{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:13:08Z","timestamp":1790266388557,"version":"4.1.0"},"reference-count":102,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pleural effusion (PE) is a frequent complication in patients with malignancies and is often associated with poor prognosis. Lung ultrasound (LUS) has become an indispensable bedside tool for detecting, characterizing, and guiding the management of pleural effusions. Methods: This narrative review summarizes the current evidence on the diagnostic performance of LUS for PE in cancer patients, emphasizing recent advances in functional ultrasound techniques. Results: B-mode LUS can detect small-volume effusions and estimate their volume. Sonographic features such as echogenicity, septations, and pleural abnormalities can help differentiate transudative from exudative effusions. Shear-wave elastography and contrast-enhanced ultrasound provide additional functional information on tissue stiffness and perfusion. This information may help distinguish between malignant and benign pleural lesions and facilitate targeted biopsy when cytology is nondiagnostic. Compared with computed tomography, LUS offers superior evaluation of juxtadiaphragmatic and pleural surface abnormalities. It facilitates safe, real-time thoracocentesis. Recent innovations, including improved quality, affordable handheld ultrasound systems and artificial intelligence-based analysis, are expected to further enhance diagnostic precision and accessibility. Conclusions: Although LUS is a sensitive and versatile tool for assessing PE in cancer patients, it has limited diagnostic accuracy in distinguishing between benign and malignant effusions. Advanced techniques, such as shear-wave elastography and contrast-enhanced ultrasound, may further support the differentiation of malignant and benign diseases. Ongoing technological advances are likely to enhance the diagnostic accuracy and accessibility of lung ultrasound.<\/jats:p>","DOI":"10.3390\/cancers18010038","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:30:18Z","timestamp":1766489418000},"page":"38","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lung Ultrasound for Pleural Effusion in Cancer Patients: Advanced Ultrasound for Pleural Lesions\u2014A Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-5452","authenticated-orcid":false,"given":"Hajo","family":"Findeisen","sequence":"first","affiliation":[{"name":"Department for Hematology, Oncology and Immunology University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1900-5149","authenticated-orcid":false,"given":"Christian","family":"G\u00f6rg","sequence":"additional","affiliation":[{"name":"Interdisciplinary Center of Ultrasound Diagnostics, Department of Gastroenterology, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Zies","sequence":"additional","affiliation":[{"name":"Department for Internal Medicine, Red Cross Hospital Bremen, 28199 Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Department for Internal Medicine, Hospital of the German Armed Forces, 10115 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-6347","authenticated-orcid":false,"given":"Christoph F.","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, 3013 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Alhyari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Asklepios Klinik Weissenfels, 06667 Weissenfels, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4573-7802","authenticated-orcid":false,"given":"Corinna","family":"Trenker-Burchert","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology and Immunology University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany"},{"name":"Interdisciplinary Center of Ultrasound Diagnostics, Department of Gastroenterology, University Hospital Giessen and Marburg, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0041-624X(64)90388-9","article-title":"Ultrasound for routine clinical investigations","volume":"2","author":"Pell","year":"1964","journal-title":"Ultrasonics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1001\/jama.1967.03120180087013","article-title":"Reflected ultrasound in the detection and localization of pleural effusion","volume":"200","author":"Joyner","year":"1967","journal-title":"JAMA"},{"key":"ref_3","first-page":"274","article-title":"Sonography of the diaphragmatic pleura in tumor patients","volume":"9","author":"Schwerk","year":"1988","journal-title":"Ultraschall Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"00464-2020","DOI":"10.1183\/23120541.00464-2020","article-title":"Thoracic ultrasound for malignant pleural effusion: A systematic review and meta-analysis","volume":"6","author":"Shiroshita","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1055\/a-0586-1107","article-title":"The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)","volume":"39","author":"Sidhu","year":"2018","journal-title":"Ultraschall Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1055\/a-0838-9937","article-title":"The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018","volume":"40","author":"Saftoiu","year":"2019","journal-title":"Ultraschall Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1056\/NEJMra1403503","article-title":"Pleural Disease","volume":"378","author":"Light","year":"2018","journal-title":"N. 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