Advanced Technologies for the Diagnosis of Pulmonary Tuberculosis Using Exhaled Breath Samples: A Systematic Scoping...

Area of Science:

• Respiratory Medicine
• Diagnostic Technologies
• Biomarker Discovery

Background:

• Pulmonary tuberculosis (TB) diagnosis is challenging in resource-limited settings.
• Non-invasive methods using exhaled breath offer potential alternatives to sputum analysis.
• Advanced technologies are being explored for TB detection in breath samples.

Purpose of the Study:

• To map the evidence on advanced technologies for detecting pulmonary TB using exhaled breath.
• To review diagnostic performance metrics of these non-invasive methods.
• To assess the readiness of these technologies for clinical implementation.

Main Methods:

• A comprehensive scoping review of studies published between 2010-2025.
• Searches conducted in major scientific databases (PubMed, Scopus, Web of Science).
• Inclusion of primary studies evaluating physical or chemical diagnostic methods on exhaled breath samples for TB detection.

Main Results:

• 19 studies were included, primarily from high TB-burden countries.
• Electronic nose (e-nose), GC-MS/MS, and ML-MS were the most evaluated techniques.
• While some near point-of-care screening tests met sensitivity requirements, specificity remains a challenge; highest reported performance: 98.5% sensitivity, 100% specificity.

Conclusions:

• Exhaled breath technologies for TB diagnosis are advancing with promising performance.
• Standardized validation, methodological improvements, and real-world field testing are crucial.
• Implementation requires further development to overcome current limitations.