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Malignant mesothelioma diagnosis with an E-nose: an interview with Associate Professor Deborah Yates, UNSW

Published on August 16, 2012 at 5:20 AM

Interview with Associate Professor Deborah Yates, UNSW conducted by

April Cashin-Garbutt, BA Hons (Cantab)

 

Please could you give us a brief explanation of what malignant mesothelioma is and who it affects?

Malignant mesothelioma is a rare tumor of the pleura which is the lining of the inside of the chest wall. It is highly linked with asbestos exposure. Typically, people are exposed to asbestos and then some 30 to 50 years later they develop this very nasty pleural tumor. It grows on the inside of the chest wall and eventually kills them.

Malignant mesothelioma is actually increasing in incidence in parallel with the exposure that occurred in many countries some 30 to 40 years ago.

What methods are currently used to diagnose malignant mesothelioma?

Currently we do a chest X-ray and then we do a CT scan of the chest. After this, we usually proceed to further tests. One of the most important tests we do is called a thoracoscopic biopsy. This is quite an invasive procedure involving an operation.

The chest wall is cut. The surgeon removes some tissue from the lining of the chest wall (the pleura) and then they try to stick the lining of the lungs to the chest wall .This is performed so that all the fluid that occurs with the tumor is removed, so that it does not come back again.

Why has malignant mesothelioma traditionally been difficult to diagnose in its early stages?

This is partly because the symptoms of malignant mesothelioma tend to present quite late. It is also because the pleura is a hidden cavity. Parts of the body that are deep inside are, of course, more difficult to access, and therefore present problems in that it is more difficult to find tumors in these cavities.

It is particularly problematic when people already have abnormal pleurae from asbestos exposure. Some people may already have pleural plaques, or a condition called diffuse pleural thickening. Trying to make a diagnosis of a malignant change in an already abnormal pleura can be very hard.

You have recently been testing an electronic nose (E-nose) to aid the diagnosis of malignant mesothelioma. Please could you describe what one of these is?

It’s a device for measuring the chemical composition of the breath. It looks at the exhaled volatile organic compounds which are produced by the body’s metabolic processes.

These analysers have been in use for some time. They have been applied in industrial settings. For example, they can detect whether sulphur dioxide has leaked from a particular factory.

The best analogy is breath detection of alcohol. However, it is not the exactly same technology.

The E-nose is a hand held device which needs training. You give the device the chemical, or, in our case, the complex chemical breath fingerprint. This tells the device what malignant mesothelioma smells like. Then the nose is meant to recognise the next time it smells it.

This is just a preliminary study, which means it is an early study. Our work does need to be substantiated by a much larger study, but so far it looks quite promising.

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