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The smell of lung disease: a review of the current status of electronic nose technology.

ABSTRACT: There is a need for timely, accurate diagnosis, and personalised management in lung diseases. Exhaled breath reflects inflammatory and metabolic processes in the human body, especially in the lungs. The analysis of exhaled breath using electronic nose (eNose) technology has gained increasing attention in the past years. This technique has great potential to be used in clinical practice as a real-time non-invasive diagnostic tool, and for monitoring disease course and therapeutic effects. To date, multiple eNoses have been developed and evaluated in clinical studies across a wide spectrum of lung diseases, mainly for diagnostic purposes. Heterogeneity in study design, analysis techniques, and differences between eNose devices currently hamper generalization and comparison of study results. Moreover, many pilot studies have been performed, while validation and implementation studies are scarce. These studies are needed before implementation in clinical practice can be realised. This review summarises the technical aspects of available eNose devices and the available evidence for clinical application of eNose technology in different lung diseases. Furthermore, recommendations for future research to pave the way for clinical implementation of eNose technology are provided.

SUBMITTER: van der Sar IG

PROVIDER: S-EPMC8448171 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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The smell of lung disease: a review of the current status of electronic nose technology.

van der Sar I G IG Wijbenga N N Nakshbandi G G Aerts J G J V JGJV Manintveld O C OC Wijsenbeek M S MS Hellemons M E ME Moor C C CC

Respiratory research 20210917 1

There is a need for timely, accurate diagnosis, and personalised management in lung diseases. Exhaled breath reflects inflammatory and metabolic processes in the human body, especially in the lungs. The analysis of exhaled breath using electronic nose (eNose) technology has gained increasing attention in the past years. This technique has great potential to be used in clinical practice as a real-time non-invasive diagnostic tool, and for monitoring disease course and therapeutic effects. To date ...[more]

PMID: 34535144

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Project description:IntroductionInterstitial lung disease (ILD) may be difficult to distinguish from other respiratory diseases due to overlapping clinical presentation. Recognition of ILD is often late, causing delay which has been associated with worse clinical outcome. Electronic nose (eNose) sensor technology profiles volatile organic compounds in exhaled breath and has potential to detect ILD non-invasively. We assessed the accuracy of differentiating breath profiles of patients with ILD from patients with asthma, chronic obstructive pulmonary disease (COPD), and lung cancer using eNose technology.MethodsPatients with ILD, asthma, COPD, and lung cancer, regardless of stage or treatment, were included in a cross-sectional study in two hospitals. Exhaled breath was analysed using an eNose (SpiroNose) and clinical data were collected. Datasets were split in training and test sets for independent validation of the model. Data were analyzed with partial least squares discriminant and receiver operating characteristic analyses.Results161 patients with ILD and 161 patients with asthma (n = 65), COPD (n = 50) or lung cancer (n = 46) were included. Breath profiles of patients with ILD differed from all other diseases with an area under the curve (AUC) of 0.99 (95% CI 0.97-1.00) in the test set. Moreover, breath profiles of patients with ILD could be accurately distinguished from the individual diseases with an AUC of 1.00 (95% CI 1.00-1.00) for asthma, AUC of 0.96 (95% CI 0.90-1.00) for COPD, and AUC of 0.98 (95% CI 0.94-1.00) for lung cancer in test sets. Results were similar after excluding patients who never smoked.ConclusionsExhaled breath of patients with ILD can be distinguished accurately from patients with other respiratory diseases using eNose technology. eNose has high potential as an easily accessible point-of-care medical test for identification of ILD amongst patients with respiratory symptoms, and could possibly facilitate earlier referral and diagnosis of patients suspected of ILD.

Project description:There is an urgent need to have reliable technologies to diagnose post-coronavirus disease syndrome (PCS), as the number of people affected by COVID-19 and related complications is increasing worldwide. Considering the amount of risks associated with the two chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), there is an immediate requirement for a screening method for PCS, which also produce symptoms similar to these conditions, especially since very often, many COVID-19 cases remain undetected because a good share of such patients is asymptomatic. Breath analysis techniques are getting attention since they are highly non-invasive methods for disease diagnosis, can be implemented easily for point-of-care applications even in primary health care centres. Electronic (E-) nose technology is coming up with better reliability, ease of operation, and affordability to all, and it can generate signatures of volatile organic compounds (VOCs) in exhaled breath as markers of diseases. The present report is an outcome of a pilot study using an E-nose device on breath samples of cohorts of PCS, asthma, and normal (control) subjects. Match/no-match and k-NN analysis tests have been carried out to confirm the diagnosis of PCS. The prediction model has given 100% sensitivity and specificity. Receiver operating characteristics (ROC) has been plotted for the prediction model, and the area under the curve (AUC) is obtained as 1. The E-nose technique is found to be working well for PCS diagnosis. Our study suggests that the breath analysis using E-nose can be used as a point-of-care diagnosis of PCS.Trial registrationBreath samples were collected from the Kasturba Hospital, Manipal. Ethical clearance was obtained from the Institutional Ethics Committee, Kasturba Medical College, Manipal (IEC 60/2021, 13/01/2021) and Indian Council of Medical Research (ICMR) (CTRI/2021/02/031357, 06/02/2021) Government of India; trials were prospectively registered.

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The smell of lung disease: a review of the current status of electronic nose technology.

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The smell of lung disease: a review of the current status of electronic nose technology.

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