Variability in the concentrations of volatile metabolites emitted by genotypically different strains of Pseudomonas aeruginosa.

AIMS: To characterize the volatile metabolites produced by genotypically diverse strains of Pseudomonas aeruginosa in order to evaluate their potential for use as biomarkers of lung infection in noninvasive breath analysis. METHODS AND RESULTS: Volatile organic compounds (VOCs) emitted from 36 clinical strains of Ps. aeruginosa (belonging to different multilocus sequence types) cultured in liquid and on solid media were analysed by gas chromatography mass spectrometry (GC-MS) and selected ion flow tube mass spectrometry (SIFT-MS). Several previously identified VOCs were detected, including ethanol, acetone, 2-butanone, 2-pentanone, isoprene, aminoacetophenone, dimethyl sulphide, dimethyl disulphide, dimethyl trisulphide and methyl thiocyanate. Additionally, significant production of 3-methyl-butanone, acetophenone, methylthioacetate and methyl thiobutanoate was observed for the first time in this study. SIFT-MS quantifications of VOCs showed high variability between genotypically distinct strains. CONCLUSIONS: The data obtained indicate that the production rates of the volatile biomarkers of Ps. aeruginosa vary by two orders of magnitude between different strains cultured under the same conditions. Similar variability was observed for both liquid and solid media. SIGNIFICANCE AND IMPACT OF THE STUDY: Inter-strain genotypic variability strongly influences the concentrations of the volatile biomarkers from Ps. aeruginosa. A group of several biomarkers quantified in real time in exhaled breath may thus provide a more valuable indicator of the course of pulmonary infections compared to a single biomarker.

Variation in hydrogen cyanide production between different strains of Pseudomonas aeruginosa.

There is increasing interest in using the cyanogenic properties of Pseudomonas aeruginosa to develop a nonmicrobiological method for its detection. Prior to this, the variation in cyanide production between different P. aeruginosa strains needs to be investigated. Hydrogen cyanide (HCN) released into the gas phase by 96 genotyped P. aeruginosa samples was measured using selected ion flow tube-mass spectrometry after 24, 48, 72 and 96 h of incubation. The HCN produced by a range of non-P. aeruginosa cultures and incubated blank plates was also measured. All P. aeruginosa strains produced more HCN than the control samples, which generated extremely low levels. Analysis across all time-points demonstrated that nonmucoid samples produced more HCN than the mucoid samples (p=0.003), but this relationship varied according to strain. There were clear differences in the headspace HCN concentration for different strains. Multivariate analysis of headspace HCN for the commonest strains (Liverpool, Midlands_1 and Stoke-on-Trent, UK) revealed a significant effect of strain (p<0.001) and a borderline interaction of strain and phenotype (p=0.051). This evidence confirms that all P. aeruginosa strains produce HCN but to varying degrees and generates interest in the possible future clinical applications of the cyanogenic properties of P. aeruginosa.

Quantification of methane in humid air and exhaled breath using selected ion flow tube mass spectrometry.

In selected ion flow tube mass spectrometry, SIFT-MS, analyses of humid air and breath, it is essential to consider and account for the influence of water vapour in the media, which can be profound for the analysis of some compounds, including H(2)CO, H(2)S and notably CO(2). To date, the analysis of methane has not been considered, since it is known to be unreactive with H(3)O(+) and NO(+), the most important precursor ions for SIFT-MS analyses, and it reacts only slowly with the other available precursor ion, O(2) (+). However, we have now experimentally investigated methane analysis and report that it can be quantified in both air and exhaled breath by exploiting the slow O(2) (+)/CH(4) reaction that produces CH(3)O(2) (+) ions. We show that the ion chemistry is significantly influenced by the presence of water vapour in the sample, which must be quantified if accurate analyses are to be performed. Thus, we have carried out a study of the loss rate of the CH(3)O(2) (+) analytical ion as a function of sample humidity and deduced an appropriate kinetics library entry that provides an accurate analysis of methane in air and breath by SIFT-MS. However, the associated limit of detection is rather high, at 0.2 parts-per-million, ppm. We then measured the methane levels, together with acetone levels, in the exhaled breath of 75 volunteers, all within a period of 3 h, which shows the remarkable sample throughput rate possible with SIFT-MS. The mean methane level in ambient air is seen to be 2 ppm with little spread and that in exhaled breath is 6 ppm, ranging from near-ambient levels to 30 ppm, with no significant variation with age and gender. Methane can now be included in the wide ranging analyses of exhaled breath that are currently being carried out using SIFT-MS.

Concentrations of some metabolites in the breath of healthy children aged 7-18 years measured using selected ion flow tube mass spectrometry (SIFT-MS).

Using selected ion flow tube mass spectrometry (SIFT-MS), measurements have been made of the levels of several metabolites in the exhaled breath of 200 healthy school children. Thus, concentration distributions of each metabolite have been obtained for the first time in the paediatric age range. The median values (in parentheses) of the concentrations in parts per billion, ppb, were ammonia (628), acetone (297), methanol (193), ethanol (187), isoprene (37), propanol (16), acetaldehyde (23) and pentanol (15). Hydrogen cyanide was not present in the breath above the detection limit of 2 ppb in the majority of subjects. The water vapour level (humidity) of the breath samples was routinely measured as a check on the sample integrity. Such data are essential if SIFT-MS breath analyses are to be used as a clinical tool to aid diagnosis and/or as a monitor of disease in children. The levels of metabolites usually followed a log-normal distribution and the levels of some compounds were similar to those obtained previously in adults. Lower values were found in the levels of acetone, ammonia, methanol and isoprene. There were no major variations in relation to gender. Some metabolites showed significant variation in relation to age and body mass index. To our knowledge, these are the first measurements of exhaled mouth breath pentanol levels. The median ammonia levels in mouth-exhaled breath of these children decreased with age, whereas in older adults, ammonia has been shown to increase with age. Breath acetone levels were significantly increased for those who had not eaten for more than 6 h prior to providing the breath sample, although dietary control was not a mandatory aspect of the protocol.

A study of sulfur-containing compounds in mouth- and nose-exhaled breath and in the oral cavity using selected ion flow tube mass spectrometry.

We have carried out a selected ion flow tube mass spectrometry (SIFT-MS) study of the concentrations of the sulfur-containing compounds H(2)S (using H(3)O(+) precursor ions), CH(3)SH (H(3)O(+)), (CH(3))(2)S (O(2)(+)), (CH(3))(2)S(2) (NO(+)) and CS(2) (O(2)(+)) in single exhalations of mouth-exhaled breath and nose-exhaled breath and in the static gas in the oral cavity for two healthy volunteers. The primary purpose of the study was to show how compounds present in breath at levels as low as a part per billion (ppb) can be identified and quantified if the overlap of 'impurity' isobaric ions with the analytical product ions for each trace compound is identified and accounted for. The H(2)S measurements are straightforward using H(3)O(+) precursor ions, since no overlapping ions are recognized and its breath concentration is relatively high at typically 20-70 ppb. Thus, its concentration distribution for two healthy volunteers has been obtained over a period of a few weeks. The situation is very similar for CH(3)SH, but to analyse this compound we had to study the kinetics of its reactions with the SIFT-MS reagent ions H(3)O(+), NO(+) and O(2)(+) in order to provide the required kinetics library data for this compound. It is seen that CH(3)SH, (CH(3))(2)S and (CH(3))(2)S(2) are present in the mouth breath/cavity at lower levels of <10 ppb. The measurements of the levels of H(2)S and these compounds in the nose-exhaled breath and the closed mouth indicate that they are largely produced in the oral cavity, although there is some indication that (CH(3))(2)S is partially systemic in these two volunteers. It was not possible to quantify CS(2) in the breath because of serious interference (overlapping ions) due to the presence of carbon dioxide and acetone that inevitably occur in exhaled breath. This study paves the way for the accurate analysis of these sulfur compounds in halitosis and potentially for probing the diseased state, especially liver disease, by breath analysis. To demonstrate the simplicity of measuring these compounds when they are present at levels of about 100 ppb and greater, data are presented on the emissions of these sulfur-containing compounds from Pseudomonas bacterial cultures in vitro.

Selected ion flow tube mass spectrometry for on-line trace gas analysis in biology and medicine.

Selected ion flow tube mass spectrometry, (SIFT-MS), is a technique for simultaneous real-time quantification of several trace gases in air and exhaled breath. It relies on chemical ionization of the trace gas molecules in air/breath samples introduced into helium carrier gas, using H(3)O(+), NO(+) and O(2)(+) reagent (precursor ions). Reactions between the precursor ions and the trace gas molecules proceed for an accurately defined time, the precursor and product ions being detected and counted by a downstream mass spectrometer. Absolute concentrations of trace gases in single breath exhalation can be determined by SIFT-MS down to parts-per-billion (ppb) levels, obviating sample collection into bags or onto traps. Calibration using chemical standards is not required, as the concentrations are calculated using the known reaction rate constants and measured flow rates and pressures. SIFT-MS has been used for many pilot investigations in several areas of research, especially as a non-invasive breath analysis tool to investigate physiological processes in humans and animals, for clinical diagnosis and for therapeutic monitoring. Examples of the results obtained from several such studies are outlined to demonstrate the potential of SIFT-MS for trace gas analysis of air, exhaled breath and the headspace above liquids.

Quantitative selected ion flow tube mass spectrometry: the influence of ionic diffusion and mass discrimination.

Selected ion flow tube mass spectrometry, (SIFT-MS), involves the partial conversion of mass-selected precursor ions to product ions in their reactions with the trace gases in an air sample that is introduced into helium carrier gas in a flow tube. The precursor and product ions are then detected and counted by a downstream quadrupole mass spectrometer. Quantification of particular trace gases is thus achieved from the ratio of the total count rate of the product ions to that for the precursor ions. However, it is important to appreciate that in this ion chemistry the light precursor ions (usually H3O+ ions) are invariably converted to heavier product ions. Hence, the product ions diffuse to the flow tube walls more slowly and thus they are more efficiently transported to the downstream mass spectrometer sampling orifice. This phenomenon we refer to as diffusion enhancement. Further, it is a well-known fact that discrimination can occur against ions of large mass-to-charge ratio, (m/z), in quadrupole mass spectrometers. If not accounted for, diffusion enhancement usually results in erroneously high trace gas concentrations and mass discrimination results in erroneously low concentrations. In this experimental investigation, we show how both these counteracting effects can be accounted for to increase the accuracy of SIFT-MS quantification. This is achieved by relating the currents of ions of various m/z that arrive at the downstream mass spectrometer sampling orifice disc to their count rates at the ion detector after mass analysis. Thus, both diffusion enhancement and mass discrimination are parameterized as a function of m/z and these are combined to provide an overall discrimination factor for the particular analytical instrument.

Assessment of rumen processes by selected-ion-flow-tube mass spectrometric analysis of rumen gases.

This work investigated the potential to use measurement of the concentration of certain gases in the rumen headspace to gain information about rumen processes and as a potential diagnostic tool. We used new equipment (selected-ion-flow-tube mass spectrometer) that allows rapid and precise analysis of many of the gases present in a sample. Samples of rumen headspace gas and corresponding samples of rumen liquor were taken from three lactating cows, prepared with rumen fistulae, at intervals after receiving their morning feed allocation (grass silage and concentrates). Hydrogen sulfide, methyl sulfide, and dimethyl sulfide, were the predominant gases that were measured in the rumen headspace by this technique. The concentrations of these sulfur compounds declined over the interval after feeding, mirroring ammonia concentrations measured in rumen liquor, reflecting their common dependence on the fermentation of sulfur amino acids. Ammonia concentrations in rumen headspace gas varied in the opposite direction to the concentration of ammonia in rumen liquor and likely depend more on the pH of rumen liquor. Consideration of the pKa of ammonia suggests that ammonia concentrations in rumen gas will be very low below pH 6, representing a useful diagnostic for subacute ruminal acidosis. Low concentrations of volatile fatty acids were detected in rumen gas. The molar proportions of volatile fatty acids were similar in gas and liquor samples, with rumen gas containing slightly less acetic acid and disproportionately more valeric and caproic acids.

Accuracy and precision of flowing afterglow mass spectrometry for the determination of the deuterium abundance in the headspace of aqueous liquids and exhaled breath water.

We have assessed the accuracy and precision of our flowing afterglow mass spectrometric method (FA-MS) for absolute measurements of deuterium abundance in water using standardised tap water/D(2)O mixtures within the D/H range from 155 ppm (local tap water) to 1104 ppm, prepared by the gravimetric method. The results of this study show that a precision and accuracy of 1% can be achieved for the deuterium abundance in water samples. This is quite adequate for the main application, which is the rapid, non-invasive measurement of total body water by deuterium analysis of breath water vapour using the D(2)O dilution method.

On-line measurement of the absolute humidity of air, breath and liquid headspace samples by selected ion flow tube mass spectrometry.

We describe how selected ion flow tube mass spectrometry (SIFT-MS) can be used to determine the absolute humidity of air, breath and liquid headspace samples. This involves the determination of the relative count rates of the H3O+ ions and those H3O+.(H2O)(1,2,3) hydrate ions that inevitably form in the helium carrier gas when humid samples are being analysed by SIFT-MS using H3O+ precursor ions. This requires an understanding of the kinetics of hydrated hydronium ion formation, the involvement of mass discrimination in the analytical quadrupole mass spectrometer and the decreased diffusive loss of the heavier hydrates along the flow tube. Thus, we show that the humidity of breath and liquid headspace samples, typically at the few percent level, can be directly obtained on-line to the SIFT-MS instrument along with the concentrations of trace gases, which are present at much lower levels. We emphasise the value of parallel humidity measurements in ensuring good real-time sampling of breath and liquid headspace and the value of such measurements to trace gas analysis using SIFT-MS.

A new 'online' method to measure increased exhaled isoprene in end-stage renal failure.

BACKGROUND: Isoprene is the most abundant hydrocarbon present in breath, and recent reports indicate that breath concentrations increase following haemodialysis. The purpose of this study was to establish whether selected ion flow tube mass spectrometry (SIFT-MS), a newly established technique in breath analysis, may be used to quantify breath isoprene in haemodialysis patients in the clinical setting. SIFT-MS is compared and contrasted with the established gas chromatography mass spectrometric technique for this purpose. METHODS: Three consecutive exhalations from 19 haemodialysis patients (12 males, seven females) undergoing a morning dialysis shift were analysed just prior to commencing treatment. Within 5 min of completing their usual dialysis regimen, using polysulphone membranes, the breath of each patient was analysed again. Additional contemporary samples were obtained from 17 normal controls. Breath isoprene was quantified using SIFT-MS, a method previously validated quantitatively using neat isoprene. RESULTS: Successful measurements of breath isoprene were obtained for each subject within 2 min, with minimum disruption to a busy dialysis environment. The coefficient of variation of triplicate measurements of breath isoprene was <10%. Prior to dialysis, the mean (+/-SD) breath isoprene concentration (138+/-63 parts per billion (ppb)) was significantly greater than for normal controls (89+/-36 ppb; P=0.016). Immediately following treatment, breath isoprene increased significantly to 184+/-95 ppb (P=0.023). CONCLUSIONS: SIFT-MS permits the accurate and rapid measurement of breath isoprene in haemodialysis patients in the clinical setting. The previously reported increase in breath isoprene following dialysis treatment is confirmed. SIFT-MS is the ideal analytical tool to investigate this phenomenon further.

On-line determination of the deuterium abundance in breath water vapour by flowing afterglow mass spectrometry with applications to measurements of total body water.

We have developed a new method for the on-line quantification of deuterium in water vapour. We call this method flowing afterglow mass spectrometry (FA-MS). A swarm of H3O+ precursor ions is created in flowing helium carrier gas by a microwave discharge. These precursor ions react with the H2O, HDO, H2(17)O and H2(18)O molecules in a water vapour sample that is introduced into the carrier gas/H3O+ ion swarm. The hydrated ions, H3O+.(H2O)3 at m/z 73, and their isotopic variant ions H8DO4(+) and H9(17)OO(3)(+) at m/z 74 and H9(18)OO(3)(+) at m/z 75, are thus formed. By adopting the known fractional abundance of 18O in water vapour, and accounting for the contribution of the isotopic ions H9(17)OO(3)(+) to the ion signal at m/z 74, a measurement of the 74/75 ion signal ratio under equilibrium conditions provides the fractional deuterium abundance in the water vapour sample. Using this technique, the deuterium abundance in the water vapour present in single exhalations of breath can be determined. Thus, from the temporal variations of breath deuterium following the ingestion of a known quantity of D(2)O, we show that total body water can be determined non-invasively and the kinetics of water flow around the body can be tracked.

Rapid measurement of deuterium content of breath following oral ingestion to determine body water.

The ability to measure total body water accurately, non-invasively and rapidly with results that are immediately available would represent an important advance in body composition research. Flowing afterglow mass spectrometry (FA-MS) has been developed to enable immediate measurement of deuterium content in breath water from single exhalations, which when combined with oral D2O loading enables measurement of total body water. We report here its first use in normal subjects, demonstrating the dispersal kinetics of deuterium in the body by monitoring deuterium in breath water following ingestion. Ten studies were performed in six normal subjects. After obtaining baseline samples, each subject ingested 0.3 g x kg(-1) of 99.9% pure D2O. Subsequently, breath samples were obtained every 3-5 minutes until equilibration had occurred. Three distinct phases in breath deuterium content were observed: an initial immediate peak due to HDO remaining in the oral cavity, a secondary peak reflecting gastrointestinal absorption and finally equilibration with the body water. The incremental increase in breath deuterium abundance between baseline and equilibration was used to calculate the total body water. Mathematical fitting of this final equilibration phase demonstrated that the measured deuterium abundance was within 0.2% of the ideal (asymptotic) value within 2 hours in all cases. We conclude that FA-MS is a powerful new method that, when combined with oral D2O loading, enables measurement of the dispersal kinetics of HDO and the calculation of total body water within 2 hours.

Influence of water vapour on selected ion flow tube mass spectrometric analyses of trace gases in humid air and breath.

Selected ion flow tube mass spectrometry (SIFT-MS) detects and quantifies in real time the trace gases, M, in air/breath samples introduced directly into a flow tube. Inevitably, relatively large partial pressures of water vapour are introduced with the sample and the water molecules become involved in the ion chemistry on which this analytical technique depends. When H(3)O(+) ions are used as the precursors for chemical ionisation and SIFT mass spectrometric analyses of M, they generally result in the formation of MH(+) ions. Also, when water vapour is present the H(3)O(+) ions are partially converted to hydrated hydronium ions, H(3)O(+).(H(2)O)(1,2,3). The latter may act as precursor ions and produce new product ions like MH(+).(H(2)O)(1,2,3) via ligand switching and association reactions. This ion chemistry and the product ions that result from it must be accounted for in accurate analyses by SIFT-MS. In this paper we describe the results of a detailed SIFT study of the reactions involved in the quantification of acetone, ethyl acetate, diethyl ether, methanol, ethanol, ammonia and methyl cyanide by SIFT-MS in the presence of water vapour. This study was undertaken to provide the essential data that allows more accurate analyses of moist air and breath by SIFT-MS to be achieved. It is shown using our standard analysis procedure that the error of SIFT-MS quantification caused by the presence of water vapour is typically 15%. An improved analysis procedure is then presented that is shown to reduce this error to typically 2%. Additionally, some fundamental data have been obtained on the association reactions of protonated organic molecules, MH(+) ions, with water molecules forming MH(+).H(2)O monohydrate ions. For some types of M, reaction sequences occur that lead to the formation of dihydrate and trihydrate ions.

Selected ion flow tube mass spectrometry analyses of stable isotopes in water: isotopic composition of H3O+ and H3O+ (H2O)3 ions in exchange reactions with water vapor

A new method has been developed for the determination of the isotope abundance ratios of deuterium, D, and oxygen-18, 18O, in water vapor (and water) using selected ion flow tube mass spectrometry (SIFT-MS). H3O+ ions are injected into the helium carrier gas where they associate with the H2O and HDO molecules in a sample of water introduced into the carrier gas. The D and 18O contents of the product cluster ions H8DO4+ and H9(18)OO3+ at m/e = 74 and 75, respectively, are determined by reference to the majority cluster ion H9O4+ at m/e = 73. Allowance is made for the contribution of the H8(17)OO3+ ions to the m/z = 74 ions. Absolute isotopic ratios are measured within seconds without the need for precalibration of the SIFT-MS instrument, currently to an accuracy of better than 2%.

Quantification of hydrogen sulphide in humid air by selected ion flow tube mass spectrometry.

We report the results of a study of the reactions of H(3)O(+), NO(+) and O(2)(+.) ions with H(2)S. This study was undertaken to provide a thorough understanding of the ion chemistry required for accurate quantification of H(2)S in humid air by selected ion flow tube mass spectrometry (SIFT-MS). It shows that slow reactions occur between H(3)S(+), the primary product ions of the H(3)O(+)/H(2)S reaction, and the abundant H(2)O molecules present in humid air and breath. These reactions disturb somewhat the quantification of H(2)S by this analytical method, but the kinetic data obtained in this study facilitate precise quantification of H(2)S in humid air. This study also shows that NO(+) does not react with H(2)S, and that O(2)(+.) does react rapidly with H(2)S, but the product H(2)S(+.) ions react rapidly with H(2)O. Thus, NO(+) and O(2)(+.) cannot be used as precursor ion for analysis of H(2)S in moist air by SIFT-MS. A sample SIFT mass spectrum is shown from which H(2)S and several other volatile compounds have been quantified in a sample of cow rumen gas.

An investigation of the reactions of H3O+ and O2+ with NO, NO2, N2O and HNO2 in support of selected ion flow tube mass spectrometry

A selected ion flow tube (SIFT) experimental investigation has been carried out of the reactions of H3O+, NO+ and O2+ with NO, NO2, N2O and HNO2, in order to obtain the essential kinetic data for the analyses of these compounds in air using selected ion flow tube mass spectrometry (SIFT-MS). These investigations show that NO+ ions do not react at a significant rate with any of these NOx compounds and that H3O+ ions react only with HNO2 (product ions H2NO2+ (75%) and NO+ (25%)). O2+ ions react with NO (product ion NO+), NO2 (product ion NO2+) and HNO2 (product ions NO+ (75%), NO2+ (25%)), but not with N2O. We conclude that both NO and NO2 can be accurately quantified in air using only O2+ precursor ions and SIFT-MS when HNO2 is not present. However, when HNO2 is present it invariably co-exists with both NO and NO2 and then both H3O+ and O2+ precursor ions are needed to determine the partial pressures of NO, NO2 and HNO2 in the air mixture. We also conclude that currently N2O cannot be analysed in air using SIFT-MS.

Trace gases in breath of healthy volunteers when fasting and after a protein-calorie meal: a preliminary study.

The selected ion flow tube technique was used to quantify in breath the trace gases acetone, ammonia, ethanol, isoprene, and methanol during single exhalations while fasting and in response to feeding. Six normal volunteers were fasted for 12 h, and, after baseline breath samples were obtained, were fed a liquid protein-calorie meal to provide 0.47 g/kg of protein (Fortisip). Further breath samples were obtained at 20, 40, and 60 min, and then hourly for a further 5 h. Breath acetone concentrations fell from a maximum during fasting, reaching their nadir between 4 and 5 h. Breath ammonia concentrations fell immediately to one-half their fasting levels before a steady increase to two or three times baseline values at 5 h. There was a brief increase in breath ethanol concentrations after feeding, reflecting detectable ethanol contamination of the food. Subsequently, breath ethanol levels remained low throughout the experimental protocol. Isoprene concentrations did not change significantly, whereas changes in methanol concentrations reflected those in the ambient air. This preliminary study indicates that the selected ion flow tube technique may be used to detect changes in the trace gases present in breath and define their concentrations in the fasting and replete state. Of particular interest is the biphasic response of the breath ammonia concentration after feeding.

Quantification of breath isoprene using the selected ion flow tube mass spectrometric analytical method.

We have used our selected ion flow tube mass spectrometric method (SIFT-MS) to study isoprene levels in the alveolar breath of 29 healthy volunteers during normal working hours at the varying states of nutrition occurring during this period. Quantification of the breath isoprene was achieved using O(2)(+) precursor ions to avoid complications which can arise when using H(3)O(+) precursor ions for isoprene analysis. The present data indicate that the spread of the alveolar isoprene levels in this sample of healthy individuals is 22 to 234 ppb and that the mean value is 83 ppb with a standard deviation of 45 ppb. These levels are compared with those previously determined using other techniques and are seen to be at the low end of the values previously reported. The present studies are a prelude to an investigation of the proposed correlation of breath isoprene levels with psychological, physical and biochemical stress.

Analysis of formaldehyde in the headspace of urine from bladder and prostate cancer patients using selected ion flow tube mass spectrometry.

We have used selected ion flow tube mass spectrometry (SIFT-MS) to determine the concentration of formaldehyde in the headspace of urine from patients suffering from bladder and prostate cancer and from several healthy subjects as controls. We address the potential problems associated with the use of ion chemistry to quantify formaldehyde in the presence of the relatively large number densities of water molecules and show that formaldehyde can be quantified in urine headspace using analysis by SIFT-MS. These studies show that formaldehyde is clearly elevated in the headspace of the urine from the cancer patients as compared with urine from the healthy controls. Thus, with further improvements in the methodology and the sensitivity of our SIFT-MS technique, formaldehyde quantification in urine headspace using this new analytical method could be a valuable non-invasive indicator of the presence of early-stage tumours in the body.