. Altering urine sample pH indicates that H2SO4 is more effective at optimising detection of VOCs than HCl or NaOH. H2SO4 resulted in a significantly larger mean number of VOCs being identified per sample (on average, 33.5 VOCs to 24.3 in HCl or 12.2 in NaOH treated urine) and more unique VOCs, produced a more diverse range of classes of VOCs, and led to less HS-SPME-GC-MS degradation. We propose that adding 0.2 mL of 2.5 M H2SO4 to 1 mL of urine within a 10 mL headspace vial is the optimal sample preparation prior to HS-SPME-GC-MS analysis. We hope the use of our optimised method for urinary HS-SPME-GC-MS analysis will enhance our understanding of human disease and bolster metabolic biomarker identification.
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Affiliation(s)
- Prashant Aggarwal
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK; (P.A.); (J.B.); (C.P.)
- School of Medicine, Cedar House, University of Liverpool, Liverpool L69 3GE, UK
| | - James Baker
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK; (P.A.); (J.B.); (C.P.)
- School of Medicine, Cedar House, University of Liverpool, Liverpool L69 3GE, UK
| | - Mark T. Boyd
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, Cancer Research Centre, University of Liverpool, Liverpool L3 9TA, UK;
| | - Séamus Coyle
- Palliative Care Institute Liverpool, Cancer Research Centre, University of Liverpool, Liverpool L3 9TA, UK;
- Clatterbridge Cancer Centre, Liverpool L7 8YA, UK
| | - Chris Probert
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK; (P.A.); (J.B.); (C.P.)
| | - Elinor A. Chapman
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK; (P.A.); (J.B.); (C.P.)
- Palliative Care Institute Liverpool, Cancer Research Centre, University of Liverpool, Liverpool L3 9TA, UK;
- School of Medical Sciences, Bangor University, Bangor, Gwynedd LL57 2DG, UK
- Correspondence:
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17
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Baldini C, Billeci L, Sansone F, Conte R, Domenici C, Tonacci A. Electronic Nose as a Novel Method for Diagnosing Cancer: A Systematic Review. BIOSENSORS-BASEL 2020; 10:bios10080084. [PMID: 32722438 PMCID: PMC7459473 DOI: 10.3390/bios10080084] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/13/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022]
Abstract
Cancer is fast becoming the most important cause of death worldwide, its mortality being mostly caused by late or wrong diagnosis. Novel strategies have been developed to identify early signs of cancer in a minimally obtrusive way, including the Electronic Nose (E-Nose) technology, user-friendly, cost- and time-saving alternative to classical approaches. This systematic review, conducted under the PRISMA guidelines, identified 60 articles directly dealing with the E-Nose application in cancer research published up to 31 January 2020. Among these works, the vast majority reported successful E-Nose use for diagnosing Lung Cancer, showing promising results especially when employing the Aeonose tool, discriminating subjects with Lung Cancer from controls in more than 80% of individuals, in most studies. In order to tailor the main limitations of the proposed approach, including the application of the protocol to advanced stage of cancer, sample heterogeneity and massive confounders, future studies should be conducted on early stage patients, and on larger cohorts, as to better characterize the specific breathprint associated with the various subtypes of cancer. This would ultimately lead to a better and faster diagnosis and to earlier treatment, possibly reducing the burden associated to such conditions.
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Affiliation(s)
- Chiara Baldini
- School of Engineering, University of Pisa, Largo Lucio Lazzarino 1, 56122 Pisa, Italy;
| | - Lucia Billeci
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Francesco Sansone
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Raffaele Conte
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Claudio Domenici
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Alessandro Tonacci
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
- Correspondence:
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18
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Becker R. Non-invasive cancer detection using volatile biomarkers: Is urine superior to breath? Med Hypotheses 2020; 143:110060. [PMID: 32683218 DOI: 10.1016/j.mehy.2020.110060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/25/2020] [Accepted: 06/27/2020] [Indexed: 12/16/2022]
Abstract
In recent years numerous reports have highlighted the options of chemical breath analysis with regard to non-invasive cancer detection. Certain volatile organic compounds (VOC) supposedly present in higher amounts or in characteristic patterns have been suggested as potential biomarkers. However, so far no clinical application based on a specific set of compounds appears to exist. Numerous reports on the capability of sniffer dogs and sensor arrays or electronic noses to distinguish breath of cancer patients and healthy controls supports the concept of genuine cancer-related volatile profiles. However, the actual compounds responsible for the scent are completely unknown and there is no correlation with the potential biomarkers suggested on basis of chemical trace analysis. It is outlined that specific features connected with the VOC analysis in breath - namely small concentrations of volatiles, interfering background concentrations, considerable sampling effort and sample instability, impracticability regarding routine application - stand in the way of substantial progress. The underlying chemical-analytical challenge can only be met considering the severe susceptibility of VOC determination to these adverse conditions. Therefore, the attention is drawn to the needs for appropriate quality assurance/quality control as the most important feature for the reliable quantification of volatiles present in trace concentration. Consequently, the advantages of urine as an alternative matrix for volatile biomarker search in the context of diagnosing lung and other cancers are outlined with specific focus on quality assurance and practicability in clinical chemistry. The headspace over urine samples as the VOC source allows adapting gas chromatographical procedures well-established in water analysis. Foremost, the selection of urine over breath as non-invasive matrix should provide considerably more resilience to adverse effects during sampling and analysis. The most important advantage of urine over breath is seen in the option to partition, dispense, mix, spike, store, and thus to dispatch taylor-made urine samples on demand for quality control measures. Although it is still open at this point if cancer diagnosis supported by non-invasively sampled VOC profiles will ultimately reach clinical application the advantages of urine over breath should significantly facilitate urgently required steps beyond the current proof-of-concept stage and towards standardisation.
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Affiliation(s)
- Roland Becker
- Bundesanstalt für Materialforschung und -prüfung (BAM), Berlin, Germany
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19
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Abstract
Volatile organic compounds (VOCs) are pervasive in the environment. Since the early 1980s, substantial work has examined the detection of these materials, as they can indicate environmental changes that can affect human health. VOCs and similar compounds present a very specific sensing problem in that they are not reactive and often nonpolar, so it is difficult to find materials that selectively bind or adsorb them. A number of techniques are applied to vapor sensing. High resolution molecular separation approaches such as gas chromatography and mass spectrometry are well-characterized and offer high sensitivity, but are difficult to implement in portable, real-time monitors, whereas approaches such as chemiresistors are promising, but still in development. Gravimetric approaches, in which the mass of an adsorbed vapor is directly measured, have several potential advantages over other techniques but have so far lagged behind other approaches in performance and market penetration. This review aims to offer a comprehensive background on gravimetric sensing including underlying resonators and sensitizers, as well as a picture of applications and commercialization in the field.
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Affiliation(s)
- Christine K. McGinn
- Department of Electrical Engineering, Columbia University, New York, New York 10027-6902, United States
| | - Zachary A. Lamport
- Department of Electrical Engineering, Columbia University, New York, New York 10027-6902, United States
| | - Ioannis Kymissis
- Department of Electrical Engineering, Columbia University, New York, New York 10027-6902, United States
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20
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Takke A, Shende P. Non-invasive Biodiversified Sensors: A Modernized Screening Technology for Cancer. Curr Pharm Des 2019; 25:4108-4120. [DOI: 10.2174/1381612825666191022162232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/14/2019] [Indexed: 01/30/2023]
Abstract
Background:
Biological sensors revolutionize the method of diagnoses of diseases from early to final
stages using the biomarkers present in the body. Biosensors are advantageous due to the involvement of minimal
sample collection with improved specificity and sensitivity for the detection of biomarkers.
Methods:
Conventional biopsies restrict problems like patient non-compliance, cross-infection and high cost and to
overcome these issues biological samples like saliva, sweat, urine, tears and sputum progress into clinical and diagnostic
research for the development of non-invasive biosensors. This article covers various non-invasive measurements
of biological samples, optical-based, mass-based, wearable and smartphone-based biosensors for the detection
of cancer.
Results:
The demand for non-invasive, rapid and economic analysis techniques escalated due to the modernization
of the introduction of self-diagnostics and miniature forms of devices. Biosensors have high sensitivity and
specificity for whole cells, microorganisms, enzymes, antibodies, and genetic materials.
Conclusion:
Biosensors provide a reliable early diagnosis of cancer, which results in faster therapeutic outcomes
with in-depth fundamental understanding of the disease progression.
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Affiliation(s)
- Anjali Takke
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, V. L. Mehta Road, Vile Parle (W), Mumbai, India
| | - Pravin Shende
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, V. L. Mehta Road, Vile Parle (W), Mumbai, India
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21
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Lima AR, Pinto J, Azevedo AI, Barros-Silva D, Jerónimo C, Henrique R, de Lourdes Bastos M, Guedes de Pinho P, Carvalho M. Identification of a biomarker panel for improvement of prostate cancer diagnosis by volatile metabolic profiling of urine. Br J Cancer 2019; 121:857-868. [PMID: 31588123 PMCID: PMC6889512 DOI: 10.1038/s41416-019-0585-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/21/2019] [Accepted: 09/04/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The lack of sensitive and specific biomarkers for the early detection of prostate cancer (PCa) is a major hurdle to improve patient management. METHODS A metabolomics approach based on GC-MS was used to investigate the performance of volatile organic compounds (VOCs) in general and, more specifically, volatile carbonyl compounds (VCCs) present in urine as potential markers for PCa detection. RESULTS Results showed that PCa patients (n = 40) can be differentiated from cancer-free subjects (n = 42) based on their urinary volatile profile in both VOCs and VCCs models, unveiling significant differences in the levels of several metabolites. The models constructed were further validated using an external validation set (n = 18 PCa and n = 18 controls) to evaluate sensitivity, specificity and accuracy of the urinary volatile profile to discriminate PCa from controls. The VOCs model disclosed 78% sensitivity, 94% specificity and 86% accuracy, whereas the VCCs model achieved the same sensitivity, a specificity of 100% and an accuracy of 89%. Our findings unveil a panel of 6 volatile compounds significantly altered in PCa patients' urine samples that was able to identify PCa, with a sensitivity of 89%, specificity of 83%, and accuracy of 86%. CONCLUSIONS It is disclosed a biomarker panel with potential to be used as a non-invasive diagnostic tool for PCa.
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Affiliation(s)
- Ana Rita Lima
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
| | - Joana Pinto
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana Isabel Azevedo
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Daniela Barros-Silva
- Cancer Biology & Epigenetics Group, Research Center (CI-IPOP) Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | - Carmen Jerónimo
- Cancer Biology & Epigenetics Group, Research Center (CI-IPOP) Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Department of Pathology and Molecular Immunology-Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Rui Henrique
- Cancer Biology & Epigenetics Group, Research Center (CI-IPOP) Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Department of Pathology and Molecular Immunology-Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | - Maria de Lourdes Bastos
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Paula Guedes de Pinho
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
| | - Márcia Carvalho
- UCIBIO/REQUIMTE, Department of Biological Sciences, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal.
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, Porto, Portugal.
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Review and Comparison of Cancer Biomarker Trends in Urine as a Basis for New Diagnostic Pathways. Cancers (Basel) 2019; 11:cancers11091244. [PMID: 31450698 PMCID: PMC6770126 DOI: 10.3390/cancers11091244] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/24/2022] Open
Abstract
Cancer is one of the major causes of mortality worldwide and its already large burden is projected to increase significantly in the near future with a predicted 22 million new cancer cases and 13 million cancer-related deaths occurring annually by 2030. Unfortunately, current procedures for diagnosis are characterized by low diagnostic accuracies. Given the proved correlation between cancer presence and alterations of biological fluid composition, many researchers suggested their characterization to improve cancer detection at early stages. This paper reviews the information that can be found in the scientific literature, regarding the correlation of different cancer forms with the presence of specific metabolites in human urine, in a schematic and easily interpretable form, because of the huge amount of relevant literature. The originality of this paper relies on the attempt to point out the odor properties of such metabolites, and thus to highlight the correlation between urine odor alterations and cancer presence, which is proven by recent literature suggesting the analysis of urine odor for diagnostic purposes. This investigation aims to evaluate the possibility to compare the results of studies based on different approaches to be able in the future to identify those compounds responsible for urine odor alteration.
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Approaches to urinary detection of prostate cancer. Prostate Cancer Prostatic Dis 2019; 22:362-381. [PMID: 30655600 PMCID: PMC6640078 DOI: 10.1038/s41391-019-0127-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/06/2018] [Accepted: 12/26/2018] [Indexed: 12/11/2022]
Abstract
Background: Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication. Methods: We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer. Results: There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests. Conclusions: Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.
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Waltman CG, Marcelissen TAT, van Roermund JGH. Exhaled-breath Testing for Prostate Cancer Based on Volatile Organic Compound Profiling Using an Electronic Nose Device (Aeonose™): A Preliminary Report. Eur Urol Focus 2018; 6:1220-1225. [PMID: 30482583 DOI: 10.1016/j.euf.2018.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/20/2018] [Accepted: 11/15/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prostate biopsy, an invasive examination, is the gold standard for diagnosing prostate cancer (PCa). There is a need for a novel noninvasive diagnostic tool that achieves a significantly high pretest probability for PCa, reducing unnecessary biopsy numbers. Recent studies have shown that volatile organic compounds (VOCs) in exhaled breath can be used to detect different types of cancers via training of an artificial neural network (ANN). OBJECTIVE To determine whether exhaled-breath analysis using a handheld electronic nose device can be used to discriminate between VOC patterns between PCa patients and healthy individuals. DESIGN, SETTING, AND PARTICIPANTS This prospective pilot study was conducted in the outpatient urology clinic of the Maastricht University Medical Center, the Netherlands. Patients with histologically proven PCa were already included before initial biopsy or during follow-up, with no prior treatment for their PCa. Urological patients with negative biopsies in the past year or patients with prostate enlargement (PE) with low or stable serum prostate-specific antigen were used as controls. Exhaled breath was probed from 85 patients: 32 with PCa and 53 controls (30 having negative biopsies and 23 PE). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Patient characteristics were statistically analyzed using independent sample t test and Pearson's chi-square test. Data analysis was performed by Aethena software after data compression using the TUCKER3 algorithm. ANN models were trained and evaluated using the leave-10%-out cross-validation method. RESULTS AND LIMITATIONS Our trained ANN showed an accuracy of 0.75, with an area under the curve of 0.79 with sensitivity and specificity of 0.84 (95% confidence interval [CI] 0.66-0.94) and 0.70 (95% CI 0.55-0.81) respectively, comparing PCa with control individuals. The negative predictive value was found to be 0.88. The main limitation is the relatively small sample size. CONCLUSIONS Our findings imply that the Aeonose allows us to discriminate between patients with untreated, histologically proven primary PCa and control patients based on exhaled-breath analysis. PATIENT SUMMARY We explored the possibility of exhaled-breath analysis using an electronic nose, to be used as a noninvasive tool in clinical practice, as a pretest for diagnosing prostate cancer. We found that the electronic nose was able to discriminate between prostate cancer patients and control individuals.
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Affiliation(s)
- Claire G Waltman
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Tom A T Marcelissen
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joep G H van Roermund
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Broza YY, Vishinkin R, Barash O, Nakhleh MK, Haick H. Synergy between nanomaterials and volatile organic compounds for non-invasive medical evaluation. Chem Soc Rev 2018; 47:4781-4859. [PMID: 29888356 DOI: 10.1039/c8cs00317c] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This article is an overview of the present and ongoing developments in the field of nanomaterial-based sensors for enabling fast, relatively inexpensive and minimally (or non-) invasive diagnostics of health conditions with follow-up by detecting volatile organic compounds (VOCs) excreted from one or combination of human body fluids and tissues (e.g., blood, urine, breath, skin). Part of the review provides a didactic examination of the concepts and approaches related to emerging sensing materials and transduction techniques linked with the VOC-based non-invasive medical evaluations. We also present and discuss diverse characteristics of these innovative sensors, such as their mode of operation, sensitivity, selectivity and response time, as well as the major approaches proposed for enhancing their ability as hybrid sensors to afford multidimensional sensing and information-based sensing. The other parts of the review give an updated compilation of the past and currently available VOC-based sensors for disease diagnostics. This compilation summarizes all VOCs identified in relation to sickness and sampling origin that links these data with advanced nanomaterial-based sensing technologies. Both strength and pitfalls are discussed and criticized, particularly from the perspective of the information and communication era. Further ideas regarding improvement of sensors, sensor arrays, sensing devices and the proposed workflow are also included.
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Affiliation(s)
- Yoav Y Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 3200003, Israel.
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Bax C, Taverna G, Eusebio L, Sironi S, Grizzi F, Guazzoni G, Capelli L. Innovative Diagnostic Methods for Early Prostate Cancer Detection through Urine Analysis: A Review. Cancers (Basel) 2018; 10:cancers10040123. [PMID: 29670060 PMCID: PMC5923378 DOI: 10.3390/cancers10040123] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 12/26/2022] Open
Abstract
Prostate cancer is the second most common cause of cancer death among men. It is an asymptomatic and slow growing tumour, which starts occurring in young men, but can be detected only around the age of 40–50. Although its long latency period and potential curability make prostate cancer a perfect candidate for screening programs, the current procedure lacks in specificity. Researchers are rising to the challenge of developing innovative tools able of detecting the disease during its early stage that is the most curable. In recent years, the interest in characterisation of biological fluids aimed at the identification of tumour-specific compounds has increased significantly, since cell neoplastic transformation causes metabolic alterations leading to volatile organic compounds release. In the scientific literature, different approaches have been proposed. Many studies focus on the identification of a cancer-characteristic “odour fingerprint” emanated from biological samples through the application of sensorial or senso-instrumental analyses, others suggest a chemical characterisation of biological fluids with the aim of identifying prostate cancer (PCa)-specific biomarkers. This paper focuses on the review of literary studies in the field of prostate cancer diagnosis, in order to provide an overview of innovative methods based on the analysis of urine, thereby comparing them with the traditional diagnostic procedures.
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Affiliation(s)
- Carmen Bax
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
| | - Gianluigi Taverna
- Humanitas Clinical and Research Center, Department of Urology, via Manzoni 56, Rozzano, 20089 Milan, Italy.
| | - Lidia Eusebio
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
| | - Selena Sironi
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
| | - Fabio Grizzi
- Humanitas Clinical and Research Center, Department of Immunology and Inflammation, via Manzoni 56, Rozzano, 20089 Milan, Italy.
| | - Giorgio Guazzoni
- Humanitas Clinical and Research Center, Department of Urology, via Manzoni 56, Rozzano, 20089 Milan, Italy.
| | - Laura Capelli
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
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Di Natale C, Martinelli E, Magna G, Mandoj F, Monti D, Nardis S, Stefanelli M, Paolesse R. Porphyrins for olfaction mimic: The Rome Tor Vergata approach. J PORPHYR PHTHALOCYA 2018. [DOI: 10.1142/s1088424617300026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The impressive chemistry shown by porphyrins in natural systems is particularly attractive for exploitation in chemical sensors. In these devices the sensing mechanisms can mimic most of the porphyrin biological reactivity, such as reversible binding, activation of small molecules, redox activity, and photoactivated processes. The simultaneous presence of multiple binding mechanisms allows porphyrins to interact with a large variety of analytes. This feature reduces the selectivity, but prompts the development of sensor arrays, where the cross-selectivity of more sensors is used to classify and identify samples characterized by a complex composition. Since 1995 the Sensors Group of the University of Rome Tor Vergata has exploited these features to prepare sensor arrays based on different transducers and aimed at several applications. These kinds of devices have been reported as electronic noses (gaseous phase analytes) and electronic tongues (liquid phase analytes) to underline that their working mechanisms are tentatively similar to that of biological senses. We report here some of the results obtained.
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Affiliation(s)
- Corrado Di Natale
- Dipartimento di Ingegneria Elettronica, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Eugenio Martinelli
- Dipartimento di Ingegneria Elettronica, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Gabriele Magna
- Dipartimento di Ingegneria Elettronica, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Mandoj
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Donato Monti
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Sara Nardis
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Manuela Stefanelli
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, 00133 Roma, Italy
| | - Roberto Paolesse
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, 00133 Roma, Italy
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Kubinec R, Kotora P, Ferenczy V, Blaško J, Podolec P, Hengerics Szabó A, Behúlová D, Bierhanzl V, Čabala R, Stuchlík S, Filipiak W, Thắng NM. Simultaneous analysis of carbohydrates, polyols and amines in urine samples using chemical ionization gas chromatography with tandem mass spectrometry. J Sep Sci 2017; 41:449-458. [DOI: 10.1002/jssc.201700715] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/28/2017] [Accepted: 10/20/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Róbert Kubinec
- Institute of Chemistry, Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava Slovakia
| | - Peter Kotora
- Institute of Process Engineering, Faculty of Mechanical Engineering; Slovak University of Technology in Bratislava; Bratislava Slovakia
| | - Viktória Ferenczy
- Institute of Chemistry, Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava Slovakia
- Department of Laboratory Medicine; University Children´s Hospital; Bratislava Slovakia
| | - Jaroslav Blaško
- Institute of Chemistry, Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava Slovakia
| | | | - Alexandra Hengerics Szabó
- Institute of Chemistry, Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava Slovakia
| | - Darina Behúlová
- Department of Laboratory Medicine; University Children´s Hospital; Bratislava Slovakia
| | - Václav Bierhanzl
- Department of Analytical Chemistry, Faculty of Natural Sciences; Charles University in Prague; Prague Czech Republic
| | - Radomír Čabala
- Department of Analytical Chemistry, Faculty of Natural Sciences; Charles University in Prague; Prague Czech Republic
- Institute of Forensic Medicine and Toxicology; General University Hospital in Prague; Prague Czech Republic
| | - Stanislav Stuchlík
- Department of Molecular Biology, Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava Slovakia
| | - Wojciech Filipiak
- Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy; Collegium Medicum in Bydgoszcz at the Nicolaus Copernicus University in Torun; Bydgoszcz Poland
| | - Ngô Mạnh Thắng
- Department of Physical and Analytical Chemistry, Faculty of Chemical Engineering, HCMC; University of Technology; HCM City Vietnam
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Capelli L, Taverna G, Bellini A, Eusebio L, Buffi N, Lazzeri M, Guazzoni G, Bozzini G, Seveso M, Mandressi A, Tidu L, Grizzi F, Sardella P, Latorre G, Hurle R, Lughezzani G, Casale P, Meregali S, Sironi S. Application and Uses of Electronic Noses for Clinical Diagnosis on Urine Samples: A Review. SENSORS 2016; 16:s16101708. [PMID: 27754437 PMCID: PMC5087496 DOI: 10.3390/s16101708] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/15/2016] [Accepted: 09/29/2016] [Indexed: 01/01/2023]
Abstract
The electronic nose is able to provide useful information through the analysis of the volatile organic compounds in body fluids, such as exhaled breath, urine and blood. This paper focuses on the review of electronic nose studies and applications in the specific field of medical diagnostics based on the analysis of the gaseous headspace of human urine, in order to provide a broad overview of the state of the art and thus enhance future developments in this field. The research in this field is rather recent and still in progress, and there are several aspects that need to be investigated more into depth, not only to develop and improve specific electronic noses for different diseases, but also with the aim to discover and analyse the connections between specific diseases and the body fluids odour. Further research is needed to improve the results obtained up to now; the development of new sensors and data processing methods should lead to greater diagnostic accuracy thus making the electronic nose an effective tool for early detection of different kinds of diseases, ranging from infections to tumours or exposure to toxic agents.
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Affiliation(s)
- Laura Capelli
- Politecnico di Milano, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy.
| | - Gianluigi Taverna
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
- Ospedale Humanitas Mater Domini, Via Gerenzano 2, Castellanza, Varese 21053, Italy.
| | - Alessia Bellini
- Politecnico di Milano, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy.
| | - Lidia Eusebio
- Politecnico di Milano, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy.
| | - Niccolò Buffi
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Massimo Lazzeri
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Giorgio Guazzoni
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Giorgio Bozzini
- Ospedale Humanitas Mater Domini, Via Gerenzano 2, Castellanza, Varese 21053, Italy.
| | - Mauro Seveso
- Ospedale Humanitas Mater Domini, Via Gerenzano 2, Castellanza, Varese 21053, Italy.
| | - Alberto Mandressi
- Ospedale Humanitas Mater Domini, Via Gerenzano 2, Castellanza, Varese 21053, Italy.
| | - Lorenzo Tidu
- Italian Ministry of Defense's, Military Veterinary Center, CEMIVET, Via Provinciale Castiglionese, 201, Grosseto 58100, Italy.
| | - Fabio Grizzi
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Paolo Sardella
- Italian Ministry of Defense's, Military Veterinary Center, CEMIVET, Via Provinciale Castiglionese, 201, Grosseto 58100, Italy.
| | - Giuseppe Latorre
- Italian Ministry of Defense's, Military Veterinary Center, CEMIVET, Via Provinciale Castiglionese, 201, Grosseto 58100, Italy.
| | - Rodolfo Hurle
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Giovanni Lughezzani
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Paolo Casale
- Department of Urology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, Milan 20089, Italy.
| | - Sara Meregali
- Ospedale Humanitas Mater Domini, Via Gerenzano 2, Castellanza, Varese 21053, Italy.
| | - Selena Sironi
- Politecnico di Milano, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", piazza Leonardo da Vinci 32, Milan 20133, Italy.
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Techniques and issues in breath and clinical sample headspace analysis for disease diagnosis. Bioanalysis 2016; 8:677-90. [PMID: 26978667 DOI: 10.4155/bio.16.22] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Analysis of volatile organic compounds (VOCs) from breath or clinical samples for disease diagnosis is an attractive proposition because it is noninvasive and rapid. There are numerous studies showing its potential, yet there are barriers to its development. Sampling and sample handling is difficult, and when coupled with a variety of analytical instrumentation, the same samples can give different results. Background air and the environment a person has been exposed to can greatly affect the VOCs emitted by the body; however, this is not an easy problem to solve. This review investigates the use of VOCs in disease diagnosis, the analytical techniques employed and the problems associated with sample handling and standardization. It then suggests the barriers to future development.
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Aggio RBM, Mayor A, Coyle S, Reade S, Khalid T, Ratcliffe NM, Probert CSJ. Freeze-drying: an alternative method for the analysis of volatile organic compounds in the headspace of urine samples using solid phase micro-extraction coupled to gas chromatography - mass spectrometry. Chem Cent J 2016; 10:9. [PMID: 26933445 PMCID: PMC4772446 DOI: 10.1186/s13065-016-0155-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Volatile organic compounds (VOCs) can be intermediates of metabolic pathways and their levels in biological samples may provide a better understanding about diseases in addition to potential methods for diagnosis. Headspace analysis of VOCs in urine samples using solid phase micro extraction (SPME) coupled to gas chromatography - mass spectrometry (GC-MS) is one of the most used techniques. However, it generally produces a limited profile of VOCs if applied to fresh urine. Sample preparation methods, such as addition of salt, base or acid, have been developed to improve the headspace-SPME-GC-MS analysis of VOCs in urine samples. These methods result in a richer profile of VOCs, however, they may also add potential contaminants to the urine samples, result in increased variability introduced by manually processing the samples and promote degradation of metabolites due to extreme pH levels. Here, we evaluated if freeze-drying can be considered an alternative sample preparation method for headspace-SPME-GC-MS analysis of urine samples. RESULTS We collected urine from three volunteers and compared the performances of freeze-drying, addition of acid (HCl), addition of base (NaOH), addition of salt (NaCl), fresh urine and frozen urine when identifying and quantifying metabolites in 4 ml samples. Freeze-drying and addition of acid produced a significantly higher number of VOCs identified than any other method, with freeze-drying covering a slightly higher number of chemical classes, showing an improved repeatability and reducing siloxane impurities. CONCLUSION In this work we compared the performance of sample preparation methods for the SPME-GC-MS analysis of urine samples. To the best of our knowledge, this is the first study evaluating the potential of freeze-dry as an alternative sample preparation method. Our results indicate that freeze-drying has potential to be used as an alternative method for the SPME-GC-MS analysis of urine samples. Additional studies using internal standard, synthetic urine and calibration curves will allow a more precise quantification of metabolites and additional comparisons between methods.Graphical abstractEnhancing VOC profiling from urine samples.
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Affiliation(s)
- Raphael B M Aggio
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, L693BX Liverpool, UK
| | - Arno Mayor
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, L693BX Liverpool, UK
| | - Séamus Coyle
- Marie Curie Palliative Care Institute Liverpool, University of Liverpool, London Road, L39TA Liverpool, UK
| | - Sophie Reade
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, L693BX Liverpool, UK
| | - Tanzeela Khalid
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, L693BX Liverpool, UK ; Department of Surgery and Cancer, South Kensington Campus, Imperial College London, SW72AZ London, UK
| | - Norman M Ratcliffe
- Faculty of Health and Applied Sciences, Frenchay Campus, University of the West of England, Coldharbour Lane, BS161QY Bristol, UK
| | - Chris S J Probert
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, L693BX Liverpool, UK
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Aggio RBM, de Lacy Costello B, White P, Khalid T, Ratcliffe NM, Persad R, Probert CSJ. The use of a gas chromatography-sensor system combined with advanced statistical methods, towards the diagnosis of urological malignancies. J Breath Res 2016; 10:017106. [PMID: 26865331 PMCID: PMC4876927 DOI: 10.1088/1752-7155/10/1/017106] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Prostate cancer is one of the most common cancers. Serum prostate-specific antigen (PSA) is used to aid the selection of men undergoing biopsies. Its use remains controversial. We propose a GC-sensor algorithm system for classifying urine samples from patients with urological symptoms. This pilot study includes 155 men presenting to urology clinics, 58 were diagnosed with prostate cancer, 24 with bladder cancer and 73 with haematuria and or poor stream, without cancer. Principal component analysis (PCA) was applied to assess the discrimination achieved, while linear discriminant analysis (LDA) and support vector machine (SVM) were used as statistical models for sample classification. Leave-one-out cross-validation (LOOCV), repeated 10-fold cross-validation (10FoldCV), repeated double cross-validation (DoubleCV) and Monte Carlo permutations were applied to assess performance. Significant separation was found between prostate cancer and control samples, bladder cancer and controls and between bladder and prostate cancer samples. For prostate cancer diagnosis, the GC/SVM system classified samples with 95% sensitivity and 96% specificity after LOOCV. For bladder cancer diagnosis, the SVM reported 96% sensitivity and 100% specificity after LOOCV, while the DoubleCV reported 87% sensitivity and 99% specificity, with SVM showing 78% and 98% sensitivity between prostate and bladder cancer samples. Evaluation of the results of the Monte Carlo permutation of class labels obtained chance-like accuracy values around 50% suggesting the observed results for bladder cancer and prostate cancer detection are not due to over fitting. The results of the pilot study presented here indicate that the GC system is able to successfully identify patterns that allow classification of urine samples from patients with urological cancers. An accurate diagnosis based on urine samples would reduce the number of negative prostate biopsies performed, and the frequency of surveillance cystoscopy for bladder cancer patients. Larger cohort studies are planned to investigate the potential of this system. Future work may lead to non-invasive breath analyses for diagnosing urological conditions.
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Affiliation(s)
- Raphael B. M. Aggio
- Institute of Translational Medicine, Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom
| | - Ben de Lacy Costello
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Paul White
- Department of Engineering, Design and Mathematics, University of the West of England, Bristol, United Kingdom
| | - Tanzeela Khalid
- Institute of Translational Medicine, Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Norman M. Ratcliffe
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Raj Persad
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Chris S. J. Probert
- Institute of Translational Medicine, Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom
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Mochalski P, Unterkofler K. Quantification of selected volatile organic compounds in human urine by gas chromatography selective reagent ionization time of flight mass spectrometry (GC-SRI-TOF-MS) coupled with head-space solid-phase microextraction (HS-SPME). Analyst 2016; 141:4796-803. [DOI: 10.1039/c6an00825a] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Selective reagent ionization time of flight mass spectrometry with NO+as the reagent ion in conjunction with gas chromatography and head-space solid-phase microextraction was used to determine 16 volatiles in human urine.
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Affiliation(s)
- Paweł Mochalski
- Breath Research Institute of the University of Innsbruck
- A-6850 Dornbirn
- Austria
| | - Karl Unterkofler
- Breath Research Institute of the University of Innsbruck
- A-6850 Dornbirn
- Austria
- Vorarlberg University of Applied Sciences
- A-6850 Dornbirn
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34
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Khalid T, Aggio R, White P, De Lacy Costello B, Persad R, Al-Kateb H, Jones P, Probert CS, Ratcliffe N. Urinary Volatile Organic Compounds for the Detection of Prostate Cancer. PLoS One 2015; 10:e0143283. [PMID: 26599280 PMCID: PMC4657998 DOI: 10.1371/journal.pone.0143283] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/03/2015] [Indexed: 01/27/2023] Open
Abstract
The aim of this work was to investigate volatile organic compounds (VOCs) emanating from urine samples to determine whether they can be used to classify samples into those from prostate cancer and non-cancer groups. Participants were men referred for a trans-rectal ultrasound-guided prostate biopsy because of an elevated prostate specific antigen (PSA) level or abnormal findings on digital rectal examination. Urine samples were collected from patients with prostate cancer (n = 59) and cancer-free controls (n = 43), on the day of their biopsy, prior to their procedure. VOCs from the headspace of basified urine samples were extracted using solid-phase micro-extraction and analysed by gas chromatography/mass spectrometry. Classifiers were developed using Random Forest (RF) and Linear Discriminant Analysis (LDA) classification techniques. PSA alone had an accuracy of 62–64% in these samples. A model based on 4 VOCs, 2,6-dimethyl-7-octen-2-ol, pentanal, 3-octanone, and 2-octanone, was marginally more accurate 63–65%. When combined, PSA level and these four VOCs had mean accuracies of 74% and 65%, using RF and LDA, respectively. With repeated double cross-validation, the mean accuracies fell to 71% and 65%, using RF and LDA, respectively. Results from VOC profiling of urine headspace are encouraging and suggest that there are other metabolomic avenues worth exploring which could help improve the stratification of men at risk of prostate cancer. This study also adds to our knowledge on the profile of compounds found in basified urine, from controls and cancer patients, which is useful information for future studies comparing the urine from patients with other disease states.
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Affiliation(s)
- Tanzeela Khalid
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Raphael Aggio
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Paul White
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Ben De Lacy Costello
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Raj Persad
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, United Kingdom
| | - Huda Al-Kateb
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Peter Jones
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
| | - Chris S. Probert
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| | - Norman Ratcliffe
- Institute of Biosensor Technology, University of the West of England, Bristol, United Kingdom
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Brooks SW, Moore DR, Marzouk EB, Glenn FR, Hallock RM. Canine olfaction and electronic nose detection of volatile organic compounds in the detection of cancer: a review. Cancer Invest 2015; 33:411-9. [PMID: 26114998 DOI: 10.3109/07357907.2015.1047510] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Olfactory cancer detection shows promise as an affordable, precise, and noninvasive way to screen for cancer. This review focuses on two methods of olfactory cancer detection: first, the ability of canines to differentiate between cancerous and healthy individuals through the use of biological samples and second, electronic nose technology that uses chemical sensors to detect known biomarkers in exhaled breath. This review summarizes and critiques past research and outlines future directions to improve understanding of both canine olfaction and electronic nose technology.
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Affiliation(s)
- Spencer W Brooks
- a Department of Neuroscience , Skidmore College , Saratoga Springs , New York , USA
| | - Daniel R Moore
- a Department of Neuroscience , Skidmore College , Saratoga Springs , New York , USA
| | - Evan B Marzouk
- a Department of Neuroscience , Skidmore College , Saratoga Springs , New York , USA
| | - Frasier R Glenn
- a Department of Neuroscience , Skidmore College , Saratoga Springs , New York , USA
| | - Robert M Hallock
- a Department of Neuroscience , Skidmore College , Saratoga Springs , New York , USA
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36
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Development and application of a new electronic nose instrument for the detection of colorectal cancer. Biosens Bioelectron 2014; 67:733-8. [PMID: 25465796 DOI: 10.1016/j.bios.2014.10.044] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 09/26/2014] [Accepted: 10/08/2014] [Indexed: 01/18/2023]
Abstract
Colorectal cancer is a leading cause of cancer death in the USA and Europe with symptoms that mimick other far more common lower gastrointestinal (GI) disorders. This difficulty in separating colorectal cancer from these other diseases has driven researchers to search for an effective, non-invasive screening technique. Current state-of-the-art method of Faecal Immunochemical Testing achieving sensitivity ~90%, unfortunately the take-up in the western world is low due to the low patient acceptability of stool samples. However, a wide range of cancers have been distinguished from each-other and healthy controls by detecting the gas/volatile content emanating patient biological media. Dysbiosis afforded by certain disease states may be expressed in the volatile content of urine - a reflection of the gut bacteria's metabolic processes. A new electronic nose instrument was developed at the University of Warwick to measure the gas/volatile content of urine headspace, based on an array of 13 commercial electro-chemical and optical sensors. An experimental setup was arranged for a cohort of 92 urine samples from patients of colorectal cancer (CRC), irritable bowel syndrome (IBS) and controls to be run through the machine. Features were extracted from response data and used in Linear Discriminant Analysis (LDA) plots, including a full 3-disease classification and one focussing on distinguishing CRC from IBS. The latter case was tested by the success of re-classification using an (n-1) K-nearest neighbour algorithm, showing 78% sensitivity and 79% specificity to CRC.
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37
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Taverna G, Tidu L, Grizzi F, Torri V, Mandressi A, Sardella P, La Torre G, Cocciolone G, Seveso M, Giusti G, Hurle R, Santoro A, Graziotti P. Olfactory system of highly trained dogs detects prostate cancer in urine samples. J Urol 2014; 193:1382-7. [PMID: 25264338 DOI: 10.1016/j.juro.2014.09.099] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 01/03/2023]
Abstract
PURPOSE We established diagnostic accuracy in terms of the sensitivity and specificity with which a rigorously trained canine olfactory system could recognize specific volatile organic compounds of prostate cancer in urine samples. MATERIALS AND METHODS Two 3-year-old female German Shepherd Explosion Detection Dogs were trained to identify prostate cancer specific volatile organic compounds in urine samples. They were tested on 362 patients with prostate cancer (range low risk to metastatic) and on 540 healthy controls with no nonneoplastic disease or nonprostatic tumor. This cross-sectional design for diagnostic accuracy was performed at a single Italian teaching hospital and at the Italian Ministry of Defense Military Veterinary Center. RESULTS For dog 1 sensitivity was 100% (95% CI 99.0-100.0) and specificity was 98.7% (95% CI 97.3-99.5). For dog 2 sensitivity was 98.6% (95% CI 96.8-99.6) and specificity was 97.6% (95% CI 95.9-98.7). When considering only men older than 45 years in the control group, dog 1 achieved 100% sensitivity and 98% specificity (95% CI 96-99.2), and dog 2 achieved 98.6% sensitivity (95% CI 96.8-99.6) and 96.4% specificity (95% CI 93.9-98.1). Analysis of false-positive cases revealed no consistent pattern in participant demographics or tumor characteristics. CONCLUSIONS A trained canine olfactory system can detect prostate cancer specific volatile organic compounds in urine samples with high estimated sensitivity and specificity. Further studies are needed to investigate the potential predictive value of this procedure to identify prostate cancer.
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Affiliation(s)
| | - Lorenzo Tidu
- Italian Ministry of Defense Military Veterinary Center, Grosseto, Milan, Italy
| | - Fabio Grizzi
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Valter Torri
- Istituto di Ricovero e Cura a Carattere Scientifico, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Paolo Sardella
- Italian Ministry of Defense Military Veterinary Center, Grosseto, Milan, Italy
| | - Giuseppe La Torre
- Italian Ministry of Defense Military Veterinary Center, Grosseto, Milan, Italy
| | | | - Mauro Seveso
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Guido Giusti
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Rodolfo Hurle
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Armando Santoro
- Humanitas Clinical and Research Center, Rozzano, Milan, Italy
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