Recent Applications of Electronic-nose Technologies for the Noninvasive Early Diagnosis of Gastrointestinal Diseases

Conventional methods for diagnosing gastrointestinal (GI) diseases have involved analysis of headspace volatile organic compounds (VOCs) present in the breath, urine, or fecal samples of patients. Most previous diagnostic testing methods have utilized purely metabolomic approaches to analyze VOCs with analytical instruments such as gas chromatography-mass spectroscopy (GC-MS), nuclear magnetic resonance (NMR) metabolomics, selected ion flow tube-mass spectrometry (SIFT-MS), proton transfer reaction-mass spectrometry (PTR-MS), and field asymmetric ion mobility spectroscopy (FAIMS). These sophisticated and expensive methods usually involve the use of large immobile (non-portable) benchtop instruments, requiring extensive data manipulations and analyses along with advanced modeling procedures to achieve diagnostic interpretations of complex chemical data. Other approaches such as colonoscopies and biopsies are more invasive and discourage patient participation in prophylactic GI-disease screenings. The more recent availability of portable electronic gas-sensing devices, developed with the aim of simplifying disease diagnoses by analysis of headspace VOC mixtures collectively using multi-sensor arrays, allow the production of disease-specific aroma signatures (smellprints) based on detection of precise complex mixtures of disease biomarker metabolites. Electronic-nose (e-nose) devices provide very fast results, are easy to operate, and are more readily applicable to clinical practice. This paper summarizes some very recent e-nose technologies being developed and tested for GI-disease diagnostic applications, including ones with dual-technology and multi-technology sensor arrays for both pattern recognition and identification of key-metabolite chemical species. In addition, novel portable electronic devices, developed with new operational mechanisms and sensor types, are described which offer possibilities of providing new means of diagnosing GI-tract diseases.