Diagnosis of Helicobacter pylori by carbon-13 urea breath test using a portable mass spectrometer

Abstract

Context:In the non-invasive detection of markers of disease, mass spectrometry is able to detect small quantities of volatile markers in exhaled air. However, the problem of size, expense and immobility of conventional mass spectrometry equipment has restricted its use. Now, a smaller, less expensive, portable quadrupole mass spectrometer system has been developed. Helicobacter pylori has been implicated in the development of chronic gastritis, gastric and duodenal ulcers and gastric cancer.Objectives:To compare the results obtained from the presence of H. pylori by a carbon-13 urea test using a portable quadrupole mass spectrometer system with those from a fixed mass spectrometer in a hospital-based clinical trial.Methods:Following ethical approval, 45 patients attending a gastroenterology clinic at the Royal Liverpool University Hospital exhaled a breath sample into a Tedlar gas sampling bag. They then drank an orange juice containing urea radiolabelled with carbon and 30 min later gave a second breath sample. The carbon-13 content of both samples was measured using both quadrupole mass spectrometer systems. If the post-drink level exceeded the pre-drink level by 3% or more, a positive diagnosis for the presence of H. pylori was made.Results:The findings were compared to the results using conventional isotope ratio mass spectrometry using a laboratory-based magnetic sector instrument off-site. The results showed agreement in 39 of the 45 patients.Conclusions:This study suggests that a portable quadrupole mass spectrometer is a potential alternative to the conventional centralised testing equipment. Future development of the portable quadrupole mass spectrometer to reduce further its size and cost is indicated, together with further work to validate this new equipment and to enhance its use in mass spectrometry diagnosis of other medical conditions.

Diagnostic of Helicobacter pylori infection

“…A portable mass spectrometer was also tested in comparison to a fixed apparatus. An agreement was observed in only 39/45 patients tested, indicating that improvement is still necessary …”

“…An agreement was observed in only 39/45 patients tested, indicating that improvement is still necessary. 49…”

Helicobacter pylori Outer Membrane Vesicles and Extracellular Vesicles from Helicobacter pylori-Infected Cells in Gastric Disease Development

“…The 13 C-labeled carbon dioxide produced by the reaction is detected in the patient’s breath by mass spectrometry or using an isotope-selective infrared spectroscope [ 185 ]. In recent years, the development of portable mass spectrometers has reduced equipment size and the cost of the analysis [ 187 ]. Serology is useful mostly for screening and in epidemiological studies [ 188 ].…”

Recent Advances in Portable Biosensors for Biomarker Detection in Body Fluids

“…The biosensor consisted of a portable quadrupole mass spectrometer (QMS) system measuring carbon-13 levels in breath samples. The results from clinical samples showed an overall agreement of 87% when compared to the laboratory isotope ratio mass spectrometry (IRMS) results [ 55 ]. Acetone in breath samples appears in a relatively high concentration of approximately 100–500 ppb.…”

“…( b ) Prototype contact biosensor for glucose sensing [ 53 ]. ( c ) Schematic diagram of the portable QMS and vacuum system [ 55 ]. ( d ) Schematic and image of the portable breath acetone monitor with Si:WO3 gas sensors [ 56 ].…”