Recent Advancement in Chest Ultrasonography in Pleural Diseases: From Morphological Imaging to Artificial Intelligence Driven Precision Diagnostics

Abstract

Pleural disease comprises a major diagnostic and therapeutic challenge in pulmonology, oncology, critical care, and emergency medicine. Over the past decades, Chest Ultrasonography (CUS) has undergone a paradigm shift from a supplementary bedside tool to a central, decision-making imaging modality in pleural diseases. This evolution has been driven by technological innovations including high-frequency probes, contrast-enhanced ultrasonography (CEUS), elastrography, three-dimensional reconstruction, and artificial intelligence(AI)- alongside standardized scanning protocols and increasing procedural integration. This state-of-the-art review synthesizes contemporary evidence on advanced pleural ultrasonography, focusing on diagnostic accuracy, tissue characterization, procedural optimization, future directions towards precision pleural medicine.

Keywords:Pleural ultrasound, Chest ultrasound, Pleural effusion, Elastrography, Contrast enhanced ultrasound, Point-of-care ultrasound, Artificial intelligence, Radiomics.

Chest Heart J. 2025; 49(1) : 35-39