title: Prostate cancer diagnosis through electronic nose in the urine headspace setting: a pilot study.
abstract: BACKGROUND
  To evaluate the efficacy of prostate cancer (PCa) detection by the electronic nose (EN) on human urine samples.
  
  
  METHODS
  Urine samples were obtained from candidates of prostate biopsy (PB). Exclusion criteria were a history of urothelial carcinoma or other malignant disease, urine infection, fasting for <12 h before PB or ingestion of alcohol or foods that might alter the urine smell in the last 24 h. The initial part of the voided urine and the midstream were collected separately in two sterile containers. Both samples were analyzed by the EN immediately after the collection. All patients underwent a standard transperineal, transrectal-ultrasound-guided PB. The pathological results were compared with the outcomes of the EN. Sensitivity and specificity of EN were assessed.
  
  
  RESULTS
  Forty-one men were included in the study. Fourteen out of the 41 patients were positive for PCa. Midstream urine did not correlate significantly neither with a positive nor with a negative PB. Instead, significantly different results on the initial part of the urine stream between positive and negative PBs were obtained. The EN correctly recognized 10 out of the 14 cases (that is, sensitivity 71.4% (confidence interval (CI) 42-92%)) of PCa while four were false negatives. Moreover, the device recognized as negative 25 out of the 27 (that is, specificity 92.6% (CI 76-99%)) samples of negative PBs, with only two false positives.
  
  
  CONCLUSIONS
  We believe this is the first demonstration of an olfactory imprinting of the initial part of the urine stream in patients with PCa that was revealed by an EN, with high specificity.
authors.affiliation: UOC of Urology, Department of Surgery, University of Rome Tor Vergata-Policlinico Casilino, Rome, Italy.
authors.forename: A D
authors.initials: AD
authors.lastname: Asimakopoulos
authors.affiliation: UOC of Urology, Department of Surgery, University of Tor Vergata, Policlinico Tor Vergata, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Del Fabbro
authors.affiliation: UOC of Urology, Department of Surgery, University of Tor Vergata, Policlinico Tor Vergata, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Miano
authors.affiliation: Center for Integrated Research-CIR, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Santonico
authors.affiliation: Department of Electronic Engineering, University of Tor Vergata, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Capuano
authors.affiliation: Center for Integrated Research-CIR, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pennazza
authors.affiliation: Department of Electronic Engineering, University of Tor Vergata, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Amico
authors.affiliation: UOC of Urology, Department of Surgery, University of Tor Vergata, Policlinico Tor Vergata, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Finazzi-Agrò
mesh_terms: D000368:Aged; D001706:Biopsy; D062609:Electronic Nose; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000652:urine*; D012680:Sensitivity and Specificity; D014556:Urine / Q000737:chemistry