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Recognition of ILD is often late, causing delay which has been associated with worse clinical outcome. Electronic nose (eNose) sensor technology profiles volatile organic compounds in exhaled breath and has potential to detect ILD non-invasively. We assessed the accuracy of differentiating breath profiles of patients with ILD from patients with asthma, chronic obstructive pulmonary disease (COPD), and lung cancer using eNose technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ILD, asthma, COPD, and lung cancer, regardless of stage or treatment, were included in a cross-sectional study in two hospitals. Exhaled breath was analysed using an eNose (SpiroNose) and clinical data were collected. Datasets were split in training and test sets for independent validation of the model. Data were analyzed with partial least squares discriminant and receiver operating characteristic analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>161 patients with ILD and 161 patients with asthma (n\u2009=\u200965), COPD (n\u2009=\u200950) or lung cancer (n\u2009=\u200946) were included. Breath profiles of patients with ILD differed from all other diseases with an area under the curve (AUC) of 0.99 (95% CI 0.97\u20131.00) in the test set. Moreover, breath profiles of patients with ILD could be accurately distinguished from the individual diseases with an AUC of 1.00 (95% CI 1.00\u20131.00) for asthma, AUC of 0.96 (95% CI 0.90\u20131.00) for COPD, and AUC of 0.98 (95% CI 0.94\u20131.00) for lung cancer in test sets. Results were similar after excluding patients who never smoked.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exhaled breath of patients with ILD can be distinguished accurately from patients with other respiratory diseases using eNose technology. eNose has high potential as an easily accessible point-of-care medical test for identification of ILD amongst patients with respiratory symptoms, and could possibly facilitate earlier referral and diagnosis of patients suspected of ILD.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12931-023-02575-3","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T11:01:50Z","timestamp":1699268510000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Differentiating interstitial lung diseases from other respiratory diseases using electronic nose technology"],"prefix":"10.1186","volume":"24","author":[{"given":"Iris G.","family":"van der Sar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies S.","family":"Wijsenbeek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert-Jan","family":"Braunstahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason O.","family":"Loekabino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie C.","family":"Dingemans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes C. 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All participants signed informed consent before participating. The medical ethics committee of Erasmus Medical Center approved the study protocol (MEC-2019-0230).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"IS reports an unrestricted grant from Boehringer Ingelheim, outside the submitted work and paid to her institution. MW reports received consultancy or speaker fees from Astra-Zeneca, Bristol Myers Squibb, CSL Behring, Galapagos, Galecto, Horizon Therapeutics, Kinevant Sciences, Molecure, NeRRe Therapeutics, Novartis, PureTech Health, Thyron and Vicore paid to her institution; grants from Boehringer-Ingelheim, Astra-Zeneca\/Daiichi-Sankyo and Hoffmann-La Roche; all outside the submitted work. GB reports grants and personal fees from Sanofi, GSK, AstraZeneca and ALK Abello; grants from Sanofi and AstraZeneca; all outside the submitted work. JL has nothing to disclose. AD reports grants from Amgen, Dutch Cancer Society and HANART; consulting fees from AMGEN, Bayer, Boehringer Ingelheim, Sanofy, Roche, Jansen and Astra Zeneca; speaker fees from Janssen, Pfizer, AstraZeneca, Lilly and Takeda; all outside the submitted work and paid to her institution. JV reports unrestricted grants from Chiesi, AstraZeneca and Teva; personal fees from GSK, Sanofi, Chiesi and AstraZeneca; all outside the submitted work. CM reports an unrestricted research grant from Boehringer-Ingelheim, Astra-Zeneca and Daiichi-Sankyio, paid to her institution.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"271"}}