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Spriet M, Vandenberghe F. Equine Nuclear Medicine in 2024: Use and Value of Scintigraphy and PET in Equine Lameness Diagnosis. Animals (Basel) 2024; 14:2499. [PMID: 39272284 PMCID: PMC11394151 DOI: 10.3390/ani14172499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024] Open
Abstract
Scintigraphy and Positron Emission Tomography (PET) are both nuclear medicine imaging techniques, providing functional information of the imaged areas. Scintigraphy is a two-dimensional projected imaging technique that was introduced in equine imaging in the late 1970s. Scintigraphy allows imaging of large body parts and can cover multiple areas, remaining the only technique commonly used in horses for whole body imaging. PET is a cross-sectional imaging technique, first used in horses in 2015, allowing higher resolution three-dimensional functional imaging of the equine distal limb. This manuscript will cover current use and values of these two modalities in equine lameness diagnosis.
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Affiliation(s)
- Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Urion RJ, Edwards RB, Mattoon JS, Wilkinson T. What Is Your Diagnosis? J Am Vet Med Assoc 2021; 258:257-259. [PMID: 33496622 DOI: 10.2460/javma.258.3.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kjærulff LNR, Lindegaard C. Performance and rideability issues in horses as a manifestation of pain: A review of differential diagnosis and diagnostic approach. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- L. N. R. Kjærulff
- Department of Veterinary Clinical Sciences Faculty of Health and Medical Sciences University of Copenhagen Taastrup Denmark
| | - C. Lindegaard
- Department of Veterinary Clinical Sciences Faculty of Health and Medical Sciences University of Copenhagen Taastrup Denmark
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Koch DW, Barrett MF, Jackman BR, MacDonald D, Goodrich LR. Comparison of lameness outcomes in horses with acute or chronic digital lameness that underwent magnetic resonance imaging. N Z Vet J 2020; 68:283-288. [PMID: 32248754 DOI: 10.1080/00480169.2020.1750499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. Methods: This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009-2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2 = return to work at a previous or higher level or lameness improved by one grade or more, 1 = return to work at a lower level or lameness improved by less than one grade, and 0 = did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner. Results: There was a difference (p = 0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality. Conclusion: In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness. Clinical relevance: Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.
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Affiliation(s)
- D W Koch
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - M F Barrett
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - L R Goodrich
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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State-of-the-Art Diagnostic Methods to Diagnose Equine Spinal Disorders, With Special Reference to Transcranial Magnetic Stimulation and Transcranial Electrical Stimulation. J Equine Vet Sci 2019; 81:102790. [PMID: 31668311 DOI: 10.1016/j.jevs.2019.102790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 11/21/2022]
Abstract
Spinal cord disorders are a common problem in equine medicine. However, finding the site of the lesion is challenging for veterinarians because of a lack of sensitive diagnostic methods that can assess neuronal functional integrity in horses. Although medical imaging is frequently applied to help diagnose corticospinal disorders, this approach does not reveal functional information. For the latter, transcranial magnetic stimulation (TMS) and more recently transcranial electrical stimulation (TES) can be useful. These are brain stimulation techniques that create either magnetic or electrical fields passing through the motor cortex, inducing muscular responses, which can be recorded either intramuscularly or extramuscularly by needle or surface electrodes. This permits the evaluation of the functional integrity of the spinal motor tracts and the nerve conduction pathways. The interest in TES in human medicine emerged these last years because unlike TMS, TES tends to bypass the motor cortex of the brain and predominantly relies on direct activation of corticospinal and extrapyramidal axons. Results from human medicine have indicated that TMS and TES recordings are mildly if not at all affected by sedation. Therefore, this technique can be reliably used in human patients under either sedation or full anesthesia to assess functional integrity of the corticospinal and adjunct motor tracts. This opens important new avenues in equine medicine.
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Quiney LE, Ireland JL, Dyson SJ. Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses. Vet Radiol Ultrasound 2018; 59:477-489. [DOI: 10.1111/vru.12626] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/01/2018] [Accepted: 03/08/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Laura E. Quiney
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
| | - Joanne L. Ireland
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
| | - Sue J. Dyson
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
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Trolinger-Meadows KD, Gaschen LE, Riggs LM. What Is Your Diagnosis? J Am Vet Med Assoc 2017; 250:275-277. [PMID: 28117645 DOI: 10.2460/javma.250.3.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dyson S. Evaluation of poor performance in competition horses: A musculoskeletal perspective. Part 2: Further investigation. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. Dyson
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk UK
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Porter EG, Brokken MT, Holmes SP. Diagnosis and treatment of carpometacarpal desmopathy in a horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. G. Porter
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; USA
| | - M. T. Brokken
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; USA
| | - S. P. Holmes
- Department of Veterinary Biosciences and Diagnostic Imaging; College of Veterinary Medicine; University of Georgia; USA
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Graham S, Solano M, Sutherland-Smith J, Sato AF, Maranda L. Diagnostic sensitivity of bone scintigraphy for equine stifle disorders. Vet Radiol Ultrasound 2014; 56:96-102. [PMID: 25065687 DOI: 10.1111/vru.12184] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 04/08/2014] [Indexed: 11/27/2022] Open
Abstract
Disorders of the stifle are a common cause of lameness in horses yet the accuracy of scintigraphy for diagnosis of stifle conditions is controversial. The aim of retrospective cross-sectional study was to determine the diagnostic sensitivity (Se) of bone scintigraphy in detecting stifle disease and to determine if two orthogonal scintigraphic images improve diagnostic Se. Horses that underwent scintigraphic examination during a two-year period were included. Horses were divided into two groups: group 1 (N = 23) had lameness that was localized to the stifle by intra-articular analgesia and group 2 (N = 182) had lameness that was localized to a different location. Scintigraphic studies (one image or two images) were independently and retrospectively analyzed by two radiologists (R1 and R2). Sensitivity, specificity (Sp) and predictive values (PV), and were calculated for each type of study (one image or two images) and for each radiologist (R1 or R2). The Se to detect stifle disorders varied between radiologists (29.2% and 20.8%). The Sp was 84.5% and 88.3%. When two images were evaluated a decrease in the positive PV for both readers occurred. The Cohen kappa coefficient (κ) between readers was poor when one image (0.084) or two images (0.117) were evaluated. Findings from this study indicated that bone-phase nuclear scintigraphy is reasonably specific but highly insensitive for detecting lameness originating from the stifle in a diverse population of both normal and affected horses. The addition of a caudal scintigraphic image acquisition did not improve diagnostic sensitivity.
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Affiliation(s)
- Sarah Graham
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32608
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Sarrafian TL, Case JT, Kinde H, Daft BM, Read DH, Moore JD, Uzal FA, Stover SM. Fatal musculoskeletal injuries of Quarter Horse racehorses: 314 cases (1990-2007). J Am Vet Med Assoc 2013; 241:935-42. [PMID: 23013508 DOI: 10.2460/javma.241.7.935] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine major causes of death and the anatomic location of musculoskeletal injuries in Quarter Horse racehorses in California. DESIGN Retrospective case series. ANIMALS 314 Quarter Horse racehorses with musculoskeletal injuries that were necropsied through the California Horse Racing Board Postmortem Program from 1990 to 2007. PROCEDURES Postmortem pathology reports were retrospectively reviewed. Musculoskeletal injuries were categorized by anatomic region and described. The number of Quarter Horse starts and starters for the same period of time were obtained from a commercial database for determination of fatal injury incidence. RESULTS Musculoskeletal injuries accounted for 314 of the 443 (71 %) Quarter Horse racehorses that died during the 18-year study period. Fatal musculoskeletal injuries occurred at a rate of 2.0 deaths/1,000 race starts and 18.6 deaths/1,000 horses that started a race. Musculoskeletal injuries occurred predominantly during racing (84%) and in the forelimbs (81%). The most common fatal musculoskeletal injuries were metacarpophalangeal and metatarsophalangeal joint (fetlock) support injuries (40%) and carpal (24%), vertebral (10%), and scapular (8%) fractures. Proximal interphalangeal (pastern) joint luxations resulted in death of 3% of horses. Fracture configurations of some bones were consistent with those of Thoroughbred racehorses. Evidence of preexisting stress remodeling of bone was reported for some fractures. CONCLUSIONS AND CLINICAL RELEVANCE Knowledge of common locations and types of fatal musculoskeletal injuries in racing Quarter Horses may enhance practitioners' ability to detect mild injuries early, rest horses, and help prevent catastrophic injuries.
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Affiliation(s)
- Tiffany L Sarrafian
- JD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, 95616, USA
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Gaschen L, Burba DJ. Musculoskeletal Injury in Thoroughbred Racehorses. Vet Clin North Am Equine Pract 2012. [DOI: 10.1016/j.cveq.2012.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mathis MG, Ley C, Berger M, Hansson K. Evaluation of a positioning method for equine lateral stifle scintigrams. Acta Vet Scand 2012; 54:38. [PMID: 22703542 PMCID: PMC3502362 DOI: 10.1186/1751-0147-54-38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 06/15/2012] [Indexed: 11/26/2022] Open
Abstract
Background The current lack of a standardized protocol for positioning of the gamma camera relative to the horse limb in a lateral stifle scintigram, and thus the reliance on subjective positioning, may be a cause of diagnostic error and inter-operator variability due to variations of the view angle. The aims of this study were to develop a reliable method to obtain a lateral scintigram of the equine stifle based on fixed anatomical landmarks and measure the resulting foot to gamma camera angle on sequential measurements of the same horse and of different horses Methods Technetium filled capsules were glued on the skin on sites adjacent to the origin of the medial and lateral femorotibial collateral ligaments in 22 horses using ultrasound guidance. A lateral view of the stifle was defined as the image where the two radioactive point sources were aligned vertically (point sources guided method). Five sequential lateral acquisitions (one to five) of the stifle with the point sources vertically aligned were acquired in each horse, and the angle between the mid-sagittal foot-axis and the vertical axis of the gamma camera (FC angle) was measured for each of these acquisitions Results For acquisition group one to five, the mean of the means FC angle was 91.6 ± 2° (2SD) and the coefficient of variation (COV) was 1.1%. In the 22 horses the 95% CI for the mean FC angles was 91.6° ± 12.1° (2SD) and the COV was 6.6%. Conclusions The use of point sources to guide gamma camera position results in less variation in the lateral scintigram than if the distal limb is used as guidance due to a difference in FC angle between horses. The point source guided positioning method is considered suitable as a reference standard method to obtain lateral scintigrams of the equine stifle, and it will be of value in clinical scintigraphy and research. The use of alignment of specifically located point sources may also be applied in other regions to standardize scintigraphic views.
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O'Brien T, Baker TA, Brounts SH, Sample SJ, Markel MD, Scollay MC, Marquis P, Muir P. Detection of Articular Pathology of the Distal Aspect of the Third Metacarpal Bone in Thoroughbred Racehorses: Comparison of Radiography, Computed Tomography and Magnetic Resonance Imaging. Vet Surg 2011; 40:942-51. [DOI: 10.1111/j.1532-950x.2011.00881.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas O'Brien
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Theresa A. Baker
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Sabrina H. Brounts
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Susannah J. Sample
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Mark D. Markel
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | | | | | - Peter Muir
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
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Podadera JM, Bell RJ, Dart AJ. Using magnetic resonance imaging to diagnose non-displaced fractures of the second phalanx in horses. Aust Vet J 2010. [DOI: 10.1111/j.1751-0813.2010.00635.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Braim AEP, Bell RJW, Textor JA, Lo WY, Puchalski SM, Galuppo LD. Computed tomography of proximal metatarsal and concurrent third tarsal bone fractures in a Thoroughbred racehorse. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2010.00081.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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BIGGI MARIANNA, DYSON SUEJ, MURRAY RACHELC. SCINTIGRAPHIC ASSESSMENT OF THE METACARPOPHALANGEAL AND METATARSOPHALANGEAL JOINTS OF HORSES WITH JOINT PAIN. Vet Radiol Ultrasound 2009; 50:536-44. [DOI: 10.1111/j.1740-8261.2009.01579.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Abstract
Gamma scintigraphy is an established imaging modality in the horse and is principally utilised to investigate skeletal disease using bone-seeking radiopharmaceuticals. However, depending on the radiopharmaceutical and imaging sequence, scintigraphy can be used to investigate disease in virtually any organ system. In this article the indications and validity of scintigraphy as a clinical diagnostic tool to investigate non-skeletal disease in the horse are reviewed. These indications include: investigation of dental disease, identification of inflammatory foci, vascular lesions, muscle and tendon pathology, assessment of physiological function of the lungs, gastrointestinal tract and other organs. Some of the techniques described for use in the horse have not been validated fully and as a result non-skeletal scintigraphy requires further investigation and validation using well-designed prospective studies. Such information can be used by clinicians to make informed decisions regarding the clinical and economic issues associated with a specific scintigraphic technique and may help when interpreting the results.
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Affiliation(s)
- D C Archer
- Philip Leverhulme Large Animal Hospital, University of Liverpool, Leahurst, Neston, The Wirral CH64 7TE, UK.
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