線維性間質性肺疾患の診断ツールとしての電子鼻技術の国際的検証
Bart J Formsma1, Iris G van der Sar1, Leda Yazbeck2,3
1Erasmus University Medical Center, Center of Excellence for ILD and Sarcoidosis, Department of Respiratory Medicine; Rotterdam, The Netherlands.
Introduction:
Fibrotic interstitial lung diseases (fILDs) are a heterogeneous group of rare lung diseases. Symptoms of ILD are non-specific, and diagnosis requires multiple investigations including invasive procedures. Therefore, diagnostic delay is common. Previous single-center studies showed that profiling of exhaled volatile organic compounds using non-invasive electronic nose (eNose) sensor technology has potential as diagnostic tool for ILD. We aimed to validate eNose technology to differentiate various ILDs in an international multicenter cohort.
Methods:
We included patients with an ILD diagnosis established in a multidisciplinary team (MDT) discussion and pulmonary fibrosis on HRCT scan in five international ILD expert centers. An eNose (SpiroNose®) was used for exhaled breath analysis. We compared eNose breath profiles of different ILD subtypes versus all other ILDs as a group, and across six different ILD subtypes. Breath profiles were analyzed with partial least squares discriminant and receiver operating characteristic analyses. Models were trained on data from a selection of centers and externally validated in other centers.
Results:
Breath profiles of 587 patients were analyzed. Comparing breath profiles of ILD subtypes versus all other ILDs resulted in area under the curve values (AUCs) ranging from 0.88-0.92 in the training set and 0.75-0.95 in the validation set. ILD subtypes could be discriminated with AUCs ranging from 0.95-0.98 in the training set and 0.83-0.93 in the validation set.
Discussion:
This international study demonstrates that eNose technology accurately differentiates breath profiles from patients with various ILDs. eNose technology holds potential as easy point-of-care tool for diagnosis of fILDs.
