Breath Analysis Distinguishes Between Malignant and Benign Pulmonary Nodules

The volatile organic compounds in exhaled breath were examined by two techniques, gas chromatography with mass spectrometry, and chemical nanoarrays.

Exhaled breath was collected from 74 patients who were under investigation for pulmonary nodules and attended a referral clinic in Colorado between March 2009 and May 2010. Scientists from Israel and Colorado analyzed the exhaled breath from each patient for volatile organic compounds. The patients also underwent a bronchoscopy, wedge resection, and/or lobectomy, whichever was required for final diagnosis. Nodules that either regressed or remained stable over a 24-month period were considered benign.


Profiles of volatile organic compounds were determined by gas chromatography/mass spectrometry (GC-MS) combined with solid-phase microextraction and by a chemical nanoarray. Both techniques accurately identified that 53 pulmonary nodules were malignant and 19 were benign.


The chemical nanoarrays also discriminated between adenocarcinoma and squamous cell carcinoma and between early versus advanced disease. The nanoarrays were developed by Prof. Hossam Haick and his colleagues at the Technion-Israel Institute of Technology (Haifa, Israel).


The pilot study, in order to be validated, needs to be repeated using a larger cohort of subjects. The testing could serve as a secondary screener for patients who were found to have pulmonary nodules after CT screening. Low-dose CT screening has reduced the mortality rate by 20% but many people still undergo invasive procedures only to learn that their pulmonary nodules are not cancerous.


The pilot study was published in the October 2012 issue of the International Association for the Study of Lung Cancer’s (IASLC) Journal of Thoracic Oncology.


The authors commented, “The reported breath test in this study could have significant impact on reducing unnecessary investigation and reducing the risk of procedure-related morbidity and costs. In addition, it could facilitate faster therapeutic intervention, replacing time-consuming clinical follow-up that would eventually lead to the same intervention.”

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Technion-Israel Institute of Technology