New International Guidelines and Consensus on the Use of Lung Ultrasound

Demi, Libertario; Wolfram, Frank; Klersy, Catherine; Silvestri, Annalisa De; Müller, Marie; Miller, Douglas L.; Feletti, Francesco; Wełnicki, Marcin; Buda, Natalia; Skoczylas, Agnieszka; Pomiećko, Andrzej; Damjanović, Domagoj; Olszewski, Robert; Kirkpatrick, A. W.; Breitkreutz, Raoul; Mathis, Gebhart; Soldati, Gino; Smargiassi, Andrea; Inchingolo, Riccardo; Perrone, Tiziano

doi:10.1002/jum.16088

Cited by 122 publications

(124 citation statements)

References 317 publications

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“…1 ) Standardization of the terminology to describe artifacts and signs in LUS is essential. There are various definitions in the literature, especially for consolidations, but also regarding pleural abnormalities [1], which was not considered in this study. Although consolidations had a moderate agreement in this study, the reliability of this finding might improve with more specific definitions and consensus-based guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Lung ultrasound (LUS) is used to differentiate quickly and precisely between the most common causes of respiratory problems. LUS has been extensively studied as a bedside diagnostic tool, and it is now universally included in point-of-care ultrasound (PoCUS) guidelines with high-quality supporting evidence [1]. LUS has the potential to refashion healthcare delivery and enables an augmented clinical interpretation of patient's status in real-time, which can have an immediate impact on clinical decisions, and even be used to monitor response to therapy and evolution [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…However, LUS is an operator-dependent modality, and its utility depends on accurate acquisition and interpretation by bedside physicians [14][15][16][17]. Poor image acquisition and incorrect identification and interpretation of artifacts are potential sources of error in the clinical application of LUS [1]. In previous studies, most of them accomplished outside of COVID-19, LUS findings demonstrated moderate to fair interrater agreement.…”

Section: Introductionmentioning

confidence: 99%

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Inter-rater Variability in the Evaluation of Lung Ultrasound on Videos Acquired from COVID-19 Patients

Herraiz¹,

Freijo²,

Navarro³

et al. 2022

Preprint

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Lung ultrasound (LUS) allows the detection of a series of manifestations of COVID-19 such as B lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the impact of performing the test in the longitudinal or transverse orientation. 33 physicians with advanced experience in LUS, independently evaluated ultrasound videos previously acquired with the ULTRACOV system of 20 patients with confirmed COVID-19. In each patient, 24 videos of 3 seconds were acquired (using 12 positions with the probe in longitudinal and transverse orientations). Physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (κ = 0.74), only a fair IRR for the presence of individual B lines (κ = 0.36) and for confluent B lines occupying &lt;50% (κ = 0.26), and a moderate IRR in consolidations and B-lines &gt;50% (κ = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR in LUS of COVID-19 patients may benefit from more standardization of the clinical protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Inter-rater Variability in the Evaluation of Lung Ultrasound on Videos Acquired from COVID-19 Patients

Herraiz¹,

Freijo²,

Navarro³

et al. 2022

Preprint

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“…The aim of this work, presenting a picture of real life in pleural unit, was not to suggest chest US in substitution of chest CT scan, but to provide pulmonologists with a useful tool to assess pleural surface [ 27 ] and chest wall [ 28 ], in addition to ionizing radiations [ 29 , 30 , 31 ], in order to indicate and guide diagnostic MT.…”

Section: Discussionmentioning

confidence: 99%

Possible Role of Chest Ultrasound in the Assessment of Costo-Phrenic Angle Lesions Prior to Medical Thoracoscopy: A Retrospective Pilot Case Series

Conte¹,

Smargiassi

Lococo

et al. 2022

Diagnostics

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Background: Pleural malignancy (PM) and malignant pleural effusion (MPE) represent an increasing burden of diseases. Costo-phrenic angle (CPA) could be involved by malignant small nodularities or thickenings in the case of MPE. The aim of this study was to evaluate whether lung ultrasound (LUS), performed prior to medical thoracoscopy (MT), could detect pleural abnormalities in CPA not easily detectable by chest computed tomography scan (CCT). Methods: Patients suspected for PM and MPE were retrospectively recruited. Patients underwent both LUS examination with a linear array and CCT prior to diagnostic medical thoracoscopy. LUS pathological findings in CPA were compared with pathological findings detected by CCT. Findings were confirmed by subsequent MT, the gold standard for PMs. Results: Twenty-eight patients were recruited. LUS detected 23 cases of pleural abnormalities in CPA. CCT was detected 12 pleural abnormalities. Inter-rater agreement between the two techniques was minimal (Cohen’s Kappa: 0.28). MT detected PMs in CPA in 22 patients. LUS had a sensitivity of 100% and specificity of 83%. CCT had a sensitivity of 54% and specificity of 100%. A better sensitivity for CCT was reached analysing only all abnormalities > 5 mm (64.3%). Conclusions: LUS examination, in the case of PMs, could change and speed up diagnostic workup.

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“…Lung Ultrasonography (LUS) is a fast technique for the diagnosis of patients with respiratory syndromes. It is an exam that allows for the evaluation of disease development and response to treatment [ 1 , 2 , 3 ]. Pulmonary illnesses with a slow evolution of worsening symptoms cannot be monitored properly by chest X-rays [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

B-Lines Lung Ultrasonography Simulation Using Finite Element Method

2022

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Introduction: Lung Ultrasonography (LUS) is a fast technique for the diagnosis of patients with respiratory syndromes. B-lines are seen in response to signal reverberations and amplifications into sites with peripheral lung fluid concentration or septal thickening. Mathematical models are commonly applied in biomedicine to predict biological responses to specific signal parameters. Objective: This study proposes a Finite-Element numerical model to simulate radio frequency ultrasonic lines propagated from normal and infiltrated lung structures. For tissue medium, a randomized inhomogeneous data method was used. The simulation implemented in COMSOL® used Acoustic Pressure and Time-Explicit models, which are based on the discontinuous Galerkin method (dG). Results: The RF signals, processed in MATLAB®, resulted in images of horizontal A-lines and vertical B-lines, which were reasonably similar to real images. Discussion: The use of inhomogeneous materials in the model was good enough to simulate the scattering response, similar to others in the literature. The model is useful to study the impact of the lung infiltration characteristics on the appearance of LUS images.

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New International Guidelines and Consensus on the Use of Lung Ultrasound

Cited by 122 publications

References 317 publications

Inter-rater Variability in the Evaluation of Lung Ultrasound on Videos Acquired from COVID-19 Patients

Inter-rater Variability in the Evaluation of Lung Ultrasound on Videos Acquired from COVID-19 Patients

Possible Role of Chest Ultrasound in the Assessment of Costo-Phrenic Angle Lesions Prior to Medical Thoracoscopy: A Retrospective Pilot Case Series

B-Lines Lung Ultrasonography Simulation Using Finite Element Method

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