Home /  All blogs

Aeonose breath analysis on TB screening South Africa

This year, the Union World Conference on Lung Health was held in Hyderabad, India. At the TBScience pre-conference, an official event entirely devoted to basic and translational tuberculosis (TB) research, study results were presented on the Aeonose exhaled-breath tests in Cape Town.

 

It shows the Aeonose may be useful as a triage test for tuberculosis in HIV-infected and uninfected persons as it meets the FIND/WHO minimum Target Product Profile (TPP) for a rule-out TB test.

 

Abstract:

An exhaled-breath screening test for the detection of active pulmonary tuberculosis in patients presenting to primary health care clinics in Cape Town, South Africa.

Aliasgar Esmail, Keertan Dheda, Muhammed Dhansay

 

Introduction: GeneXpert Ultra is unsuitable for community-based mass screening and in up to one-third of patients an adequate sputum sample is unavailable. By contrast, the analysis of exhaled breath obtained by the Aeonose-TB device has the potential to provide an easy, onsite, rapid, and non-invasive diagnosis of tuberculosis. Thus, it may serve as a useful community-based triage tool (a major unmet need in the TB field).

 

Methods: We enrolled 1,143 participants (31% HIV- infected) with suspected TB (243 microbiologically-con- firmed TB, 130 probable TB, and 770 non-TB) from primary care clinics in Cape Town, South Africa. Sputum GeneXpert MTB/RIF and/ or culture served as the reference standard. Volatile organic compounds in exhaled-breath were detected using an electronic nose containing 3 metal-oxide sensors (AeonoseTM, Zutphen, The Netherlands). Data were analysed by machine learning using artificial neural networks (ANN) in a ‘leave-10%-out’ cross-validation training set (n=756; 189 TB and 567 non-TB) and the findings ratified in a test set (n=257).

 

Results: In the training set the sensitivity, specificity, PPV, NPV of Aeonose-TB (95% CI) was 81% (74-86) and 60% (55-64), 40% (35-45), and 90% (87-93), respectively. However, in HIV uninfected patients, using a ANN- derived rule-in threshold, performance characteristics were 59% (50-69), 91% (87-93), 68% (58-77), and 87% (83-90), respectively. In the same group, using an ANN- derived rule-out threshold, the performance characteristics were 90% (83-95), 59% (54-65), 43% (36-49) and 95% (91-97), respectively. Results in the validation set, and in HIV-infected persons, showed comparable performance characteristics.

 

Conclusion: Aeonose-TB may be useful as a triage test for tuberculosis in HIV-infected and uninfected persons as it meets the FIND/WHO minimum Target Product Profile (TPP) for a rule-out TB test. However, it may also have utility to rule in TB in sputum scarce or smear-negative persons. Further studies are now required to clarify these findings.


Aeonose breath analysis on TB screening Peru

The Union World Conference on Lung Health 2019 was held in Hyderabad (India) from October 30 – November 2. Dr. Ruvandhi Nathavitharana (Harvard University) presented results on the Aeonose exhaled-breath TB-study in Lima, suggesting Aeonose may meet WHO triage test criteria to rule out TB (90% sensitivity, 70% specificity) in lower-risk patients admitted with cough or TB risk factors.


Improving lung cancer screening results

At the ERS Conference in Madrid (September 28 – October 2, 2019), Sharina Kort (MST, Enschede, the Netherlands) presented clinical study results on diagnosing lung cancer using the Aeonose:

  1. Improving lung cancer diagnosis from exhaled-breath analysis by adding clinical parameters to the artificial neural network (oral presentation)
  2. Combining exhaled-breath analysis data with clinical parameters to improve the diagnosis of lung cancer (poster presentation)

Combining the electronic nose data and easily-available clinical parameters, she obtained a sensitivity of 96% and a negative predictive value of 93%. Nice results!


Pancreas new diagnostics

Improved diagnostics for pancreatic diseases are badly needed. An electronic nose (AeoNose™) analysing exhaled breath was successfully used to distinguish between pancreas carcinoma, chronic pancreatitis (inflammation of the pancreas), and healthy controls: promising results from a multicenter pilot study in the Netherlands.

Pancreatic ductal adenocarcinoma and chronic pancreatitis may be diagnosed by exhaled-breath profiles: a multicenter pilot study


Presentations at DDW San Diego

At the Digestive Disease Week in San Diego, 4 posters were presented discussing ongoing clinical studies with the Aeonose for exhaled-breath analysis:

  • Colorectal cancer and advanced adenomas
  • Barrett’s esophagus (presented both by Radboud University (Nijmegen, the Netherlands) and Mayo Clinic (Rochester))
  • Fasting state

Mo1003 — 2019  AGA
BREATH ANALYSIS CAN BE USED TO DETECT COLORECTAL CANCER AND ADVANCED ADENOMAS: PROOF-OF-PRINCIPLE STUDY
Kelly v. Keulen1, Maud E. Jansen2, Ruud W. Schrauwen3, J.J. Kolkman2,4, Peter D. Siersema1

 

Sa1136 — 2019  AGA    Poster of Distinction 
DETECTION OF BARRETT’S ESOPHAGUS THROUGH EXHALED BREATH USING A NON-INVASIVE SCREENING TOOL
Yonne Peters1, Ruud W. Schrauwen2, A.C. Tan3, Sanne Bogers2, Bart de Jong1, Peter D. Siersema1

 

Sa1153 — 2019  AGA   
NON-INVASIVE SCREENING FOR BARRETT’S ESOPHAGUS USING AN ELECTRONIC NOSE
Juan Reyes Genere1, Kavel Visrodia2, Liam Zakko3, Bryan Linn1, Magdalen A. Clemens1, James Allen1, Lori S. Lutzke1, Kenneth K. Wang1

 

Mo2053 — 2019  AGA   
PRE-PROCEDURAL ASSESSMENT OF THE FASTING STATE BY EXHALED VOLATILE ORGANIC COMPOUNDS USING AN ELECTRONIC NOSE
Juan Reyes Genere1, Liam Zakko2, Kavel Visrodia3, Magdalen A. Clemens1, James Allen1, Bryan Linn1, Lori S. Lutzke1, Kenneth K. Wang1


Paper on wound-swaps

The majority of clinical studies has been based on exhaled-breath analysis, but for the current study, a dedicated eNose-device was used, ‘Aetholab’, that enables headspace analysis of 4 vials simultaneously. For this purpose, 4 electronic noses have been integrated. Data analysis methods in this case are similar to the ones used in exhaled-breath analysis.

Our first paper on headspace analysis for human diagnostics was recently published in the journal ‘Clinical Microbiology and Infection’:

‘Differentiation between infected and not infected wounds using an electronic nose’


Page 1 of 712345...>>>