Home /  Clinical results /  Lung diseases

Study focus is on lung cancer, pilot studies have been conducted on COPD and pulmonary embolism.

Papers and conference proceeding can be found below.

Just published in ‘Gut’, results from a pilot study on Barrett’s oesophagus using the Aeonose

Detection of Barrett’s oesophagus through exhaled breath using an electronic nose device

Yonne Peters, Ruud W M Schrauwen, Adriaan C Tan, Sanne K Bogers, Bart de Jong, Peter D Siersema


Timely detection of oesophageal adenocarcinoma (OAC) and even more so its precursor Barrett’s oesophagus (BO) could contribute to decrease OAC incidence and mortality. An accurate, minimally-invasive screening method for BO for widespread use is currently not available. In a proof-of-principle study in 402 patients, we developed and cross-validated a BO prediction model using volatile organic compounds (VOCs) analysis with an electronic nose device. This electronic nose was able to distinguish between patients with and without BO with good diagnostic accuracy (sensitivity 91% specificity 74%) and seemed to be independent of proton pump inhibitor use, the presence of hiatal hernia, and reflux. This technique may enable an efficient, well-tolerated, and sensitive and specific screening method to select high-risk individuals to undergo upper endoscopy.

Multicenter study Colon rectal cancer and advanced adenomas

In December 2019, results of a multicenter clinical study on detection of colorectal cancer and advanced adenomas using exhaled-breath analysis was published in ‘Alimentary Pharmacology & Therapeutics’:

Title: ‘Volatile organic compounds in breath can serve as a non‐invasive diagnostic biomarker for the detection of advanced adenomas and colorectal cancer’

Authors: Kelly van Keulen, Maud Jansen, Ruud Schrauwen, Jeroen Kolkman, and Peter Siersema

The paper can be viewed online here (Open Access)

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.



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!

Multi-centre prospective study on lung cancer


Electronic nose technology using the Aeonose™ can play an important role in rapidly excluding lung cancer due to the high negative predictive value for various types of lung cancer. Next step will be to find out if the Aeonose™ can be used for population screening on lung cancer.

The article ‘Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis’ is now available online.

Using this link, you get 50 days’ free access to the article (until November 28, 2018). No sign up, registration or fees are required.

Presentations on European Respiratory Society (ERS)


At the International Congress of the European Respiratory Society (ERS), held in Paris from 15-19 September 2018, the following results on clinical Aeonose studies were presented:

  • Sharina Kort (Enschede, Netherlands), Mayke Tiggeloven, Marjolein Brusse-Keizer, Hugo Schouwink, Frans De Jongh, Emanuel Citgez, Jan Willem Gerritsen, Job Van Der Palen, Detecting subtypes of non-small cell lung cancer by electronic nose. (PA1761)
  • Sharina Kort (Enschede, Netherlands), Marjolein Brusse-Keizer, Hugo Schouwink, Frans De Jongh, Emanuel Citgez, Jan Willem Gerritsen, Job Van Der Palen, Detection of small cell lung cancer by electronic nose. (PA1762)
  • Ekaterina Krauss (Giessen, Germany), Jana Zoelitz, Jasmin Wagner, Guillermo Barretto, Maria Degen, Werner Seeger, Andreas Guenther, The use of electronic nose technology for the detection of Lung Cancer (LC): analysis of exhaled volatile compounds by Aeonose® (PA1758)
  • Michiel Bannier (Maastricht, Netherlands), Kim Van De Kant, Quirijn Jobsis, Edward Dompeling, Feasibility and diagnostic accuracy of an electronic nose in children with asthma and cystic fibrosis (OA338)
  • Luisa Quesada (Brookline, United States of America), Sergio Poli De Frías, Gessica Di Toro, Emines Salas, Ana Gutierrez, Jessica Bello, Isabel Tovar, Maria España, Heriberto Perez, Julian Villalba, Marlene Villalon, Jacobus De Waard, Late Breaking Abstract – An Electronic Nose as a screening tool for childhood Tuberculosis (PA4757)

We’re Losing the Fight’: Tuberculosis Batters a Venezuela in Crisis

Article Aeonose project Venezuela

Tuberculosis (TB) is the world’s deadliest infectious disease, and a top ten cause of death worldwide. Each year, almost 2 million people die from TB. Venezuela is one of the high burden countries with devastating consequences. In Caracas, a medical team (PI: Dr. Jacobus de Waard, mentioned in the NYT-article) is conducting a study for fast TB-screening using an electronic nose (‘Aeonose’) for exhaled-breath analysis. Improved treatment regimes and diagnostics are urgently needed!

Page 1 of 212>