Current evidence for lung ultrasound elastography in the field of pneumology: a systematic review

Abstract

­ Background and objectives: Elastography is a technology that has strongly impacted several medical specialties; however, it is not yet applied as part of standard clinical practice in the field of pulmonology. The objective of this systematic review is to analyse the evidence available to date in relation to pleuropulmonary ultrasound elastography, especially focusing on the three pathologies with the most publications: subpleural consolidations, interstitial lung diseases (ILDs), and pleural effusion.­ Methods: Originalin vivostudies published up until 12/08/2023 in the Embase, MEDLINE, or Web of Science databases were included. The QUADAS-2 tool was applied to analyse bias.­ Results:o Included studies: we found 613 records in databases searching. After duplicates removal, we screened 246 records, and finally included 18 papers.o Synthesis of the results: The average cohort sample size was 109 patients. The elastography modes most frequently used were strain (22.2%), transient elastography (TE; 22.2%), point shear-wave elastography (pSWE; 38.9%), and two-dimensional shear-wave elastography (2D-SWE; 22.2%). The possibility of a meta-analysis was ruled out because of the heterogeneity of the studies included.­ Discussion: The currently available literature indicated that pleuropulmonary ultrasound elastography produced promising and consistent results, although the lack of standardisation in the use of the technique and in the elastography modes employed still impedes its use in daily clinical pneumology practice. The development of a clinical guideline establishing a common nomenclature and standardised techniques for pleuropulmonary elastography will be imperative to generate quality scientific evidence in this field.­ Other:o  Funding: none.o  Registration: PROSPERO № CRD42023472828.