{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:35:56Z","timestamp":1789043756101,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Lung cancer (LC) remains one of the leading causes of cancer-related mortality worldwide, emphasizing the urgent need for innovative diagnostic tools to improve early detection and patient outcomes. Contrast-enhanced ultrasound (CEUS) has emerged as a promising complement to conventional imaging modalities, offering distinct advantages such as real-time dynamic imaging, cost-effectiveness, and the absence of ionizing radiation. By enhancing the visualization of tumor vascularization, CEUS enables differentiation between benign and malignant pulmonary nodules while providing valuable insights into tumor angiogenesis, a hallmark of malignancy, and therapeutic response. Additionally, CEUS demonstrates utility in assessing regional lymph nodes, detecting distant metastases, and analyzing blood flow dynamics through quantitative methods such as time-intensity curve analysis. Despite these benefits, certain limitations persist, including reduced efficacy in imaging deep-seated lesions, variability due to patient-specific physiological factors, and dependency on operator expertise. However, advancements in targeted contrast agents, integration with multimodal imaging techniques, and the application of artificial intelligence hold significant potential to address these challenges. This review systematically evaluates the clinical applications, advantages, and limitations of CEUS in LC diagnosis, providing a comprehensive understanding of its role in modern precision oncology. Furthermore, it highlights future research directions aimed at enhancing diagnostic accuracy, improving clinical workflows, and expanding the adoption of CEUS in routine practice.<\/jats:p>","DOI":"10.3389\/fmed.2025.1543033","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T05:16:26Z","timestamp":1742361386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Advances in the clinical diagnosis of lung cancer using contrast-enhanced ultrasound"],"prefix":"10.3389","volume":"12","author":[{"given":"Jian-wei","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-yu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1136\/thorax-2022-219210","article-title":"Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radio X): a randomised controlled trial","volume":"78","author":"Woznitza","year":"2023","journal-title":"Thorax"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3727","DOI":"10.3390\/cancers16223727","article-title":"Changes in staging and Management of non-Small Cell Lung Cancer (NSCLC) patients following the implementation of low-dose chest computed tomography (LDCT) screening at Kaohsiung Medical University Hospital","volume":"16","author":"Chen","year":"2024","journal-title":"Cancers (Basel)"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"5779","DOI":"10.21037\/jtd-24-294","article-title":"Baseline computed tomography imaging findings could assist in early diagnosis of visceral pleural invasion for newly discovered early subpleural non-small cell lung cancer: T1 or T2","volume":"16","author":"Li","year":"2024","journal-title":"J Thorac Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"15199","DOI":"10.1002\/cam4.6206","article-title":"Magnetic resonance imaging characteristics of brain metastases in small cell lung cancer","volume":"12","author":"Zhu","year":"2023","journal-title":"Cancer Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.cllc.2024.08.005","article-title":"Efficacy of prophylactic cranial irradiation in early to mid-stage small cell lung Cancer patients in the era of magnetic resonance imaging","volume":"25","author":"Liu","year":"2024","journal-title":"Clin Lung Cancer"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"480","DOI":"10.2967\/jnumed.107.047787","article-title":"Recommendations on the use of 18F-FDG PET in oncology","volume":"49","author":"Fletcher","year":"2008","journal-title":"J Nucl Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1055\/s-0042-107411","article-title":"A milestone: approval of CEUS for diagnostic liver imaging in adults and children in the USA","volume":"37","author":"Seitz","year":"2016","journal-title":"Ultraschall Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1007\/s00261-018-1473-8","article-title":"Contrast-enhanced ultrasound (CEUS) in abdominal intervention","volume":"43","author":"Huang","year":"2018","journal-title":"Abdom Radiol (NY)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/S0221-0363(09)70094-0","article-title":"Evaluation de l'angiog\u00e9n\u00e8se tumorale \u00e0 l'aide de l'\u00e9chographie de contraste. 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