REVIEW article
Front. Surg.
Sec. Thoracic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1567390
This article is part of the Research TopicAdvancing Thoracic Surgery: Harnessing the Potential of Ultrasound for Improved Intraoperative Visualization and Patient OutcomesView all articles
Utility of VATS-US for the identification and characterization of pulmonary nodules: a narrative review
Provisionally accepted
- 1Autonomous University of Barcelona, Barcelona, Spain
- 2Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
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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.
Keywords: VATS-US, pulmonary nodules, echogenic pattern, nodule identification, Nodule characterization
Received: 27 Jan 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Gonzalez-Suárez, Grao Roca, Vivas and Jauregui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Susana Gonzalez-Suárez, Autonomous University of Barcelona, Barcelona, Spain
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