We report on an artificially intelligent nanoarray based on molecularly modified gold nanoparticles and a random network of single-walled carbon nanotubes for noninvasive diagnosis and classification of a number of diseases from exhaled breath. The performance of this artificially intelligent nanoarray was clinically assessed on breath samples collected from 1404 subjects having one of 17 different disease conditions included in the study or having no evidence of any disease (healthy controls). Blind experiments showed that 86% accuracy could be achieved with the artificially intelligent nanoarray, allowing both detection and discrimination between the different disease conditions examined. Analysis of the artificially intelligent nanoarray also showed that each disease has its own unique breathprint, and that the presence of one disease would not screen out others. Cluster analysis showed a reasonable classification power of diseases from the same categories. The effect of confounding clinical and environmental factors on the performance of the nanoarray did not significantly alter the obtained results. The diagnosis and classification power of the nanoarray was also validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry. This analysis found that 13 exhaled chemical species, called volatile organic compounds, are associated with certain diseases, and the composition of this assembly of volatile organic compounds differs from one disease to another. Overall, these findings could contribute to one of the most important criteria for successful health intervention in the modern era, viz. easy-to-use, inexpensive (affordable), and miniaturized tools that could also be used for personalized screening, diagnosis, and follow-up of a number of diseases, which can clearly be extended by further development.

Clinical Trials.gov number, NCT01420588 (3/11/2013).

Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. All patients, including the controls, had undergone colonoscopy. The samples were analysed with two different techniques. The first technique relied on gas chromatography coupled with mass spectrometry (GC-MS) for identification and quantification of volatile organic compounds (VOCs). The T-test was used to identify significant VOCs (p values < 0.017). The second technique relied on sensor analysis with a pattern recognition method for building a breath pattern to identify different groups. Blind analysis or leave-one-out cross validation was conducted for validation. The GC-MS analysis revealed four significant VOCs that identified the tested groups; these were acetone and ethyl acetate (higher in CRC), ethanol and 4-methyl octane (lower in CRC). The sensor-analysis distinguished CRC from the control group with 85% sensitivity, 94% specificity and 91% accuracy. The performance of the sensors in identifying the advanced adenoma group from the non-advanced adenomas was 88% sensitivity, 100% specificity, and 94% accuracy. The performance of the sensors in identifying the advanced adenoma group was distinguished from the control group was 100% sensitivity, 88% specificity, and 94% accuracy. For summary, volatile marker testing by using sensor analysis is a promising noninvasive approach for CRC screening.Globally colorectal cancer (CRC) is the third most prevalent cancer and the fourth leading cause of death from malignant diseases. 1 The 5-year survival rate for colorectal cancer when diagnosed at an early stage before it has spread is about 90%. But only about four out of 10 colorectal cancers are found at that early stage. In advanced stages, the survival rates are substantially lower. Therefore, regular CRC screening or testing are considered as some of the most powerful tools for preventing colorectal cancer caused mortality. 2 Not only does CRC screening save lives, but it also is cost effective. Studies have shown that the cost-effectiveness of CRC screening is consistent with many other kinds of preventive services and is lower than some common interventions. 3 The laboratory-based faecal immunochemical test (FIT) is the test-of-choice currently in the EU. 4 Alternatively, several recent studies have demonstrated the ability of flexiblesigmoidoscopy to decrease the disease-specific mortality when used as a screening tool. 5-7 However, colonoscopy is considered better than sigmoidoscopy in preventing mortality. 8 Poland, Germany and Czech Republic are using colonoscopy as their primary screening tool. Nevertheless, the major problem with endoscopic methods for CRC screening is low compliance. 9 A systemic review of participation in CRC screening within trial settings after the first-time invitation has reported only...