title: Breath-print analysis by e-nose for classifying and monitoring chronic liver disease: a proof-of-concept study.
abstract: Since the liver plays a key metabolic role, volatile organic compounds in the exhaled breath might change with type and severity of chronic liver disease (CLD). In this study we analysed breath-prints (BPs) of 65 patients with liver cirrhosis (LC), 39 with non-cirrhotic CLD (NC-CLD) and 56 healthy controls by the e-nose. Distinctive BPs characterized LC, NC-CLD and healthy controls, and, among LC patients, the different Child-Pugh classes (sensitivity 86.2% and specificity 98.2% for CLD vs healthy controls, and 87.5% and 69.2% for LC vs NC-CLD). Moreover, the area under the BP profile, derived from radar-plot representation of BPs, showed an area under the ROC curve of 0.84 (95% CI 0.76-0.91) for CLD, of 0.76 (95% CI 0.66-0.85) for LC, and of 0.70 (95% CI 0.55-0.81) for decompensated LC. By applying the cut-off values of 862 and 812, LC and decompensated LC could be predicted with high accuracy (PPV 96.6% and 88.5%, respectively). These results are proof-of-concept that the e-nose could be a valid non-invasive instrument for characterizing CLD and monitoring hepatic function over time. The observed classificatory properties might be further improved by refining stage-specific breath-prints and considering the impact of comorbidities in a larger series of patients.
authors.affiliation: Clinical Medicine and Hepatology Department, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Vincentis
authors.affiliation: Center for Integrated Research - CIR, Unit of Electronics for Sensor Systems, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pennazza
authors.affiliation: Center for Integrated Research - CIR, Unit of Electronics for Sensor Systems, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Santonico
authors.affiliation: Clinical Medicine and Hepatology Department, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vespasiani-Gentilucci
authors.affiliation: Clinical Medicine and Hepatology Department, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Galati
authors.affiliation: Clinical Medicine and Hepatology Department, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gallo
authors.affiliation: Center for Integrated Research - CIR, Unit of Electronics for Sensor Systems, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Vernile
authors.affiliation: Chair of Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.affiliation: Chair of Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.|San Raffaele- Cittadella della Carità Foundation, Taranto, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli Incalzi
authors.affiliation: Clinical Medicine and Hepatology Department, Campus Bio-Medico University, via Alvaro del Portillo 200, 00128 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Picardi
mesh_terms: D000328:Adult; D000368:Aged; D001944:Breath Tests / Q000295:instrumentation*; D062609:Electronic Nose; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008107:Liver Diseases / Q000145:classification* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity