{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:26:48Z","timestamp":1790508408868,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["113\u20102628\u2010B\u2010002\u2010017\u2010MY3"],"award-info":[{"award-number":["113\u20102628\u2010B\u2010002\u2010017\u2010MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Electronic Nose (eNose) breathprints are promising non\u2010invasive lung cancer diagnostic tools, but cross\u2010site validation and adaptation remain barriers to clinical applications. It remains unknown whether a natural language processing\u2010pretrained large language model (LLM) can enable few\u2010shot, site\u2010specific classification of lung cancer using eNose breathprints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected eNose breathprints of lung cancer and non\u2010lung cancer patients from two medical centres in Taiwan. A GPT\u20102\u2013backbone LLM with parameter\u2010efficient adaptation was compared with convolutional neural networks (CNN) trained from scratch or pretrained on CIFAR\u2010100. Few\u2010shot protocols (2\u20136 shots per class) and full\u2010data training were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We collected 432 eNose breathprints from two sites (S1 and S2). With 6 labelled samples per class (6 shots), LLM achieved an area under the curve (AUC) of 0.79 (95% CI: 0.71\u20130.87), sensitivity of 0.74 (0.63\u20130.83), and specificity of 0.77 (0.67\u20130.87) on S1. On S2, it achieved an AUC of 0.76 (0.69\u20130.82), sensitivity of 0.77 (0.69\u20130.84), and specificity of 0.61 (0.51\u20130.70). LLM outperforms scratch CNN models (S1; AUC: 0.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002) (S2; AUC: 0.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0198) and CNN pretrained on CIFAR\u2010100 images (S1; AUC: 0.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0100) and (S2; AUC: 0.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0248). LLM or a CNN model trained on the source site fails to improve performance after transferring to the target site for fine\u2010tuning; for the LLM, performance even deteriorates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study demonstrates the potential of pretrained LLMs for few\u2010shot lung cancer classification in a real\u2010world mixed clinical cohort, reducing dependence on large training datasets.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70266-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70266","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T23:21:23Z","timestamp":1779405683000},"page":"912-921","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Few\u2010Shot Lung Cancer Classification via Electronic Nose Using Large Language Models: A Multicentre Prospective Study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-4833","authenticated-orcid":false,"given":"Meng\u2010Rui","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Internal Medicine National Taiwan University Hospital Hsin\u2010Chu Branch  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering National Tsing Hua University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce Yue","family":"Sun","sequence":"additional","affiliation":[{"name":"International Bilingual School at Hsinchu\u2010Science\u2010Park  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Ru","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Internal Medicine Min\u2010Sheng General Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Yuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai\u2010Hui","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Nursing National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kea\u2010Tiong","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering National Tsing Hua University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-366X","authenticated-orcid":false,"given":"Jann\u2010Yuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8156-2413","authenticated-orcid":false,"given":"Chao\u2010Chi","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010Yuan","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-9392","authenticated-orcid":false,"given":"Chong\u2010Jen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.0377"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13480"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.05.006"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/s21227620"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408\u2010024\u201000776\u20101"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010024\u201002840\u2010z"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00723\u20102024"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.snb.2024.135578"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2021.10.005"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/mi13081260"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13061431"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.06.013"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.snb.2022.131652"},{"key":"e_1_2_11_16_1","unstructured":"T. B.Brown B.Mann N.Ryder et\u00a0al. \u201cLanguage Models Are Few\u2010Shot Learners \u201d [Preprint] arXiv(2020) https:\/\/doi.org\/10.48550\/arXiv.2005.14165."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1609\/aaai.v36i7.20729"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.5555\/3666122.3667999"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5555\/3666122.3666983"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2024.05.026"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2023.06.012"},{"key":"e_1_2_11_22_1","unstructured":"A.Krizhevsky V.Nair andG.Hinton \u201cCIFAR\u201010 and CIFAR\u2010100 Datasets \u201d University of Toronto(2009) https:\/\/www.cs.toronto.edu\/~kriz\/cifar.html."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.01.002"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13046\u2010024\u201003026\u20107"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.09.005"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209120"},{"key":"e_1_2_11_27_1","unstructured":"D.\u2010E.Jonas D.\u2010S.Reuland S.\u2010M.Reddy et\u00a0al. \u201cScreening for Lung Cancer With Low\u2010Dose Computed Tomography: An Evidence Review for the U.S. Preventive Services Task Force. [Internet] \u201d Rockville (MD): Agency for Healthcare Research and Quality (US) Report No.: 20\u201005266\u2010EF\u20101(2021)."},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408\u2010025\u201000828\u20100"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1088\/1752\u20107163\/add291"},{"key":"e_1_2_11_30_1","unstructured":"Z.Zhao C.Shen H.Tong et\u00a0al. \u201cFrom Images to Signals: Are Large Vision Models Useful for Time Series Analysis?\u201d [Preprint] arXiv(2025) https:\/\/doi.org\/10.48550\/arXiv.2505.24030."}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70266","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/resp.70266","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:27:14Z","timestamp":1788337634000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/resp.70266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/resp.70266"],"URL":"https:\/\/doi.org\/10.1002\/resp.70266","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"2025-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}