Universität zu Köln

Richeldi, Luca, Scholand, Mary Beth, Lynch, David A., Colby, Thomas, V, Myers, Jeffrey L., Groshong, Steve D., Chung, Jonathan H., Benzaquen, Sadia, Nathan, Steven D., Davis, J. Russell, Schmidt, Shelley L., Hagmeyer, Lars, Sonetti, David, Hetzel, Jurgen, Criner, Gerard J., Case, Amy H., Ramaswamy, Murali, Calero, Karel, Gauhar, Umair A., Patel, Nina M., Lancaster, Lisa, Choi, Yoonha, Pankratz, Daniel G., Walsh, P. Sean, Lofaro, Lori R., Huang, Jing, Bhorade, Sangeeta M., Kennedy, Giulia C., Martinez, Fernando J. and Raghu, Ganesh (2021). Utility of a Molecular Classifier as a Complement to High-Resolution Computed Tomography to Identify Usual Interstitial Pneumonia. Am. J. Respir. Crit. Care Med., 203 (2). S. 211 - 221. NEW YORK: AMER THORACIC SOC. ISSN 1535-4970

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Abstract

Rationale: Usual interstitial pneumonia (UIP) is the defining morphology of idiopathic pulmonary fibrosis (IPF). Guidelines for IPF diagnosis conditionally recommend surgical lung biopsy for histopathology diagnosis of UIP when radiology and clinical context are not definitive. A molecular diagnosis of UIP in transbronchial lung biopsy, the Envisia Genomic Classifier, accurately predicted histopathologic UIP. Objectives: We evaluated the combined accuracy of the Envisia Genomic Classifier and local radiology in the detection of UIP pattern. Methods: Ninety-six patients who had diagnostic lung pathology as well as a transbronchial lung biopsy for molecular testing with Envisia Genomic Classifier were included in this analysis. The classifier results were scored against reference pathology. UIP identified on high-resolution computed tomography (HRCT) as documented by features in local radiologists' reports was compared with histopathology. Measurements and Main Results: In 96 patients, the Envisia Classifier achieved a specificity of 92.1% (confidence interval [CI],78.6-98.3%) and a sensitivity of 60.3% (CI, 46.6-73.0%) for histology-proven UIP pattern. Local radiologists identified UIP in 18 of 53 patients with UIP histopathology, with a sensitivity of 34.0% (CI, 21.5-48.3%) and a specificity of 96.9% (CI, 83.8-100%). In conjunction with HRCT patterns of UIP, the Envisia Classifier results identified 24 additional patients with UIP (sensitivity 79.2%; specificity 90.6%). Conclusions: In 96 patients with suspected interstitial lung disease, the Envisia Genomic Classifier identified UIP regardless of HRCT pattern. These results suggest that recognition of a UIP pattern by the Envisia Genomic Classifier combined with HRCT and clinical factors in a multidisciplinary discussion may assist clinicians in making an interstitial lung disease (especially IPF) diagnosis without the need for a surgical lung biopsy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Richeldi, Luca UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholand, Mary Beth UNSPECIFIED UNSPECIFIED UNSPECIFIED Lynch, David A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Colby, Thomas, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Myers, Jeffrey L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Groshong, Steve D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chung, Jonathan H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzaquen, Sadia UNSPECIFIED UNSPECIFIED UNSPECIFIED Nathan, Steven D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Davis, J. Russell UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Shelley L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagmeyer, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Sonetti, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Hetzel, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Criner, Gerard J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Case, Amy H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ramaswamy, Murali UNSPECIFIED UNSPECIFIED UNSPECIFIED Calero, Karel UNSPECIFIED UNSPECIFIED UNSPECIFIED Gauhar, Umair A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Patel, Nina M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lancaster, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yoonha UNSPECIFIED UNSPECIFIED UNSPECIFIED Pankratz, Daniel G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Walsh, P. Sean UNSPECIFIED UNSPECIFIED UNSPECIFIED Lofaro, Lori R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huang, Jing UNSPECIFIED UNSPECIFIED UNSPECIFIED Bhorade, Sangeeta M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kennedy, Giulia C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Martinez, Fernando J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raghu, Ganesh UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-606425
DOI:	10.1164/rccm.202003-0877OC
Journal or Publication Title:	Am. J. Respir. Crit. Care Med.
Volume:	203
Number:	2
Page Range:	S. 211 - 221
Date:	2021
Publisher:	AMER THORACIC SOC
Place of Publication:	NEW YORK
ISSN:	1535-4970
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IDIOPATHIC PULMONARY-FIBROSIS; LUNG-DISEASE; DIAGNOSIS; PATHOLOGISTS; GUIDELINE; BIOPSY Multiple languages Critical Care Medicine; Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60642