Suspected IPF patients could be spared risky lung biopsy

Patients that have suspected idiopathic pulmonary fibrosis (IPF) may not have to undergo the risks of a lung biopsy to confirm the diagnosis thanks to new findings. 

Typically, suspected IPF patients that don't present with the usual high resolution computed tomography (HRCT) scans have to undergo a biopsy for an accurate diagnosis. However, new research suggests that IPF could be diagnosed by radiological and clinical findings only.

IPF is becoming more common throughout the UK and US, according to new research, and causes more deaths every year than ovarian cancer, leukaemia or kidney cancer. In the US, around the same number of patients die from IPF as they do from breast cancer. It has no cure and usually patients only live for between three and five years following diagnosis.

It causes the lung to no longer be able to supply oxygen to the body due to excessive scarring. Treatment for the disease is difficult as lung biopsies are needed in a lot of cases to confirm the disease.

HRCT are currently used to diagnose IFP. These scans can identify the pattern of lung scarring that is typical in IPF patients, along with usual interstitial pneumonia (UIP) - damage to the air sacs. However, when no UIP pattern is shown on the HRCT scans of patients with suspected IPF, a lung biopsy is needed.

The study, published in 'The Lancet Respiratory Medicine', looked at 315 patients aged over 40 years that showed little or no signs or UIP on their HRCT scans. Some 84 patients that had a possible UIP pattern shown on their scans were diagnosed with IPF by expert pathologists and radiologists, before receiving a definitive diagnosis through biopsy. 

According to Professor Ganesh Raghu, leader of the research at the University of Washington Medical Center, US, the findings indicate that patients with suspected IPF could be diagnosed without having to undergo a lung biopsy.

"Our findings suggest that when a team of multidisciplinary experts in interstitial lung disease at a regional centre (that includes a chest radiologist and a pulmonologist) work together to interpret possible UIP pattern on high-resolution CT in a patient suspected to have IPF, surgical lung biopsy might not be necessary to reach a diagnosis of IPF," he said.