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Use of an Electronic Nose as a Novel Screening Method for the Diagnosis of Tuberculous Pleural Effusion
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A5543 - Use of an Electronic Nose as a Novel Screening Method for the Diagnosis of Tuberculous Pleural Effusion
Author Block: F. Poli1, L. Quesada1, S. Poli1, D. Garcia1, G. Ippoliti1, E. Salas2, J. Villalba1, J. H. de Waard2; 1Escuela de Medicina ""Dr. Jose Maria Vargas"" Universidad Central de Venezuela, Caracas, Venezuela, Bolivarian Republic of, 2Servicio Autónomo Instituto de Biomedicina ""Dr. Jacinto Convit"", Caracas, Venezuela, Bolivarian Republic of.
Rationale: Exhaled breath contains gaseous volatile compounds, which, analyzed as a whole and using a pattern recognition algorithm, can be used in the diagnosis of Tuberculous Pleural Effusion (TPE). Here we determined the accuracy of an electronic nose, the AeonoseTM, for the diagnosis of TPE and compare it with adenosine deaminase activity (ADA) in pleural fluid and culture of pleural fluid samples for M. tuberculosis.
Methods: 84 HIV-negative patients with clinical and radiological findings of a pleural effusion were enrolled in this study. All underwent a physical examination and were tested with the AeonoseTM. Pleural fluid samples were obtained for ADA determination, cytochemistry and microbiologic studies. Histopathology studies of the pleural biopsy were used as the gold standard for disease classification. A pattern recognition algorithm was developed, which differentiated between exhaled air of TPE patients from patients with other pleural diseases.
Results: Of the 84 patients, 34 were diagnosed with TPE as confirmed by the pleural biopsy. 50 subjects were diagnosed with lung cancer and other pleural diseases. The sensitivity and specificity of the AeonoseTM were 88% and 94% respectively. The ADA determination and pleural fluid culture had a sensitivity of 97% and 17.6% and a specificity of 96% and 100% respectively.
Conclusions: The AeonoseTM is a useful point-of-care device for screening of TPE. Although the ADA determination has a better diagnostic yield and the pleural fluid culture is more specific, the use of this device is a less invasive strategy and can be used for screening subjects who require further evaluation. Its simple design makes it an ideal tool for rural areas, where there is no laboratory facility to process pleural fluid samples or biopsies. Moreover, the pattern recognition algorithm is still in development and results will improve in the future.
Author Block: F. Poli1, L. Quesada1, S. Poli1, D. Garcia1, G. Ippoliti1, E. Salas2, J. Villalba1, J. H. de Waard2; 1Escuela de Medicina ""Dr. Jose Maria Vargas"" Universidad Central de Venezuela, Caracas, Venezuela, Bolivarian Republic of, 2Servicio Autónomo Instituto de Biomedicina ""Dr. Jacinto Convit"", Caracas, Venezuela, Bolivarian Republic of.
Rationale: Exhaled breath contains gaseous volatile compounds, which, analyzed as a whole and using a pattern recognition algorithm, can be used in the diagnosis of Tuberculous Pleural Effusion (TPE). Here we determined the accuracy of an electronic nose, the AeonoseTM, for the diagnosis of TPE and compare it with adenosine deaminase activity (ADA) in pleural fluid and culture of pleural fluid samples for M. tuberculosis.
Methods: 84 HIV-negative patients with clinical and radiological findings of a pleural effusion were enrolled in this study. All underwent a physical examination and were tested with the AeonoseTM. Pleural fluid samples were obtained for ADA determination, cytochemistry and microbiologic studies. Histopathology studies of the pleural biopsy were used as the gold standard for disease classification. A pattern recognition algorithm was developed, which differentiated between exhaled air of TPE patients from patients with other pleural diseases.
Results: Of the 84 patients, 34 were diagnosed with TPE as confirmed by the pleural biopsy. 50 subjects were diagnosed with lung cancer and other pleural diseases. The sensitivity and specificity of the AeonoseTM were 88% and 94% respectively. The ADA determination and pleural fluid culture had a sensitivity of 97% and 17.6% and a specificity of 96% and 100% respectively.
Conclusions: The AeonoseTM is a useful point-of-care device for screening of TPE. Although the ADA determination has a better diagnostic yield and the pleural fluid culture is more specific, the use of this device is a less invasive strategy and can be used for screening subjects who require further evaluation. Its simple design makes it an ideal tool for rural areas, where there is no laboratory facility to process pleural fluid samples or biopsies. Moreover, the pattern recognition algorithm is still in development and results will improve in the future.
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