Diagnostic Performance of Electronic Nose Technology in Sarcoidosis
Aim: To evaluate the reliability and validity of exhaled breath analysis using eNose technology to differentiate between sarcoidosis, healthy control subjects, and interstitial lung disease (ILD).
Take home message: eNose technology can noninvasively and accurately distinguish sarcoidosis from ILD and healthy controls, potentially reducing the need for invasive tests.
Introduction
Diagnosing sarcoidosis is challenging, as there are no standardized noninvasive diagnostic tools. This study investigates the diagnostic potential of the electronic nose (eNose) technology, which profiles volatile organic compounds (VOCs) in exhaled breath, to differentiate sarcoidosis from interstitial lung disease (ILD) and healthy controls. Additionally, it explores whether eNose can distinguish among sarcoidosis subtypes.
Methods
The study included 252 sarcoidosis patients, 317 with ILD, and 48 healthy controls. Participants were recruited at Erasmus Medical Center and used the SpiroNose® to perform standardized breath tests. Clinical data were retrieved from medical records, and partial least squares discriminant analysis (PLS-DA) and receiver-operating characteristic (ROC) analyses assessed the diagnostic accuracy.
Results
ENose technology demonstrated high accuracy in differentiating sarcoidosis patients from healthy controls with an AUC of 1.00. The device also distinguished sarcoidosis patients from ILD patients, particularly hypersensitivity pneumonitis, with validation set AUCs of 0.87-0.88. Within sarcoidosis, no significant differences in breathprints were observed based on organ involvement or fibrosis status, but patients with high soluble IL-2 receptor levels showed distinctive breath profiles (AUC of 0.78).
Discussion
This study supports eNose technology as a reliable tool for diagnosing sarcoidosis, potentially reducing the need for invasive biopsies. Breathprints did not vary across sarcoidosis subtypes, suggesting an underlying disease signal. Further research is recommended to explore eNose’s ability to monitor sarcoidosis activity and differentiate other granulomatous diseases, potentially enabling widespread diagnostic use in clinical settings.
