title: Feasibility of analysing [13C]urea breath tests for Helicobacter pylori by gas chromatography-mass spectrometry in the selected ion monitoring mode.
abstract: BACKGROUND
  The [13C]urea breath test for Helicobacter pylori is nonradioactive, as well as noninvasive, but few clinical laboratories have the expensive isotope ratio mass spectrometer used for analysis.
  
  
  METHODS
  To demonstrate the feasibility of analysing [13C]urea breath tests with a gas chromatograph-mass spectrometer routinely used for drug testing, 13CO2 standards for breath tests and breath samples from patients in a multiple-blind study were analysed. The breath samples were also analysed by isotope ratio mass spectrometry, and the diagnoses were compared with biopsy results.
  
  
  RESULTS
  The precision of the enrichment measurements by gas chromatography-mass spectrometry was 1.1 parts per thousand, and the calculated differences in enrichment between standard gases equaled the certified values. The sensitivity (94%), specificity (94%), and percentage agreement (94%) for diagnosis of Helicobacter pylori (n = 34) were as high or higher than for analysis of replicate breath samples by isotope ratio mass spectrometry and comparable to the values reported for diagnosis of the bacterium by other currently accepted tests.
  
  
  CONCLUSIONS
  The study demonstrates that a gas chromatograph-mass spectrometer can be used to analyse [13C]urea breath tests, thus potentially lowering the cost of the test and increasing the number of laboratories that can perform the test.
authors.affiliation: CURE, Department of Medicine, University of California at Los Angeles, USA.
authors.forename: V N
authors.initials: VN
authors.lastname: Kasho
authors.forename: S
authors.initials: S
authors.lastname: Cheng
authors.forename: D M
authors.initials: DM
authors.lastname: Jensen
authors.forename: H
authors.initials: H
authors.lastname: Ajie
authors.forename: W N
authors.initials: WN
authors.lastname: Lee
authors.forename: L D
authors.initials: LD
authors.lastname: Faller
mesh_terms: D001944:Breath Tests; D002138:Calibration; D002245:Carbon Dioxide / Q000032:analysis / Q000378:metabolism; D002247:Carbon Isotopes; D005240:Feasibility Studies; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000378:metabolism*; D016480:Helicobacter pylori; D006801:Humans; D007700:Kinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018629:Spectrometry, Mass, Secondary Ion / Q000379:methods; D014508:Urea / Q000032:analysis* / Q000378:metabolism
chemical_list: D002247:Carbon Isotopes; D002245:Carbon Dioxide; D014508:Urea