Device for detection of hepatocellar carcinoma (HCC) using an octanoate breath test
Methods and systems for diagnosis, prognosis and monitoring of hepatocellular carcinoma (HCC). Specifically, the present invention relates to the use of breath tests based on isotope-labeled octanoate in the detection and monitoring of HCC.
1. A device for hepatocellular carcinoma (HCC) detection comprising a processor configured to:
obtaining a level of an isotope-labeled octanoate metabolic product measured in a subject's exhaled breath with a sensor following administering the isotope-labeled octanoate;
comparing the measured level of the isotope-labeled octanoate metabolic product to a reference level; and
detecting HCC based on a difference between the measured level of the isotope-labeled octanoate metabolic product and the reference level; wherein a significantly decreased level of isotope-labeled octanoate metabolic product is indicative of active HCC.
2. The device of claim 1 , wherein the processor is further configured to distinguish between impaired liver function caused by fibrosis or cirrhosis and HCC, based on the comparing.
3. The device of claim 1 , wherein the reference level is a level of isotope-labeled octanoate metabolic product typically measured in breath of healthy subjects.
4. The device of claim 1 , wherein the sensor is configured to perform continuous measurements.
5. The device of claim 1 , wherein the isotope-labeled octanoate is selected from the group consisting of carbon-13, carbon-14 and oxygen-18.
6. The device of claim 1 , wherein the processor is configured to generate at least one of a delta over baseline (DOB) curve, a percentage dose recovery (PDR) curve and/or a cumulative PDR (CPDR) curve, and to compare at least one parameter of said DOB, PDR or CPDR curves to at least one parameter of reference DOB, PDR and/or CPDR curves.
7. The device of claim 6 , wherein the processor is configured to generate a PDR curve and to compare at least one parameter of said PDR curve to at least one parameter of a reference PDR curve, wherein the at least one parameter is selected from the group consisting of PDR maximum level (peak height), time of appearance of the peak (time to peak) and the slope of rate of metabolism.
8. The device of claim 7 , wherein the parameter is peak height and/or time to peak, and wherein decreased peak height is indicative of HCC and a longer time to peak is indicative of HCC.
9. The device of claim 1 , wherein the processor is configured to obtain a disease etiology of the subject and to normalize the measured level of isotope-labeled octanoate metabolic product according to the disease etiology.
10. The device of claim 9 , wherein the disease etiology is NASH or NAFLD.
11. The device of claim 1 , wherein the processor is further configured to obtain one or more blood test results and to normalize the measured level of isotope-labeled octanoate metabolic product according to the one or more blood test results.
12. The device of claim 11 , wherein the blood test results are selected from the group consisting of: fasting glucose levels, insulin levels, ALT levels, AST levels, ALP levels, GGTP levels, bilirubin levels, albumin levels and sodium levels.
13. The device of claim 1 , wherein the processor is further configured to obtain a treatment that the subject is receiving or has received and to normalize the measured level of isotope-labeled octanoate metabolic product according to the treatment.
14. The device of claim 13 , wherein the treatment is sorafenib.
15. The device of claim 1 , wherein the processor is further configured to obtain values indicative of CO 2 levels in the subject breath.
16. The device of claim 1 , further comprising a CO 2 sensor.