How Is Pulmonary Fibrosis Diagnosed?
If you have shortness of breath and your doctor has mentioned pulmonary fibrosis, you’re probably wondering how is pulmonary fibrosis diagnosed? In the past, physicians relied on CT scans. Because these scans were inconclusive, many patients faced lung surgery to confirm the presence of scar tissue in the lungs. Today, The Lung Center at Penn Highlands Healthcare in Dubois, Penn., uses an innovative genetic test called the Envisia Genomic Classifier to detect pulmonary fibrosis without the need for surgery.
Envisia Genomic Classifier
Obtaining an accurate pulmonary fibrosis diagnosis as early as possible can help patients get pulmonary fibrosis treatment that can help slow the progression of the disease, improve quality of life, and extend a patient’s life.
The pulmonary care experts at Penn Highlands were some of the first in the country to begin using the Envisia Genomic Classifier by Veracyte for the detection of pulmonary fibrosis in 2018. The revolutionary concept of this diagnostic tool is that it uses a nonsurgical procedure plus genomic testing to allow pulmonologists to make a diagnosis of pulmonary fibrosis.
To perform the diagnostic test, the pulmonologist inserts a thin, flexible tube down your throat into your lungs while you are asleep. Using this commonly performed procedure, called a transbronchial biopsy, the pulmonologist then collects a small amount of lung tissue. The Envisia classifier, which looks at 190 genes, is used to detect whether the genomic pattern of usual interstitial pneumonia is present. This type of pneumonia is a hallmark of idiopathic pulmonary fibrosis (IPF), the most common type of pulmonary fibrosis.
The genomic classifier technology was developed using Veracyte’s RNA whole-transcriptome sequencing and machine learning technology to improve physicians’ ability to differentiate pulmonary fibrosis from other interstitial lung diseases without the need for surgery.
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FAQs
Yes, it is possible to have pulmonary fibrosis and not know it, particularly in the early stages of the disease when you have no symptoms or you have mild symptoms. Even once you have symptoms, pulmonary fibrosis can be misdiagnosed or undiagnosed.
According to Veracyte, a survey conducted by the Pulmonary Fibrosis Foundation found that more than half of patients with IPF (idiopathic means that there is no known cause) and other interstitial lung diseases (conditions that cause lung scarring) were misdiagnosed at least once. More than one in five patients with IPF in the study reported that they had been treated during this prolonged diagnosis process with systemic corticosteroids. Corticosteroids are potentially harmful for IPF patients.
The right treatment—which usually includes the use of antifibrotic therapies—can slow progression of the disease. But it’s important they be started as early in the disease process as possible. That’s why getting a timely, accurate diagnosis is so critical.
Can a blood test diagnose pulmonary fibrosis?
There is no blood test to detect pulmonary fibrosis. Your doctor may order a blood test to rule out other causes of your symptoms, such as shortness of breath, but it won’t tell whether you have pulmonary fibrosis. Blood tests may also be ordered regularly once a pulmonary fibrosis diagnosis has been confirmed to monitor the progression of the disease.
Pulmonary fibrosis is a chronic (long-lasting) and progressive (it gets worse over time) disease. While there is no formal classification system, the disease is generally considered to have four stages: mild, moderate, severe and very severe. Your physician will use a combination of the following to determine the stage of your pulmonary fibrosis:
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Symptom severity
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Lung function testing
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CT scan
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An exercise (walk) test
