Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review

The aim of this study was to show the efficacy described in the scientific literature of lung ultrasound (LU) during video-assisted thoracic surgery (VATS) to determine the location and characterization of pulmonary nodules. The results showed that intraoperative LU is especially useful in localizin...

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Main Authors: Susana González-Suárez, María Grao Roca, Juan-Camilo Vivas, Alberto Jauregui
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1567390/full
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author Susana González-Suárez
Susana González-Suárez
Susana González-Suárez
María Grao Roca
Juan-Camilo Vivas
Alberto Jauregui
Alberto Jauregui
author_facet Susana González-Suárez
Susana González-Suárez
Susana González-Suárez
María Grao Roca
Juan-Camilo Vivas
Alberto Jauregui
Alberto Jauregui
author_sort Susana González-Suárez
collection DOAJ
description The aim of this study was to show the efficacy described in the scientific literature of lung ultrasound (LU) during video-assisted thoracic surgery (VATS) to determine the location and characterization of pulmonary nodules. The results showed that intraoperative LU is especially useful in localizing lung lesions by VATS with a sensitivity close to 100%. It was also shown to be useful in planning very precise lung resections, reducing the resection of healthy lung tissue. Although general criteria could be established for the degree of benignity/malignancy of lung lesions based on the ultrasound patterns obtained, the great variability observed in these patterns does not offer sufficient guarantees to make a reliable diagnosis. In this sense, the application of Doppler ultrasound or the utilization of Intraoperative Contrast-Enhanced Ultrasound (Io-CEUS) in a completely collapsed lung can be advantageous for the accurate localization and characterization of pulmonary lesions. Even so, at present, definitive confirmation of the nature of lung lesions usually requires biopsy and histopathological study. The development of artificial intelligence algorithms that integrate the results of histological analyses with various types of ultrasonographic patterns (based on pulmonary aeration obtained, as well as Doppler and Io-CEUS records) will likely represent the future of ultrasonographic differentiation of these lesions.
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spelling doaj-art-16b7395048bf43ddbfe65295646e9eb02025-08-20T01:52:18ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-05-011210.3389/fsurg.2025.15673901567390Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative reviewSusana González-Suárez0Susana González-Suárez1Susana González-Suárez2María Grao Roca3Juan-Camilo Vivas4Alberto Jauregui5Alberto Jauregui6Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Anesthesia and Intensive Care, University Hospital Vall d'Hebron, Barcelona, SpainCardiovascular Diseases Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, SpainDepartment of Anesthesia and Intensive Care, University Hospital Vall d´Hebron, Barcelona, SpainDepartment of Thoracic Surgery and Lung Transplant, University Hospital Vall d´Hebron, Barcelona, SpainDepartment of Thoracic Surgery and Lung Transplant, University Hospital Vall d´Hebron, Barcelona, SpainDepartment of Surgery, Universitat Autònoma de Barcelona, Barcelona, SpainThe aim of this study was to show the efficacy described in the scientific literature of lung ultrasound (LU) during video-assisted thoracic surgery (VATS) to determine the location and characterization of pulmonary nodules. The results showed that intraoperative LU is especially useful in localizing lung lesions by VATS with a sensitivity close to 100%. It was also shown to be useful in planning very precise lung resections, reducing the resection of healthy lung tissue. Although general criteria could be established for the degree of benignity/malignancy of lung lesions based on the ultrasound patterns obtained, the great variability observed in these patterns does not offer sufficient guarantees to make a reliable diagnosis. In this sense, the application of Doppler ultrasound or the utilization of Intraoperative Contrast-Enhanced Ultrasound (Io-CEUS) in a completely collapsed lung can be advantageous for the accurate localization and characterization of pulmonary lesions. Even so, at present, definitive confirmation of the nature of lung lesions usually requires biopsy and histopathological study. The development of artificial intelligence algorithms that integrate the results of histological analyses with various types of ultrasonographic patterns (based on pulmonary aeration obtained, as well as Doppler and Io-CEUS records) will likely represent the future of ultrasonographic differentiation of these lesions.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1567390/fullVATS-USpulmonary nodulesechogenic patternnodule identificationnodule characterization
spellingShingle Susana González-Suárez
Susana González-Suárez
Susana González-Suárez
María Grao Roca
Juan-Camilo Vivas
Alberto Jauregui
Alberto Jauregui
Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
Frontiers in Surgery
VATS-US
pulmonary nodules
echogenic pattern
nodule identification
nodule characterization
title Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
title_full Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
title_fullStr Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
title_full_unstemmed Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
title_short Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review
title_sort role of vats us in identifying and characterizing pulmonary nodules a narrative review
topic VATS-US
pulmonary nodules
echogenic pattern
nodule identification
nodule characterization
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1567390/full
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