Early Detection of Lung Cancer Using Nano-Nose - A Review

Smelling the Disease: Diagnostic Potential of Breath Analysis

Breath analysis is a relatively recent field of research with much promise in scientific and clinical studies. Breath contains endogenously produced volatile organic components (VOCs) resulting from metabolites of ingested precursors, gut and air-passage bacteria, environmental contacts, etc. Numerous recent studies have suggested changes in breath composition during the course of many diseases, and breath analysis may lead to the diagnosis of such diseases. Therefore, it is important to identify the disease-specific variations in the concentration of breath to diagnose the diseases. In this review, we explore methods that are used to detect VOCs in laboratory settings, VOC constituents in exhaled air and other body fluids (e.g., sweat, saliva, skin, urine, blood, fecal matter, vaginal secretions, etc.), VOC identification in various diseases, and recently developed electronic (E)-nose-based sensors to detect VOCs. Identifying such VOCs and applying them as disease-specific biomarkers to obtain accurate, reproducible, and fast disease diagnosis could serve as an alternative to traditional invasive diagnosis methods. However, the success of VOC-based identification of diseases is limited to laboratory settings. Large-scale clinical data are warranted for establishing the robustness of disease diagnosis. Also, to identify specific VOCs associated with illness states, extensive clinical trials must be performed using both analytical instruments and electronic noses equipped with stable and precise sensors.

Paper-Based Multiplex Sensors for the Optical Detection of Plant Stress

The rising population and the ongoing climate crisis call for improved means to monitor and optimise agriculture. A promising approach to tackle current challenges in food production is the early diagnosis of plant diseases through non-invasive methods, such as the detection of volatiles. However, current devices for detection of multiple volatiles are based on electronic noses, which are expensive, require complex circuit assembly, may involve metal oxides with heating elements, and cannot easily be adapted for some applications that require miniaturisation or limit front-end use of electronic components. To address these challenges, a low-cost optoelectronic nose using chemo-responsive colorimetric dyes drop-casted onto filter paper has been developed in the current work. The final sensors could be used for the quantitative detection of up to six plant volatiles through changes in colour intensities with a sub-ppm level limit of detection, one of the lowest limits of detection reported so far using colorimetric gas sensors. Sensor colouration could be analysed using a low-cost spectrometer and the results could be processed using a microcontroller. The measured volatiles could be used for the early detection of plant abiotic stress as early as two days after exposure to two different stresses: high salinity and starvation. This approach allowed a lowering of costs to GBP 1 per diagnostic sensing paper. Furthermore, the small size of the paper sensors allows for their use in confined settings, such as Petri dishes. This detection of abiotic stress could be easily achieved by exposing the devices to living plants for 1 h. This technology has the potential to be used for monitoring of plant development in field applications, early recognition of stress, implementation of preventative measures, and mitigation of harvest losses.

Cancer nanotechnology: current status and perspectives

Modern medicine has been waging a war on cancer for nearly a century with no tangible end in sight. Cancer treatments have significantly progressed, but the need to increase specificity and decrease systemic toxicities remains. Early diagnosis holds a key to improving prognostic outlook and patient quality of life, and diagnostic tools are on the cusp of a technological revolution. Nanotechnology has steadily expanded into the reaches of cancer chemotherapy, radiotherapy, diagnostics, and imaging, demonstrating the capacity to augment each and advance patient care. Nanomaterials provide an abundance of versatility, functionality, and applications to engineer specifically targeted cancer medicine, accurate early-detection devices, robust imaging modalities, and enhanced radiotherapy adjuvants. This review provides insights into the current clinical and pre-clinical nanotechnological applications for cancer drug therapy, diagnostics, imaging, and radiation therapy.

Bio-inspired graphene-based nano-systems for biomedical applications

The increasing demands of environmentally sustainable, affordable, and scalable materials have inspired researchers to explore greener nanosystems of unique properties which can enhance the performance of existing systems. Such nanosystems, extracted from nature, are state-of-art high-performance nanostructures due to intrinsic hierarchical micro/nanoscale architecture and generous interfacial interactions in natural resources. Among several, bio-inspired nanosystems graphene nanosystems have emerged as an essential nano-platform wherein a highly electroactive, scalable, functional, flexible, and adaptable to a living being is a key factor. Preliminary investigation project bio-inspired graphene nanosystems as a multi-functional nano-platform suitable for electronic devices, energy storage, sensors, and medical sciences application. However, a broad understanding of bio-inspired graphene nanosystems and their projection towards applied application is not well-explored yet. Considering this as a motivation, this mini-review highlights the following; the emergence of bio-inspired graphene nanosystems, over time development to make them more efficient, state-of-art technology, and potential applications, mainly biomedical including biosensors, drug delivery, imaging, and biomedical systems. The outcomes of this review will certainly serve as a guideline to motivate scholars to design and develop novel bio-inspired graphene nanosystems to develop greener, affordable, and scalable next-generation biomedical systems.

Optical detection of formaldehyde in air in the 3.6 µm range

The optical detector of formaldehyde designed for sensing cancer biomarkers in air exhaled from human lungs with possible application in free atmosphere is described. The measurements were performed at wavelengths ranging from 3595.77-3596.20 nm. It was stated that at the pressure of 0.01 atm this absorption band exhibits the best immunity to typical interferents that might occur at high concentration in human breath. Multipass absorption spectroscopy was also applied. The method of optical fringes quenching by wavelength modulation and signal averaging over the interferences period was presented. The application of such approaches enabled the detection limit of about single ppb to be achieved.

Sniffing Out Urinary Tract Infection-Diagnosis Based on Volatile Organic Compounds and Smell Profile

Current available methods for the clinical diagnosis of urinary tract infection (UTI) rely on a urine dipstick test or culturing of pathogens. The dipstick test is rapid (available in 1-2 min), but has a low positive predictive value, while culturing is time-consuming and delays diagnosis (24-72 h between sample collection and pathogen identification). Due to this delay, broad-spectrum antibiotics are often prescribed immediately. The over-prescription of antibiotics should be limited, in order to prevent the development of antimicrobial resistance. As a result, there is a growing need for alternative diagnostic tools. This paper reviews applications of chemical-analysis instruments, such as gas chromatography-mass spectrometry (GC-MS), selected ion flow tube mass spectrometry (SIFT-MS), ion mobility spectrometry (IMS), field asymmetric ion mobility spectrometry (FAIMS) and electronic noses (eNoses) used for the diagnosis of UTI. These methods analyse volatile organic compounds (VOCs) that emanate from the headspace of collected urine samples to identify the bacterial pathogen and even determine the causative agent's resistance to different antibiotics. There is great potential for these technologies to gain wide-spread and routine use in clinical settings, since the analysis can be automated, and test results can be available within minutes after sample collection. This could significantly reduce the necessity to prescribe broad-spectrum antibiotics and allow the faster and more effective use of narrow-spectrum antibiotics.

Electronic Nose: Recent Developments in Gas Sensing and Molecular Mechanisms of Graphene Detection and Other Materials

Keywords: graphene; electronic nose; carbon nanotubes; porphyrins; conductive polymers.

Breath based volatile organic compounds in the detection of breast, lung, and colorectal cancers: A systematic review

BACKGROUND

Detecting volatile organic compounds (VOCs) could provide a rapid, noninvasive, and inexpensive screening tool for detecting cancer.

OBJECTIVE

In this systematic review, we identified specific exhaled breath VOCs correlated with lung, colorectal, and breast cancer.

METHODS

We identified relevant studies published in 2015 and 2016 by searching Pubmed and Web of Science. The protocol for this systematic review was registered in PROSPERO and the PRISMA guidelines were used in reporting. VOCs and performance data were extracted.

RESULTS

Three hundred and thirty three records were identified and 43 papers were included in the review, of which 20 were review articles themselves. We identified 17 studies that listed the VOCs with at least a subset of statistics on detection cutoff levels, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and gradient.

CONCLUSIONS

Breath analysis for cancer screening and early detection shows promise, because samples can be collected easily, safely, and frequently. While gas chromatography-mass spectrometry is considered the gold standard for identifying specific VOCs, breath analysis has moved into analyzing patterns of VOCs using a variety of different multiple sensor techniques, such as eNoses and nanomaterials. Further development of VOCs for early cancer detection requires clinical trials with standardized breath sampling methods.

Exhaled air analysis using wideband wave number tuning range infrared laser photoacoustic spectroscopy

The infrared laser photoacoustic spectroscopy (LPAS) and the pattern-recognition-based approach for noninvasive express diagnostics of pulmonary diseases on the basis of absorption spectra analysis of the patient’s exhaled air are presented. The study involved lung cancer patients ( N = 9 ), patients with chronic obstructive pulmonary disease ( N = 12 ), and a control group of healthy, nonsmoking volunteers ( N = 11 ). The analysis of the measured absorption spectra was based at first on reduction of the dimension of the feature space using principal component analysis; thereafter, the dichotomous classification was carried out using the support vector machine. The gas chromatography–mass spectrometry method (GC–MS) was used as the reference. The estimated mean value of the sensitivity of exhaled air sample analysis by the LPAS in dichotomous classification was not less than 90% and specificity was not less than 69%; the analogous results of analysis by GC–MS were 68% and 60%, respectively. Also, the approach to differential diagnostics based on the set of SVM classifiers usage is presented.

The Pursuit of Noninvasive Diagnosis of Lung Cancer

The noninvasive diagnosis of lung cancer remains a formidable challenge. Although tissue diagnosis will remain the gold standard for the foreseeable future, questions pertaining to the risks and costs associated with invasive diagnostic procedures are of prime relevance. This review addresses new modalities for improving the noninvasive evaluation of suspicious lung nodules. Ultimately, the goal is to translate early diagnosis into early treatment. We discuss how biomarkers could assist in distinguishing benign from malignant nodules and aggressive from indolent tumors. The field of biomarkers is rapidly expanding and progressing, and efforts are well underway to apply molecular diagnostics to address the shortcomings of current lung cancer diagnostic tools.

Lung cancer in the Indian subcontinent

Smoking tobacco, both cigarettes and beedis, is the principal risk factor for causation of lung cancer in Indian men; however, among Indian women, the association with smoking is not strong, suggesting that there could be other risk factors besides smoking. Despite numerous advances in recent years in terms of diagnostic methods, molecular changes, and therapeutic interventions, the outcomes of the lung cancer patients remain poor; hence, a better understanding of the risk factors may impact the preventive measures to be implemented at the community level. There is a lack of comprehensive data on lung cancer in India. In this review, we attempt to collate the available data on lung cancer from India.

Exhaled Breath Analysis for Monitoring Response to Treatment in Advanced Lung Cancer

INTRODUCTION

The Response Evaluation Criteria in Solid Tumors (RECIST) serve as the accepted standard to monitor treatment efficacy in lung cancer. However, the time intervals between consecutive computerized tomography scans might be too long to allow early identification of treatment failure. This study examines the use of breath sampling to monitor responses to anticancer treatments in patients with advanced lung cancer.

METHODS

A total of 143 breath samples were collected from 39 patients with advanced lung cancer. The exhaled breath signature, determined by gas chromatography/mass spectrometry and a nanomaterial-based array of sensors, was correlated with the response to therapy assessed by RECIST: complete response, partial response, stable disease, or progressive disease.

RESULTS

Gas chromatography/mass spectrometry analysis identified three volatile organic compounds as significantly indicating disease control (PR/stable disease), with one of them also significantly discriminating PR/stable disease from progressive disease. The nanoarray had the ability to monitor changes in tumor response across therapy, also indicating any lack of further response to therapy. When one-sensor analysis was used, 59% of the follow-up samples were identified correctly. There was 85% success in monitoring disease control (stable disease/partial response).

CONCLUSION

Breath analysis, using mainly the nanoarray, may serve as a surrogate marker for the response to systemic therapy in lung cancer. As a monitoring tool, it can provide the oncologist with a quick bedside method of identifying a lack of response to an anticancer treatment. This may allow quicker recognition than does the current RECIST analysis. Early recognition of treatment failure could improve patient care.