European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
Intraoperative Contrast-Enhanced Ultrasound Versus Traditional Intraoperative Ultrasound for Detecting Lung Nodules During Robotic-assisted Thoracic Surgery.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Messina Gaetana, Vicario Giuseppe, Filippo Vincenzo Di, Pica Davide Gerardo, Leonardi Beatrice, Giorgiano Noemi Maria, Iovine Angela, Vinciguerra Riccardo, Capasso Francesca, Chiodini Paolo, Smimmo Annafrancesca, Vicidomini Giovanni, Fiorelli Alfonso
Аннотация
OBJECTIVES: Intraoperative ultrasound (Io-US) is used during thoracoscopy to detect lung lesions, but it remains underused during robotic-assisted thoracic surgery (RATS), probably due to the difficulty interpreting US findings. We evaluated whether the use of contrast-enhanced ultrasound (CEUS) could improve the diagnostic accuracy of traditional Io-CEUS for detecting lung nodules during RATS.
MATERIAL AND METHODS: It was a retrospective single-centre study including all consecutive patients undergoing RATS for management of small, deeply located lung nodules. In all cases, Io-CEUS was used when Io-US failed to detect lung lesion. The diagnostic accuracy of 2 methods to detect lesions and the inter-group differences regarding operative and perioperative outcomes were statistically evaluated.
RESULTS: Our study population included 33 patients. Io-US correctly detected 15 out of 33 lesions (45%) but missed 18 lesions with isoechoic patterns that were corrected identified by Io-CEUS with a significant improvement of diagnostic accuracy (difference 55%; 95% confidence interval: 37.56- 71.53; P < .0001). The Io-US group (n = 15) compared to the Io-CEUS group (n = 18) showed no significant differences regarding nodule characteristics such as size (8 mm [7-9] vs 7.8 mm [6-9], P = .78); distance from pleura (32 mm [20-44] vs 21 mm [20-42]; P = .69); lobe location (lower lobe: 66% vs 61%, P = .74); and histological diagnosis (primary lung cancer: 100% vs 88%, P = .18).
CONCLUSIONS: Io-CEUS is an additional tool for thoracic surgeons to detect lung lesions and could be useful, especially in cases of isoechoic lesions that were poorly defined by traditional Io-US.
MATERIAL AND METHODS: It was a retrospective single-centre study including all consecutive patients undergoing RATS for management of small, deeply located lung nodules. In all cases, Io-CEUS was used when Io-US failed to detect lung lesion. The diagnostic accuracy of 2 methods to detect lesions and the inter-group differences regarding operative and perioperative outcomes were statistically evaluated.
RESULTS: Our study population included 33 patients. Io-US correctly detected 15 out of 33 lesions (45%) but missed 18 lesions with isoechoic patterns that were corrected identified by Io-CEUS with a significant improvement of diagnostic accuracy (difference 55%; 95% confidence interval: 37.56- 71.53; P < .0001). The Io-US group (n = 15) compared to the Io-CEUS group (n = 18) showed no significant differences regarding nodule characteristics such as size (8 mm [7-9] vs 7.8 mm [6-9], P = .78); distance from pleura (32 mm [20-44] vs 21 mm [20-42]; P = .69); lobe location (lower lobe: 66% vs 61%, P = .74); and histological diagnosis (primary lung cancer: 100% vs 88%, P = .18).
CONCLUSIONS: Io-CEUS is an additional tool for thoracic surgeons to detect lung lesions and could be useful, especially in cases of isoechoic lesions that were poorly defined by traditional Io-US.