Advances in the clinical diagnosis of lung cancer using contrast-enhanced ultrasound

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.