Making a more accurate diagnosis is always important. This is particularly true when we are working with patients who have scarring diseases of the lung. An accurate diagnosis gives us the path to the most effective treatment available. In many cases, when the diagnosis is between two very similar diseases treatments can be conflicting and detrimental if poorly chosen.
So called “idiopathic pulmonary fibrosis” (IPF) is a disease which we see fairly often and is similar in presentation to at least two other scarring lung diseases. The only real way to make an accurate diagnosis is to look at a biopsy of the lung. This biopsy must be obtained surgically, which is associated with at least a 2% in hospital mortality. For this reason, other more indirect ways of making the diagnosis have evolved. These techniques primarily involve the use of CT scans. The findings on CT scans may be very supportive, but can miss early disease and must rely on the interpretation of the radiologist.
Recent work by researchers may provide a more accurate and safe way to achieve a diagnosis of IPF. The new approach involves analysis of 190 genes found in transbronchial lung biopsies. We have been doing transbronchial lung biopsies for decades and they have proven to have less risk than a surgical biopsy. As this technique develops, it is hoped that it will significantly contribute to our ability to get a more accurate diagnosis of IPF and, just as importantly, identify other diseases.