Ex vivo pulmonary nodule detection with miniaturized ultrasound convex probes

Clinical value of pulmonary congestion detection by lung ultrasound in patients with chronic heart failure

Chronic heart failure is one of the common causes of hospitalization and death. Pulmonary congestion is the common disease feature of patients with chronic heart failure, which could be correctly diagnosed by lung ultrasound. Efficacy of lung ultrasound‐guided pulmonary congestion management for patients with acute heart failure is well documented, however, more evidence is needed to establish the clinical value of pulmonary congestion detection by lung ultrasound examination in patients with chronic heart failure. This review summarized current evidence related to the use and clinical value of pulmonary congestion assessment by lung ultrasound in patients with chronic heart failure, aiming to provide new suggestions on promoting the widespread use of lung ultrasound in patients with chronic heart failure to improve the quality of life and outcome of patients with chronic heart failure.

Ultrasound location of pulmonary nodules in video-assisted thoracoscopic surgery for precise sublobectomy

BACKGROUND

We investigated the clinical value of accurate sublobectomy of pulmonary nodules using video-assisted thoracoscopy (VATS). In June 2017 to June 2019, single lung nodule patients who accepted thoracoscopic resection were included. Palpation and intraoperative ultrasound (IU) were used to localize lung nodules, and the success rate, location time and safety compared. Performance of lung nodule ultrasound was assessed. The success rate of IU localization of pulmonary nodules with different properties was studied.

RESULTS

A total of 33 cases with single pulmonary nodules were included in the study, and 32 cases (97%) were successfully located by IU as opposed to 16 cases (48.5%) located by palpation (P < 0.05). Clear hypoechoic ultrasound images of nodules were obtained in all 32 cases, and the diameter of pulmonary nodules on ultrasound and CT were found to have a significant correlation (R = 0.860, P = 0.000). The average positioning time of IU was lower than that of the palpation group (P < 0.05). No complications occurred during ultrasound examination. The success rate of intraoperative ultrasonic localization between the pure ground-glass opacity (p-GGO) group and the mixed-ground-glass opacity (m-GGO) group was 90%, 100% (P = 0.526).

CONCLUSIONS

In thoracoscopic surgery, IU can locate pulmonary nodules accurately, efficiently and safely, and also has a high degree of accuracy in locating different types of pulmonary nodules.

The use of ultrasound in detecting and defining ground-glass opacities: results of an ex vivo evaluation

OBJECTIVES

To evaluate the role of ultrasound in detecting and defining ground-glass opacities (GGOs) in surgical specimens of patients undergoing thoracoscopic diagnostic resection.

METHODS

We performed an observational single-centre study of all consecutive patients undergoing thoracoscopic diagnostic resection of GGOs. In each patient, the specimen was scanned with ultrasound; then, a needle was inserted into the lesion to facilitate its detection by the pathologist. We evaluated the rate of detection with ultrasound, compared the size and depth measurements of the lesions as determined from ultrasound scans with those from the histological specimens and correlated the ultrasound findings with the histological subtypes of adenocarcinomas.

RESULTS

We reviewed 17 tissue samples. The final diagnoses were 1 (6%) atypical adenomatous hyperplasia, 5 (29%) adenocarcinomas in situ, 4 (24%) minimally invasive adenocarcinomas and 7 (41%) invasive adenocarcinomas. All tumours were successfully identified using ultrasound. The size (P = 0.87) and depth (P = 0.25) of the lesions measured with ultrasound did not significantly differ from the measurements obtained from the histological specimens. In addition, ultrasound size (r = 0.945; P < 0.0001) and depth (r = 0.588; P = 0.013) were significantly correlated with the pathological measurements. All lesions with hyperechoic findings (n = 6) were pure GGOs, whereas lesions with mixed echoic (n = 11) patterns were mixed GGOs. We were unable to differentiate the histological subtypes of adenocarcinomas using the ultrasound scans.

CONCLUSIONS

Detection of GGOs on ultrasound scans is feasible, but differentiation of the histological subtypes of adenocarcinomas is not possible. The next step is to evaluate the intraoperative reproducibility of our results.

Ultrasound for intraoperative localization of lung nodules during thoracoscopic surgery

In low-dose CT screening era, an ideal preoperative localization method is essential for resection of small and deep-seated pulmonary nodules by video-assisted thoracoscopic surgery (VATS). This article focuses on intraoperative ultrasonography localization method during thoracoscopy. Performing ultrasonography intraoperatively is a real-time and alternative approach to localize small, non-visible and non-palpable pulmonary lesions without injury to lung parenchyma. Its widespread usage has been limited due to the air in the lung parenchyma; however, its application can be useful in some conditions with guidance to find the lesion.