ArticleQuantitative imaging in medicine and surgery2026
Feasibility and efficiency of ultrahigh-frequency ultrasound for intraoperatively localizing early lung cancer presenting as ground-glass opacity in lung tissue: a prospective study.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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14 authors.
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Abstract
Background: The accurate intraoperative localization of lung cancers presenting as ground-glass opacities (GGOs) in lung tissue remains challenging. Ultrahigh-frequency ultrasound (UHFUS), which allows for the visualization of micron-scale structures, may help address this issue. This study aimed to evaluate whether UHFUS can serve as a reliable intraoperative tool for real-time detection and localization of GGOs in excised lung specimens. Methods: This prospective observational study included patients with suspected lung cancer who underwent surgery between June 2023 and March 2024. Each excised GGO was sequentially detected and localized intraoperatively via palpation and UHFUS (22-38 MHz). The UHFUS features were independently examined and evaluated by two radiologists. Comparisons between localization rate and time consumption were analyzed with the McNemar and Wilcoxon signed-rank tests. Results: In total, 36 patients (55±10 years; 9 males) comprising 58 GGOs were included, of which 50 were small (≤1 cm) and 8 were general (>1 cm) GGOs; when grouped by density, 37 were considered pure and 21 mixed GGOs. UHFUS, as compared to palpation, demonstrated a superior localization rate for both small nodules (UHFUS: n=48, 96.0%; palpation: n=40, 80.0%; P=0.02) and pure GGOs (UHFUS: n=33, 94.3%; palpation: n=25; 71.4%; P=0.02). Even in the micronodule subgroup (≤5 mm), UHFUS showed better localization ability (n=15, 100%) than did palpation (n=12, 80%). For small GGOs, the median localization time of UHFUS [5 s, interquartile range (IQR) 5-8 s] was significantly shorter (P=0.003) than that for palpation (5 s, IQR 5-15 s); this difference was more pronounced (P=0.004) in pure GGOs (UHFUS: median 5 s, IQR 5-10 s; palpation: 12.5 s, IQR 5-20 s). On UHFUS, 83.3% of GGOs appeared as indistinct hypoechoic areas with posterior shadowing. UHFUS could detect new GGOs, and the agreement in diameter between UHFUS and pathology surpassed that between CT and pathology. Conclusions: This prospective observational trial supports the use of real-time, noninvasive, and radiation-free UHFUS for the intraoperative localization of GGOs in lung tissue. It has the potential to enhance the efficiency of lung surgery in detecting small tumors and identify new nodules.
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