Although genomic testing is useful when an interstitial lung disease diagnosis is uncertain, the testing results themselves aren't sufficient to make the diagnosis, Daniel Dilling, MD, FCCP, said in a presentation at the annual meeting of the American College of Chest Physicians, which was held virtually.
The genomic classifier (Envisia, Veracyte) helps differentiate idiopathic pulmonary fibrosis (IPF) by detecting usual interstitial pneumonia (UIP), the hallmark pattern of this interstitial lung disease.
However, UIP is just one piece of the larger diagnostic puzzle, according to Dilling, professor of medicine in the interstitial lung disease program at Loyola University Medical Center in Maywood, Ill.
"Remember, it's just a pattern, and not a diagnosis of IPF," Dilling said in his presentation.
Genomic classifier results correlate well with both histologic and radiographic UIP pattern, studies show.
However, Dilling said the value of the genomic classifier is not in isolation.
"We don't use this in a vacuum," he said. "It increases our confidence and consensus, but it has to be incorporated into a multidisciplinary discussion group."
Part of the Diagnostic Pathway
Dilling said the genomic classifier should be considered part of a diagnostic pathway in uncertain cases, particularly when the risk of surgical lung biopsy is high.
Current clinical practice guidelines recommend surgical lung biopsy for histopathologic diagnosis when clinical and radiologic findings are not definitive for IPF, the speaker said.
