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Nappo D, Massarenti C, Andreis ME, Zini E, Lacava G, Rabba S, Auriemma E. Computed tomographic anatomic variations of the phrenicoabdominal veins in cats. Vet Radiol Ultrasound 2024. [PMID: 38979844 DOI: 10.1111/vru.13408] [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: 02/08/2024] [Revised: 06/16/2024] [Accepted: 06/22/2024] [Indexed: 07/10/2024] Open
Abstract
There are no published reports describing the anatomic variations of the phrenicoabdominal (PhAbd) veins in cats. The aim of this study was to evaluate the anatomic variations of the PhAbd veins in cats without adrenal disease. This is an anatomic study. Abdominal CT images of cats acquired from January 2021 to February 2023 were retrospectively reviewed. Inclusion criteria were the presence of pre- and postcontrast CT images of the abdomen and the absence of any abdominal diseases that compromise the left and right PhAbd veins visualization. A total of 128 cats were included. Three different vascular anatomic variations were found in the distal pericaval segment of the left phrenicoabdominal (LPhAbd) vein. In the first type, found in 65 cases (50.8%), the LPhAbd vein drained directly into the caudal vena cava. In the second type defined IIa, found in 25 cases (19.5%), the LPhAbd vein drained into the distal third of the left renal vein, less than 5 mm from its opening into the caudal vena cava. In the third type defined IIb, found in 38 cases (29.7%), the LPhAbd vein drained into the distal third of the left renal vein, more than 5 mm from its opening into the caudal vena cava. The right phrenicoabdominal vein had a consistent path and drained into the caudal vena cava in all cases. The knowledge of these vascular variations is expected to help the surgeon during adrenalectomy due to masses with vascular invasion in cats.
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Affiliation(s)
- Dario Nappo
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
| | - Chiara Massarenti
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
| | | | - Eric Zini
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse, Zurich, Switzerland
| | - Giuseppe Lacava
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
| | - Silvia Rabba
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
| | - Edoardo Auriemma
- AniCura Istituto Veterinario Novara, Granozzo con Monticello, Novara, Italy
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Teter K, Jacobowitz G, Rockman C, Gupta M, Muntyan I, Pachter L. Surgical management of recurrent and extra-adrenal pheochromocytomas requiring vascular resection and reconstruction. J Vasc Surg Cases Innov Tech 2023; 9:101202. [PMID: 37799829 PMCID: PMC10547824 DOI: 10.1016/j.jvscit.2023.101202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/06/2023] [Indexed: 10/07/2023] Open
Abstract
This case series highlights that extra-adrenal and recurrent pheochromocytomas can require en bloc vascular resection to achieve negative margins. Through this series of cases performed in a multidisciplinary fashion, we aim to highlight the technical aspects of these cases that can add to their complexity. Vascular invasion alone should not preclude an otherwise feasible oncologic resection.
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Affiliation(s)
- Katherine Teter
- Division of Vascular and Endovascular Surgery, Department of Surgery, NYU Langone Health, New York, NY
| | - Glenn Jacobowitz
- Division of Vascular and Endovascular Surgery, Department of Surgery, NYU Langone Health, New York, NY
| | - Caron Rockman
- Division of Vascular and Endovascular Surgery, Department of Surgery, NYU Langone Health, New York, NY
| | - Mohit Gupta
- Department of Urology, NYU Langone Health, New York, NY
| | - Igor Muntyan
- Department of Anesthesia, NYU Langone Health, New York, NY
| | - Leon Pachter
- Division of General Surgery, Department of Surgery, NYU Langone Health, New York, NY
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3
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Büttelmann G, Harder LK, Nolte I, Wefstaedt P. Impact of body weight and sex in selected dog breeds on the canine adrenal gland dimensions measured by computed tomographic imaging. BMC Vet Res 2023; 19:99. [PMID: 37516850 PMCID: PMC10385925 DOI: 10.1186/s12917-023-03641-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 07/10/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND The present study aimed to investigate possible influences of body weight and sex on adrenal gland size in endocrinologically healthy dogs. Possible factors influencing the adrenal size are discussed in relation to a universal upper reference value from the literature of 7.4 mm as the thickness in the caudal pole of the adrenal gland. The adrenal size was measured by computed tomography (CT) from 66 normal dogs of six different breeds (Labrador Retriever (n = 16), German Shepherd (n = 10), Boxer (n = 8), Beagle (n = 14), Dachshund (n = 6) and Jack Russell Terrier (n = 12); male n = 38 (thereof neutered n = 23), female n = 28 (thereof neutered n = 17)) based on volume quantification and linear measurements using the data processing software Amira. For interbreed comparability, a ratio consisting of the third root of adrenal volume to aortic diameter (Ratio volume-aorta, RVA) was introduced. Additionally, breed-related attenuation values in contrast-enhanced CT data sets were measured. RESULTS The measured volumes ranged from 0.34 to 1.93 cm3 for the right and from 0.39 to 2.23 cm3 for the left adrenal gland. The present study was able to demonstrate a body weight effect on the adrenal volume as well as on length and height. In terms of adrenal size, no significant differences between male and female, nor between intact and neutered dogs were obtained due to the RVA. In addition, for the weight classes, a breed independent threshold for dogs less (left 1.4; right gland 1.5) or more than 20 kg body weight (left 1.1; right gland 1.2) based on RVA was defined. Breed-related significant differences with respect to attenuation were determined only for the left adrenal gland, with lower attenuation values in large dog breeds. CONCLUSION The present study points out the importance of weight-related data when assessing CT data of the canine adrenal gland regarding volume, size and attenuation. The use of a universal reference value for the assessment of adrenal size appears unsuitable considering weight-related volume and linear measurements. Sex seems not to affect adrenal gland size.
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Affiliation(s)
- Gerrit Büttelmann
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
| | - Lisa Katharina Harder
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
| | - Ingo Nolte
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany.
| | - Patrick Wefstaedt
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
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Takeuchi R, Ishigaki K, Yoshida O, Sakurai N, Terai K, Heishima T, Asano K. Preemptively planned en bloc resection of an extensive right adrenal pheochromocytoma involving the right hepatic division, caval thrombus and segmental caudal vena cava in a dog with Budd-Chiari-like syndrome. Vet Med Sci 2023; 9:1078-1086. [PMID: 36913113 DOI: 10.1002/vms3.1110] [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: 01/17/2022] [Revised: 01/22/2023] [Accepted: 02/19/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Surgical resection is the treatment of choice for canine adrenal pheochromocytomas (PHEOs). Information on en bloc resection of adrenal PHEO with tumour thrombus, right hepatic division and segmental caudal vena cava (CVC) running through the adrenal tumour and right hepatic division is limited. OBJECTIVE To describe the preemptively planned en bloc resection of an extensive right adrenal PHEO involving the right hepatic division, the caval thrombus and the segmental CVC in a dog with Budd-Chiari-like syndrome (BCLS). METHODS A 13-year-old castrated male miniature dachshund was referred for surgical treatment due to anorexia, lethargy and severe abdominal distension caused by abundant ascites. Preoperative computed tomography (CT) revealed a large mass in the right adrenal gland with a large caval thrombus obstructing the CVC and hepatic veins, which caused BCLS. Additionally, collateral vessels were formed between the CVC and azygos veins. No findings suggested obvious metastases. Based on CT findings, an en bloc resection of the adrenal tumour with caval thrombus, right hepatic division and segmental CVC was planned. RESULTS The preoperatively planned resection was feasible; the tumour was completely resected grossly. The operation time and total Pringle manoeuvre time were 162 min and 16 min 56 s, respectively. There was no postoperative hindlimb oedema, renal dysfunction, ascites or abdominal distention. The patient's clinical signs, including appetite, fully improved. Hospitalization lasted 16 days. However, the patient died on the 130th postoperative day due to suspected metastases and cachexia. CONCLUSIONS Even in case of an extensive infiltration of adrenal PHEO causing BCLS, an en bloc resection might be successfully achieved based on the preoperative CT findings speculating the collateral vessels formed for caudal venous return.
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Affiliation(s)
- Ryo Takeuchi
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Kumiko Ishigaki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Orie Yoshida
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Naoki Sakurai
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Kazuyuki Terai
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Tatsuya Heishima
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
| | - Kazushi Asano
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Japan
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Swepson R, Hosgood G, Stander N. Algorithmic estimation of adrenal volume based on body weight and CT landmarks in dogs. Vet Radiol Ultrasound 2022; 63:264-271. [PMID: 34997659 DOI: 10.1111/vru.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
Computed tomographic (CT) methods for quantifying adrenal size are helpful for identifying and directing management of adrenal disease in dogs. This retrospective, observational study aimed to use CT to determine anatomic landmarks associated with adrenal gland volume in dogs, and subsequently develop an algorithm to estimate adrenal volume for individual subjects. Abdominal CT images from 150 dogs without adrenal disease were assessed. The volume of the left and right adrenals, as well as dimensions from anatomic structures, were measured. Predictive models for adrenal volume were examined with cross validation. A further 29 dogs were used for external validation and model fit. Dogs in the test cohort weighed from 3.1 to 67.5 kg (mean 24.4 kg) with left (VLA ) and right (VRA ) adrenal volume ranging from 0.23 to 2.84 cm3 (mean 1.22 cm3 ) and 0.14 to 2.97 cm3 (mean 1.11 cm3 ), respectively. A predictive model for each adrenal based on weight (W) and L1 height (HL1 ) best explained the adrenal volume, with external validation confirming model fit. The final models, adjusted for bias, were: VLA = 0.154 + (0.02 × W) + (0.07 × HL1 ) (adjR2 = 0.62); and VRA = -0.116 + (0.02 × W) + (0.06 × HL1 ) (adjR2 = 0.64). In dogs undergoing CT, these algorithms can be used to estimate expected adrenal volume and allow comparison with the actual volume measured on CT, facilitating interpretation of CT findings, and clinical decision-making.
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Affiliation(s)
- Ryan Swepson
- Department of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Giselle Hosgood
- Department of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Nerissa Stander
- Vet Imaging Specialists, The Animal Hospital at Murdoch University, Perth, Australia
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Pey P, Specchi S, Rossi F, Diana A, Drudi I, Zwingenberger AL, Mayhew PD, Pisoni L, Mari D, Massari F, Dalpozzo B, Fracassi F, Nicoli S. Prediction of vascular invasion using a 7-point scale computed tomography grading system in adrenal tumors in dogs. J Vet Intern Med 2022; 36:713-725. [PMID: 35233853 PMCID: PMC8965227 DOI: 10.1111/jvim.16371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies evaluating the accuracy of computed tomography (CT) in detecting caudal vena cava (CVC) invasion by adrenal tumors (AT) used a binary system and did not evaluate for other vessels. OBJECTIVE Test a 7-point scale CT grading system for accuracy in predicting vascular invasion and for repeatability among radiologists. Build a decision tree based on CT criteria to predict tumor type. METHODS Retrospective observational cross-sectional case study. Abdominal CT studies were analyzed by 3 radiologists using a 7-point CT grading scale for vascular invasion and by 1 radiologist for CT features of AT. ANIMALS Dogs with AT that underwent adrenalectomy and had pre- and postcontrast CT. RESULTS Ninety-one dogs; 45 adrenocortical carcinomas (50%), 36 pheochromocytomas (40%), 9 adrenocortical adenomas (10%) and 1 unknown tumor. Carcinoma and pheochromocytoma differed in pre- and postcontrast attenuation, contralateral adrenal size, tumor thrombus short- and long-axis, and tumor and thrombus mineralization. A decision tree was built based on these differences. Adenoma and malignant tumors differed in contour irregularity. Probability of vascular invasion was dependent on CT grading scale, and a large equivocal zone existed between 3 and 6 scores, lowering CT accuracy to detect vascular invasion. Radiologists' agreement for detecting abnormalities (evaluated by chance-corrected weighted kappa statistics) was excellent for CVC and good to moderate for other vessels. The quality of postcontrast CT study had a negative impact on radiologists' performance and agreement. CONCLUSIONS AND CLINICAL IMPORTANCE Features of CT may help radiologists predict AT type and provide probabilistic information on vascular invasion.
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Affiliation(s)
- Pascaline Pey
- Department of Veterinary Medical ScienceAlma Mater Studiorum, University of BolognaOzzano Emilia (BO)Italy,Antech Imaging Services, IrvineCAUSA
| | - Swan Specchi
- Ospedale Veterinario i Portoni RossiBologna (BO)Italy
| | - Federica Rossi
- Clinica Veterinaria dell'OrologioSasso Marconi (BO)Italy
| | - Alessia Diana
- Department of Veterinary Medical ScienceAlma Mater Studiorum, University of BolognaOzzano Emilia (BO)Italy
| | - Ignazio Drudi
- Department of Statistical SciencesAlma Mater Studiorum, University of BolognaBologna (BO)Italy
| | - Allison L. Zwingenberger
- Department of Surgical & Radiological SciencesSchool of Veterinary Medicine, University of CaliforniaDavisCaliforniaUSA
| | - Philipp D. Mayhew
- Department of Surgical & Radiological SciencesSchool of Veterinary Medicine, University of CaliforniaDavisCaliforniaUSA
| | - Luciano Pisoni
- Department of Veterinary Medical ScienceAlma Mater Studiorum, University of BolognaOzzano Emilia (BO)Italy
| | | | | | - Boris Dalpozzo
- Clinica Veterinaria dell'OrologioSasso Marconi (BO)Italy
| | - Federico Fracassi
- Department of Veterinary Medical ScienceAlma Mater Studiorum, University of BolognaOzzano Emilia (BO)Italy
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7
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Lee E, Choi BK, Lee SK, Choi J. 3.0-Tesla MRI of normal canine adrenal glands. Vet Radiol Ultrasound 2022; 63:206-215. [PMID: 35073434 DOI: 10.1111/vru.13066] [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: 12/22/2020] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Adrenal disease is a common problem in dogs and MRI is increasingly being used as an adjunctive diagnostic test. To date, the MRI features of normal canine adrenal glands have only been reported using 1.5-Tesla (T) MRI. The aims of this prospective, methods-comparison, exploratory study were to evaluate the effects of pulse sequence on the appearance of normal canine adrenal glands using 3 Tesla MRI. Six research beagle dogs were sampled and the following pulse sequences were acquired for each: (1) T2-weighted images using two-dimensional (2D) turbo spin-echo (TSE), single-shot spin-echo (SSTSE), and three-dimensional (3D) TSE, (2) T1-weighted images using 2D TSE, 3D TSE, and 3D turbo field echo sequences, (3) post-contrast T1-weighted images, and (4) chemical shift imaging. The signal-to-noise ratio and contrast-to-noise ratio were measured for each dog and each pulse sequence. The signal intensity, clarity of the contour, distinction of the corticomedullary junction, degrees of motion, partial volume, and chemical shift artifact, and homogeneity of the contrast enhancement were evaluated qualitatively. In all sequences, except for chemical shift imaging, the adrenal glands were visualized in both planes with successful control of motion artifacts by manual ventilation. The adrenal contour was considered to be most clearly visualized with 2D TSE. Adrenal images were acquired within the shortest time using SSTSE although the contour was less clearly visualized than with TSE. Findings from this study in normal dogs can serve as background for further 3.0-T MRI studies of dogs with adrenal disease.
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Affiliation(s)
- Eunji Lee
- College of Veterinary Medicine, Chonnam National University, Yongbong-ro, Buk-gu, Gwangju, South Korea
| | - Bo-Kwon Choi
- College of Veterinary Medicine, Chonnam National University, Yongbong-ro, Buk-gu, Gwangju, South Korea
| | - Sang-Kwon Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
| | - Jihye Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
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8
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Marin C, Tuts J, Luyten FP, Vandamme K, Kerckhofs G. Impaired soft and hard callus formation during fracture healing in diet-induced obese mice as revealed by 3D contrast-enhanced computed tomography imaging. Bone 2021; 150:116008. [PMID: 33992820 DOI: 10.1016/j.bone.2021.116008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/21/2022]
Abstract
The impact of diabetes mellitus on bone fracture healing is clinically relevant as the patients experience delayed fracture healing. Even though efforts have been made to understand the detrimental effects of type 2 diabetes mellitus (T2DM) on the fracture healing process, the exact mechanisms causing the pathophysiological outcomes remain unclear. The aim of this study was to assess alterations in bone fracture healing (tibial fracture surgery, intramedullary pinning) of diet-induced obese (DIO) mice, and to investigate the in vitro properties of osteochondroprogenitors derived from the diabetic micro-environment. High-resolution contrast-enhanced microfocus X-ray computed tomography (CE-CT) enabled a simultaneous 3D assessment of the amount and spatial distribution of the regenerated soft and hard tissues during fracture healing and revealed that osteogenesis as well as chondrogenesis are altered in DIO mice. Compared to age-matched lean controls, DIO mice presented a decreased bone volume fraction and increased callus volume and adiposity at day 14 post-fracture. Of note, bone turnover was found altered in DIO mice relative to controls, evidenced by decreased blood serum osteocalcin and increased serum CTX levels. The in vitro data revealed that not only the osteogenic and adipogenic differentiation of periosteum-derived cells (PDCs) were altered by hyperglycemic (HG) conditions, but also the chondrogenic differentiation. Elevated PPARγ expression in HG conditions confirmed the observed increase in differentiated adipocytes in vitro. Finally, chondrogenesis-related genes COL2 and COL10 were downregulated for PDCs treated with HG medium, confirming that chondrogenic differentiation is compromised in vitro and suggesting that this may affect callus formation and maturation during the fracture healing process in vivo. Altogether, these results provide novel insights into the alterations of long bone fracture repair and suggest a link between HG-induced dysfunctionality of osteochondroprogenitor differentiation and fracture healing impairment under T2DM conditions.
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Affiliation(s)
- Carlos Marin
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium; Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Jolien Tuts
- Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Frank P Luyten
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium; Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Greet Kerckhofs
- Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium; Department of Material Science and Engineering, KU Leuven, Leuven, Belgium; Biomechanics lab, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium; Institute for Experimental and Clinical Research, UCLouvain, Woluwe, Belgium.
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9
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Latifi M, Skinner OT, Spoldi E, Ackerman L, Souza CHDM, Yoon J, Vinayak A, Tuohy JL, Wallace ML, Dornbusch JA, Selmic LE, Menard J, Sumner JP, Schrock KC, Wustefeld-Janssens BG, Matz BM, Daniel TE, Mickelson MA. Outcome and postoperative complications in 73 dogs with thyroid carcinoma with gross vascular invasion managed with thyroidectomy. Vet Comp Oncol 2021; 19:685-696. [PMID: 33993605 DOI: 10.1111/vco.12739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/26/2021] [Accepted: 05/13/2021] [Indexed: 12/19/2022]
Abstract
Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion.
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Affiliation(s)
- Max Latifi
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Owen T Skinner
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Elisa Spoldi
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Leah Ackerman
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Carlos H De M Souza
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Jin Yoon
- Surgical Oncology Department, VCA West Coast Specialty and Emergency Animal Hospital, Fountain Valley, California, USA
| | - Arathi Vinayak
- Surgical Oncology Department, VCA West Coast Specialty and Emergency Animal Hospital, Fountain Valley, California, USA
| | - Joanne L Tuohy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Mandy L Wallace
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Josephine A Dornbusch
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Laura E Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Jenna Menard
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Julia P Sumner
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Kelly C Schrock
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biosciences, Texas A&M University, College Station, Texas, USA
| | - Brandan G Wustefeld-Janssens
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biosciences, Texas A&M University, College Station, Texas, USA
| | - Brad M Matz
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Todd E Daniel
- Department of Information Technology and Cybersecurity, College of Business, Missouri State University, Springfield, Missouri, USA
| | - Megan A Mickelson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
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10
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Perfetti S, Diana A, Baron Toaldo M, Cipone M, Quinci M, Pey P. CT measures of adrenal gland length and caudal pole diameter are reproducible in large breed dogs: A pilot study. Vet Radiol Ultrasound 2021; 62:402-412. [PMID: 33831244 PMCID: PMC8360083 DOI: 10.1111/vru.12970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 12/04/2022] Open
Abstract
Computed tomography (CT) is increasingly available to evaluate dogs with suspected adrenal disease, however, published studies describing the reproducibility of CT methods for quantifying adrenal gland (AG) measurements are lacking. This prospective, pilot, observer agreement study aimed to evaluate reproducibility and repeatability of two different methods of measurement of AGs on CT to establish a usable technique and define standard reference ranges. Multiplanar reformatted (MPR) CT images of both AGs of six large breed dogs were obtained with the MPR axis parallel to the spine and parallel to the long axis of the AG. Ten measurements were performed: maximal length and diameter at cranial and caudal poles on dorsal, sagittal, and transverse images; and minimal diameter of cranial and caudal poles on transverse images. Three observers with different levels of experience repeated these measurements three times for each dog. Intra‐ and interobserver variability were calculated through intraclass correlation coefficient (ICC). The differences in time to perform measurements between the two methods were tested with Student's t‐test. Regardless of the measurement method used, length of AGs on dorsal and sagittal MPR images had the lowest intra‐ and inter‐observer variability (ICC = 0.93‐0.99), diameter of caudal pole on transverse plane showed low intra‐ and interobserver variability (ICC = 0.77‐0.80) and diameter of cranial pole had the highest variability (ICC = 0.12‐0.61). Although length was the less variable measurement, its use may be unrealistic in daily practice. Interestingly measurement of caudal pole on transverse plane was characterized by low intra‐ and interobserver variability. No difference in time performing the measurements was noted between the two methods.
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Affiliation(s)
- Simone Perfetti
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Alessia Diana
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Marco Baron Toaldo
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Mario Cipone
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Manuela Quinci
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Pascaline Pey
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
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11
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Chiti LE, Mayhew PD, Massari F. Renal venotomy for thrombectomy and kidney preservation in dogs with adrenal tumors and renal vein invasion. Vet Surg 2021; 50:872-879. [PMID: 33616246 DOI: 10.1111/vsu.13593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/28/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the surgical technique and report the outcomes of adrenalectomy and thrombus removal with kidney preservation by renal venotomy in a population of dogs with adrenal tumors and vascular invasion into the renal vein (RV) and caudal vena cava (CVC). STUDY DESIGN Short case series. ANIMALS Five client-owned dogs that underwent adrenalectomy. METHODS Dogs with adrenal tumors and vascular invasion into the RV and CVC were retrospectively enrolled in this multi-institutional study. Renal venotomy was performed at the time of adrenalectomy for tumor thrombus removal. Recorded data included signalment, clinical signs and results of laboratory testing, physical examination findings, diagnostic imaging results, surgical technique, surgical time, surgical complications, and outcome. RESULTS Tumor thrombus was removed by renal venotomy in five dogs. In one dog with an ectopic adrenal tumor located ventral to the left kidney, the thrombus was occluding 90% of caval flow, and a small caval venotomy was required to remove it. Kidney preservation was achieved in all dogs. No significant intraoperative or postoperative complications occurred, and all dogs were discharged 3 to 4 days postoperatively. Median surgical time was 125 minutes (range, 80-210). At the end of the study, four dogs were alive without signs of recurrence, while one dog died of a suspected pulmonary embolism at 510 days. Median follow-up was 510 days (range, 279-890). CONCLUSION Renal venotomy is feasible for thrombectomy in dogs with adrenal tumors and RV invasion and allowed for the preservation of the kidney in this case series, thus limiting perioperative morbidity.
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Affiliation(s)
- Lavinia E Chiti
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano-Lodi, Lodi, Lombardy, Italy.,Clinica Veterinaria Nervianese, Nerviano, Milan, Italy
| | - Philipp D Mayhew
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, California, USA
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12
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Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- BVSc, Ce666rtAVP, DipECVDI, Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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13
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Use of Contrast-Enhanced Ultrasonography for the Characterization of Tumor Thrombi in Seven Dogs. Animals (Basel) 2020; 10:ani10091613. [PMID: 32927883 PMCID: PMC7552278 DOI: 10.3390/ani10091613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 01/11/2023] Open
Abstract
Simple Summary Some neoplasia—such as adrenal and thyroid glands tumors—have been associated with “tumor thrombi” both in humans and dogs. The detection and characterization of these venous tumor thrombi is important for both surgical planning and prognosis. In human medicine, contrast-enhanced ultrasonography (CEUS) is considered an accurate diagnostic technique for differentiating malignant from benign portal vein thrombosis in hepatocellular carcinomas. Data regarding the characteristics of tumor thrombi in dogs are currently lacking. Therefore, the aim of this study was to assess the feasibility of CEUS for the characterization of malignant venous thrombosis in dogs. On the basis of our results, CEUS appeared to be useful in the detection of malignant intravascular invasion; contrast uptake of the thrombus was present in all cases. In addition, CEUS may clearly detect newly formed vessels within the thrombus, and arterial-phase enhancement and washout in the venous phase were the main features in malignant thrombosis in our dogs. As CEUS is an easy to perform, noninvasive technique, its application in the detection of malignant thrombosis in dogs may be used to improve the diagnosis in oncological canine patients. Abstract Tumors of adrenal and thyroid glands have been associated with vascular invasions—so-called tumor thrombi, both in humans and dogs. The detection and characterization of venous thrombi is an important diagnostic step in patients with primary tumors for both surgical planning and prognosis. The aim of this study was to describe the use of contrast-enhanced ultrasonography (CEUS) for the characterization of tumor thrombi. Dogs with tumor thrombus who underwent bi-dimensional ultrasound (B-mode US) and CEUS were included. Seven dogs were enrolled in this retrospective case series. On B-mode US, all thrombi were visualized, and vascular distension and thrombus-tumor continuity were seen in three and two cases, respectively. On color Doppler examination, all thrombi were identified, seemed non-occlusive and only two presented vascularity. On CEUS, arterial-phase enhancement and washout in the venous phase were observed in all cases. Non-enhancing areas were identified in the tumor thrombi most likely representing non-vascularized tissue that could potentially be embolized in the lungs after fragmentation of the tumor thrombi. On the basis of these preliminary study, CEUS appeared to be useful for the characterization of malignant intravascular invasion.
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Appelgrein C, Hosgood G, Drynan E, Nesbitt A. Short-term outcome of adrenalectomy in dogs with adrenal gland tumours that did not receive pre-operative medical management. Aust Vet J 2020; 98:449-454. [PMID: 32583433 DOI: 10.1111/avj.12991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Review medical records of dogs that underwent adrenalectomy without pre-operative medical management, to examine the peri-operative morbidity and mortality. DESIGN Case series of 65 dogs. METHODS Medical records were reviewed. Features recorded included the histologic diagnosis, intra-operative hypertension or tachycardia, requirement for cavotomy, administration of intra- and post-operative corticosteroids, performance of additional surgery and the occurrence of peri-operative complications. Dogs requiring emergency surgery were excluded. RESULTS Of the 65 dogs, 49 had adrenocortical tumours (11 bilateral), 13 had pheochromocytomas (one bilateral) and three dogs had tumours in both adrenal glands of a different tumour type. Five dogs had caudal vena cava invasion and 33 had additional procedures performed at the same time. Mortality occurred in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%), major complications were identified in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%) and minor complications occurred in 10/53 dogs (15%; 95% CI 8.6%-26%). CONCLUSION Based on the limited peri-operative complications and low mortality in this pre-operatively untreated cohort, and based on critique of the available literature, the added value afforded by pre-operative treatment is questioned. With appropriate management, adrenal tumours can be removed with few peri-operative complications and low mortality.
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Affiliation(s)
- C Appelgrein
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - G Hosgood
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - E Drynan
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - A Nesbitt
- School of Veterinary Medicine, Murdoch University, Perth, Australia
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15
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Specchi S, d'Anjou MA. Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review. Vet Radiol Ultrasound 2019; 60:613-632. [PMID: 31243852 DOI: 10.1111/vru.12780] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 12/26/2022] Open
Abstract
Advances in interventional radiology and surgical techniques now allow complex abdominal diseases to be more successfully treated in small animals. Abdominal vascular alterations, acquired as individual process or as complication of other lesions such as neoplasia, can be life-threatening or at least greatly limit curative interventions of underlying diseases. Computed tomography (CT) and high-definition ultrasonography are now readily available in veterinary referral centers. Yet, there is little information currently available on the use of these modalities for the diagnosis and characterization of these vascular alterations. The purpose of this article is to review the CT and ultrasonographic findings of acquired vascular diseases in the abdomen of dogs and cats, using both the veterinary and human medicine literature as references, and highlighting essential concepts through figures.
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Affiliation(s)
- Swan Specchi
- Ospedale Veterinario i Portoni Rossi, Bologna, 40069, Italy.,Animages, Longueuil, Quebec, J4G 2L2, Canada
| | - Marc-André d'Anjou
- Ospedale Veterinario i Portoni Rossi, Bologna, 40069, Italy.,Animages, Longueuil, Quebec, J4G 2L2, Canada
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16
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Mayhew PD, Boston SE, Zwingenberger AL, Giuffrida MA, Runge JJ, Holt DE, Raleigh JS, Singh A, Culp WTN, Case JB, Steffey MA, Balsa IM. Perioperative morbidity and mortality in dogs with invasive adrenal neoplasms treated by adrenalectomy and cavotomy. Vet Surg 2019; 48:742-750. [PMID: 31034643 DOI: 10.1111/vsu.13221] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 03/11/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report the morbidity and mortality associated with adrenalectomy with cavotomy for resection of invasive adrenal neoplasms in dogs and evaluate risk factors for perioperative outcomes. STUDY DESIGN Retrospective study. ANIMALS Forty-five client-owned dogs. METHODS Dogs that underwent open adrenalectomy with cavotomy for resection of adrenal masses with tumor thrombus extending into the vena cava were included. Clinicopathologic data were harvested from medical records. Selected clinical, imaging, and operative variables were statistically evaluated as risk factors for packed red blood cell transfusion, nephrectomy, perioperative death, and overall survival. RESULTS Thirty-six of 45 masses were pheochromocytomas, 7 were adrenocortical carcinomas, and 2 were unknown type. Caval thrombus terminated prehepatically in 21 of 45 dogs and extended beyond the porta hepatis but terminated prediaphragmatically (intrahepatic prediaphragmatic location) in 15 dogs and thrombi extended postdiaphragmatically in 5 dogs. Thirty-four (76%) dogs were discharged from the hospital, and 11 (24%) dogs died or were euthanized prior to discharge. Median overall survival time for all 45 dogs was 547 days (95%CI 146-710). Bodyweight, tumor type, and size and extent of caval thrombus did not affect survival to discharge, but postdiaphragmatic (rather than prediaphragmatic) thrombus termination was associated with a greater risk of death. CONCLUSION Long-term survival was common in dogs that survived the perioperative period. Postdiaphragmatic thrombus extension affected the prognosis for overall survival. CLINICAL SIGNIFICANCE Findings of this study help to stratify operative risk in dogs with adrenal neoplasia and caval invasion.
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Affiliation(s)
- Philipp D Mayhew
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Sarah E Boston
- VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, Ontario, Canada
| | | | - Michelle A Giuffrida
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Jeffrey J Runge
- Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - David E Holt
- Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph S Raleigh
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Ameet Singh
- Departments of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - William T N Culp
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - J Brad Case
- School of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Michele A Steffey
- School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Ingrid M Balsa
- School of Veterinary Medicine, University of California-Davis, Davis, California
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17
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Mayhew PD, Culp WTN, Balsa IM, Zwingenberger AL. Phrenicoabdominal venotomy for tumor thrombectomy in dogs with adrenal neoplasia and suspected vena caval invasion. Vet Surg 2017; 47:227-235. [DOI: 10.1111/vsu.12728] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/04/2017] [Accepted: 06/22/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Philipp D. Mayhew
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - William T. N. Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Ingrid M. Balsa
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Allison L. Zwingenberger
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
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18
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Yoon S, Oui H, Lee JH, Son KY, Cho KO, Choi J. Repetitive ultrasonographic assessment of adrenal size and shape changes: a clue for an asymptomatic sex hormone-secreting adenoma. J Vet Sci 2017; 18:105-109. [PMID: 27297418 PMCID: PMC5366294 DOI: 10.4142/jvs.2017.18.1.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/16/2016] [Accepted: 05/12/2016] [Indexed: 12/02/2022] Open
Abstract
Diagnosis of an adrenal tumor without typical clinical signs related to hyperadrenocorticism and elevated alkaline phosphatase is challenging. This report describes a sex hormone-secreting adrenal tumor in a 10-year-old castrated male Shih Tzu evaluated through repetitive ultrasonographic examination. An adrenocorticotropic hormone stimulation test revealed elevated concentrations of androstenedione and 17-hydroxyprogesterone but a normal cortisol concentration. A mass was surgically excised and adenoma was diagnosed histopathologically. In the present case, adrenal tumor was strongly suspected based on a gradual increase in adrenal size and a change from peanut shape to an irregular mass on repetitive ultrasonography. Repetitive ultrasonographic examination of the adrenal gland is recommended when an abnormal ultrasonographic appearance of adrenal gland is identified, even in an asymptomatic dog.
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Affiliation(s)
- Seunghyeon Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea
| | - Heejin Oui
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea
| | - Ju-Hwan Lee
- Department of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea
| | - Kyu-Yeol Son
- Chonnam National University Veterinary Teaching Hospital, Gwangju 61186, Korea
| | - Kyoung-Oh Cho
- Chonnam National University Veterinary Teaching Hospital, Gwangju 61186, Korea
| | - Jihye Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea
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19
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Bertolini G, Drigo M, Angeloni L, Caldin M. INCIDENTAL AND NONINCIDENTAL CANINE THYROID TUMORS ASSESSED BY MULTIDETECTOR ROW COMPUTED TOMOGRAPHY: A SINGLE-CENTRE CROSS SECTIONAL STUDY IN 4520 DOGS. Vet Radiol Ultrasound 2017; 58:304-314. [DOI: 10.1111/vru.12477] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/28/2016] [Indexed: 12/18/2022] Open
Affiliation(s)
- Giovanna Bertolini
- Diagnostic and Interventional Radiology, San Marco Veterinary Clinic; via Sorio 114/c, 35141 Padova Italy
| | - Michele Drigo
- Dipartimento di Medicina Animale, Produzioni e Salute; Università degli Studi di Padova Scuola di Agraria e Medicina Veterinaria; Italy
| | - Luca Angeloni
- Diagnostic and Interventional Radiology, San Marco Veterinary Clinic; via Sorio 114/c, 35141 Padova Italy
| | - Marco Caldin
- San Marco Veterinary Laboratory; via Sorio 114/c, 35141 Padova Italy
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20
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Galac S, Korpershoek E. Pheochromocytomas and paragangliomas in humans and dogs. Vet Comp Oncol 2017; 15:1158-1170. [DOI: 10.1111/vco.12291] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/04/2016] [Accepted: 10/22/2016] [Indexed: 12/18/2022]
Affiliation(s)
- S. Galac
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - E. Korpershoek
- Department of Pathology, Erasmus Medical Center Cancer Institute; University Medical Center Rotterdam; Rotterdam The Netherlands
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21
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Pitt KA, Mayhew PD, Steffey MA, Culp WTN, Fuller MC, Della Maggiore A, Nelson RW. Laparoscopic Adrenalectomy for Removal of Unilateral Noninvasive Pheochromocytomas in 10 Dogs. Vet Surg 2016; 45:O70-O76. [DOI: 10.1111/vsu.12552] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 06/03/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kathryn A. Pitt
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Philipp D. Mayhew
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Michele A. Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - William T. N. Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Mark C. Fuller
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Ann Della Maggiore
- Department of Medicine and Epidemiology, School of Veterinary Medicine; University of California-Davis; Davis California
| | - Richard W. Nelson
- Department of Medicine and Epidemiology, School of Veterinary Medicine; University of California-Davis; Davis California
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23
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Bargellini P, Orlandi R, Dentini A, Paloni C, Rubini G, Fonti P, Diana A, Peterson ME, Boiti C. Use of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Adrenal Tumors in Dogs. J Am Anim Hosp Assoc 2016; 52:132-43. [DOI: 10.5326/jaaha-ms-6363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
We evaluated the diagnostic accuracy of the contrast-enhanced ultrasonography (CEUS), using a second-generation microbubble contrast agent, in differentiating the different types of adrenal mass lesions in 24 dogs. At B-mode ultrasound, 9 lesions involved the right adrenal gland, 14 the left, and 1 was bilateral. Each dog received a bolus of the contrast agent into the cephalic vein, immediately followed by a 5-mL saline flush. The first contrast enhancement of each adrenal lesion was evaluated qualitatively to assess the degree of enhancement and its distribution during the wash-in and wash-out phases, as well as the presence of non-vascularized areas and specific vascular patterns. Pathological diagnoses were determined in all dogs by histopathology or by cytology. Combining enhancement degree and vascularity resulted in the best predictive model, allowing CEUS to differentiate adrenocortical adenoma (n=10), adenocarcinoma (n=7), and pheochromocytoma (n=7) with an accuracy of 91.7% (P < 0.001). Combining enhancement degree and vascularity, CEUS can discriminate malignant versus benign adrenal lesions with a sensitivity of 100.0%, a specificity of 80.0%, and an accuracy of 91.7% (P < 0.001). In conclusion, results of this study confirm that CEUS is useful for differentiating between the different types of adrenal tumors in dogs.
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Affiliation(s)
- Paolo Bargellini
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Riccardo Orlandi
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Alfredo Dentini
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Chiara Paloni
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Giuseppe Rubini
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Paolo Fonti
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Alessia Diana
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Mark E. Peterson
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
| | - Cristiano Boiti
- From the Tyrus Clinica Veterinaria, Terni, Italy (P.B., R.O., A.D., C.P.); Ultravet Diagnostic, Bologna, Italy (G.R.); Centro Veterinario Specialistico, Roma, Italy (P.F.); Dipartimento di Scienze Mediche Veterinarie, Ozzano Emilia, Italy (A.D.); Animal Endocrine Clinic, New York, NY (M.E.P.); and Laboratorio di Biotecnologie Fisiologiche, Università degli Studi di Perugia, Perugia, Italy (C.B.)
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Blaser A, Dennler M, Mosing M, Gent TC, Santner G, Imhasly S, Boretti FS, Reusch CE, Kircher P, Sieber-Ruckstuhl NS. Effects of contrast medium injection technique on attenuation values of adrenal glands in healthy dogs during contrast-enhanced computed tomography. Am J Vet Res 2016; 77:144-50. [PMID: 27027707 DOI: 10.2460/ajvr.77.2.144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the effects of 3 contrast medium injection techniques on attenuation values for canine adrenal glands during contrast-enhanced CT. ANIMALS 9 healthy Beagles. PROCEDURES 3 protocols were evaluated in a randomized cross-over design study: 700 mg of iodine/kg at a constant injection rate over 20 seconds (full-dose constant rate), the same dose at a rate following an exponential decay curve over 20 seconds (full-dose decelerated rate), and 350 mg of iodine/kg at a constant injection rate over 10 seconds (half-dose constant rate). Multislice CT images were obtained before and at predetermined time points after the start of contrast medium injection. RESULTS Median peak attenuation values were 129, 133, and 87 Hounsfield units with the full-dose constant rate, full-dose decelerated rate, and half-dose constant rate injection protocols, respectively. Peak attenuation differed significantly between the full-dose constant rate and half-dose constant rate injection protocols and between the full-dose decelerated rate and half-dose constant rate injection protocols. Median time to peak attenuation did not differ significantly among injection methods and was 30, 23, and 15 seconds for the full-dose constant rate, full-dose decelerated rate, and half-dose constant rate injections, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The dose of contrast medium and the timing of postinjection CT scanning were main determinants of peak attenuation for adrenal glands in healthy dogs; effects of the 3 injection protocols on attenuation were minor. The exponentially decelerated injection method was subjectively complex. A constant injection protocol delivering 700 mg of iodine/kg over 20 seconds, with scans obtained approximately 30 seconds after starting contrast medium injection, provided images with maximum adrenal gland attenuation values.
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Yoshida O, Kutara K, Seki M, Ishigaki K, Teshima K, Ishikawa C, Iida G, Edamura K, Kagawa Y, Asano K. Preoperative Differential Diagnosis of Canine Adrenal Tumors Using Triple-Phase Helical Computed Tomography. Vet Surg 2016; 45:427-35. [PMID: 27007886 DOI: 10.1111/vsu.12462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 06/12/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To characterize the computed tomography (CT) findings for canine adrenal tumors, including cortical adenoma, cortical adenocarcinoma, and pheochromocytoma, and to evaluate the feasibility and usefulness of preoperative triple-phase helical CT for differentiation of tumor types and surgical planning. STUDY DESIGN Retrospective study. ANIMALS Dogs with adrenal tumors (n=36). METHODS All dogs underwent triple-phase helical CT, followed by adrenalectomy and histopathological diagnosis of the resected mass. Precontrast images, arterial, venous, and delayed phase images were obtained. In all cases, morphological characteristics and CT values and calculations, including the percentage enhancement washout ratio, relative percentage washout, enhancement washin, and enhancement washout, were analyzed and compared among the tumor types. RESULTS Of the 36 dogs with adrenal masses, cortical adenocarcinoma was most commonly diagnosed (16 dogs), followed by pheochromocytoma (13 dogs), and cortical adenoma (7 dogs). The precontrast minimum CT value and enhancement washout between venous and delayed phases in the cortical adenoma were significantly higher than those in the cortical adenocarcinoma. The maximum CT values of the precontrast image and arterial and venous phases, the enhancement washin and washouts, percentage enhancement washout ratio, and relative percentage washout in the pheochromocytomas were significantly higher than those in cortical adenocarcinoma. CONCLUSION The differential diagnosis of canine adrenal tumors was feasible based on triple-phase CT findings, including morphological features, CT values, and intratumoral contrast attenuation. Preoperative diagnosis using triple-phase helical CT may be useful for surgical planning in dogs with adrenal tumors.
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Affiliation(s)
- Orie Yoshida
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kenji Kutara
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Mamiko Seki
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kumiko Ishigaki
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kenji Teshima
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Chieko Ishikawa
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Gentoku Iida
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kazuya Edamura
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | | | - Kazushi Asano
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
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Cook AK, Spaulding KA, Edwards JF. Clinical findings in dogs with incidental adrenal gland lesions determined by ultrasonography: 151 cases (2007-2010). J Am Vet Med Assoc 2015; 244:1181-5. [PMID: 24786166 DOI: 10.2460/javma.244.10.1181] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of and clinical features associated with incidental adrenal gland lesions (IAGLs) discovered during abdominal ultrasonography in dogs. DESIGN Retrospective case series. ANIMALS 151 dogs with an IAGL and 400 control dogs. PROCEDURES Reports of ultrasonographic examinations of the abdomen of dogs performed during a 3.5-year period were reviewed. Adrenal glands were classified as having an IAGL if a nodule or mass was described or the width of either gland was ≥ 10 mm. For dogs with an IAGL, information regarding signalment, concurrent disorders, and outcome was obtained from the medical record. Findings were compared with those in a control population of 400 dogs examined during the same period. RESULTS An IAGL was detected in 151 of 3,748 (4%) dogs. Dogs with an IAGL were significantly older (median age, 11.25 years) and heavier (median body weight, 21 kg [46.2 lb]) than the control population (median age, 9.5 years; median body weight, 14 kg [30.8 lb]). Malignant tumors were reported in 6 of 20 (30%) dogs that underwent adrenal glandectomy or necropsy and had a maximum IAGL dimension that ranged from 20 to 46 mm; benign lesions all had a maximum dimension < 20 mm. Various coincidental conditions were reported in dogs with an IAGL, including nonadrenal gland malignant neoplasia in 43 (28.5%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE IAGLs were more likely in dogs ≥ 9 years of age. On the basis of this small data set, malignancy should be suspected for IAGLs ≥ 20 mm in maximum dimension.
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Affiliation(s)
- Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
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27
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Pey P, Rossi F, Vignoli M, Duchateau L, Marescaux L, Saunders JH. Use of contrast-enhanced ultrasonography to characterize adrenal gland tumors in dogs. Am J Vet Res 2014; 75:886-92. [PMID: 25255177 DOI: 10.2460/ajvr.75.10.886] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the contrast-enhanced ultrasonographic characteristics and vascular patterns of adrenal gland tumors in dogs and determine whether those features are indicative of malignancy or histologic type of tumor. ANIMALS 14 dogs with 16 adrenal gland lesions (10 carcinomas [8 dogs], 3 adenomas [3 dogs], and 3 pheochromocytomas [3 dogs]). PROCEDURES Unsedated dogs with adrenal gland lesions underwent B-mode ultrasonography and contrast-enhanced ultrasonography ≤ 48 hours before adrenalectomy; contrast-enhanced ultrasonographic examinations were video-recorded. Macroscopic evaluation of the adrenal gland lesions and histologic examination of removed adrenal gland tissues were subsequently performed. Surgical and histopathologic findings and the ultrasonographic and contrast-enhanced ultrasonographic characteristics were recorded for the various tumor types. Time-intensity curves were generated from the contrast-enhanced ultrasonographic recordings and used to calculate regional blood volume (value proportional to area under the curve) and mean transit time (time the lesion began to enhance to the half-peak intensity). RESULTS In adrenal gland carcinomas, tortuous feeding vessels were noticeable during the arterial and venous phases of contrast enhancement. Heterogeneity of contrast enhancement was evident only in malignant tumors. Compared with adenomas, adrenal gland carcinomas and pheochromocytomas had significantly less regional blood volume. Mean transit times were significantly shorter in adrenal gland carcinomas and pheochromocytomas than in adenomas. CONCLUSIONS AND CLINICAL RELEVANCE For dogs, evaluation of the vascular pattern and contrast-enhancement characteristics of adrenal gland tumors by means of contrast-enhanced ultrasonography may be useful in assessment of malignancy and tumor type.
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Affiliation(s)
- Pascaline Pey
- Departments of Medical Imaging of Domestic Animals and Orthopedy of Small Animals, Ghent University, 9820 Merelbeke, Belgium
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Mayhew PD, Culp WTN, Hunt GB, Steffey MA, Mayhew KN, Fuller M, Della-Maggiore A, Nelson RW. Comparison of perioperative morbidity and mortality rates in dogs with noninvasive adrenocortical masses undergoing laparoscopic versus open adrenalectomy. J Am Vet Med Assoc 2014; 245:1028-35. [DOI: 10.2460/javma.245.9.1028] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gregori T, Mantis P, Benigni L, Priestnall SL, Lamb CR. Comparison of computed tomographic and pathologic findings in 17 dogs with primary adrenal neoplasia. Vet Radiol Ultrasound 2014; 56:153-9. [PMID: 25139015 DOI: 10.1111/vru.12209] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/28/2014] [Indexed: 01/10/2023] Open
Abstract
The CT appearance of canine adrenal masses has been reported, but associations between imaging features and pathologic features of these lesions have not been investigated in detail. The purpose of this study was to test associations between different types of adrenal neoplasia and their CT and pathologic features. A retrospective cross-sectional study was performed and inclusion criteria were histologic diagnosis of primary adrenal neoplasia, contrast-enhanced CT examination of the abdomen and surgical resection of the mass or necropsy examination. For all included dogs, CT images and histopathologic specimens were reviewed independently by two veterinary radiologists and a veterinary pathologist, respectively. Seventeen dogs met inclusion criteria. Diagnoses were adenocarcinoma in nine (53%) dogs, pheochromocytoma in five (29%) dogs, and adenoma in three (18%) dogs. Pheochromocytoma was associated with CT signs of vascular invasion (likelihood ratio = 4.8, 95% CI = 1.3-18.3, P = 0.03) and macroscopic vascular invasion (likelihood ratio = 9.6, 95% CI = 1.4-65.9, P = 0.02). There was excellent agreement between signs of vascular invasion in CT images and vascular invasion at surgery or necropsy (kappa = 0.86, P = 0.001). A peripheral contrast-enhancing rim in delayed postcontrast CT images was associated with fibrous encapsulation of the tumor (kappa = 0.53, P = 0.05), and a heterogeneous pattern of contrast distribution in delayed postcontrast CT images was associated with adrenal hemorrhage or infarction on histological examination (kappa = 0.45, P = 0.05). Findings indicated that CT enabled assessment of adrenal neoplasia features that reflected their biological behavior and pathological findings, however overlapping characteristics between tumor types limited the potential for reliably distinguishing them based on CT alone.
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Affiliation(s)
- Tommaso Gregori
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, Hertfordshire AL9 7TA, UK
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30
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Andrade N, Rivas LR, Milovancev M, Radlinsky MA, Cornell K, Schmiedt C. Intercostal approach for right adrenalectomy in dogs. Vet Surg 2014; 43:99-104. [PMID: 24392699 DOI: 10.1111/j.1532-950x.2014.12105.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 10/01/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe an intercostal (IC) approach to the right adrenal (RA) gland in dogs. STUDY DESIGN Cadaveric study and case series. ANIMALS Dogs with right adrenal (RA) tumors (n = 11) and normal canine cadavers (6). METHODS Cadavers had an IC (n = 3) or paracostal (3) approach to the RA. The relative spatial position of the RA to the incision was evaluated. Medical records (June 2007-December 2012) of dogs that had an IC approach to the RA were reviewed. Perioperative data were recorded and described. RESULTS In cadavers, the RA was closer to the cranial aspect of the surgical incision after an IC approach compared with a paracostal approach. The IC approach for right adrenalectomy was successfully performed in 11 dogs (6 adrenocortical carcinomas, 4 pheochromocytomas, and 1 osteosarcoma) with a mean anesthesia duration of 242 minutes and mean surgical of 144 minutes. Dogs had vascular invasion into the phrenicoabdominal vein (n = 11) and caudal vena cava (6). There were no significant intra- or postoperative complications. One dog was euthanatized intraoperatively. Median survival time for all dogs was 786 days. CONCLUSIONS The IC approach for right adrenalectomy offers superior exposure of the RA compared with a paracostal approach.
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Affiliation(s)
- Natalia Andrade
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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31
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Lo AJ, Holt DE, Brown DC, Schlicksup MD, Orsher RJ, Agnello KA. Treatment of aldosterone-secreting adrenocortical tumors in cats by unilateral adrenalectomy: 10 cases (2002-2012). J Vet Intern Med 2013; 28:137-43. [PMID: 24372771 PMCID: PMC4895543 DOI: 10.1111/jvim.12186] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/25/2013] [Accepted: 08/06/2013] [Indexed: 11/28/2022] Open
Abstract
Background Primary hyperaldosteronism (PHA) in cats occurs as a consequence of excessive hormone production by an adrenocortical tumor. Median survival time, association between tumor type and prognosis, and the likelihood that cats require continued medical therapy after surgery have not been systematically evaluated. Objectives To determine the median survival time of cats with PHA treated by unilateral adrenalectomy. To examine if tumor type, anesthesia time, or tumor location (left or right side) affect survival and if affected cats require continued postoperative treatment for persistent hypertension or hypokalemia. Animals Ten client‐owned cats. Methods Retrospective study. Cats were diagnosed with PHA based on clinical signs, increased plasma aldosterone concentration, and advanced imaging. Cats underwent unilateral adrenalectomy. Survival time (days alive after surgery) was determined for each cat. Factors affecting median survival time were investigated, including histopathology, anesthesia time, and location (side) of the tumor. Results Eight of 10 cats survived to discharge from the hospital post adrenalectomy. Overall median survival was 1,297 days (range 2–1,582 days). The only significant factor affecting median survival time was anesthesia time >4 hours. Tumor type and location (side) did not significantly affect median survival time. No cats required continued medical treatment for PHA. Conclusions and Clinical Importance Although PHA in cats is still considered an uncommon condition, it should be considered in middle to older aged cats with hypokalemic polymyopathy and systemic hypertension. Surgical correction by unilateral adrenalectomy is a viable approach to definitive treatment of PHA with no need for continued medical management.
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Affiliation(s)
- A J Lo
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
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32
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Behrend EN, Kooistra HS, Nelson R, Reusch CE, Scott-Moncrieff JC. Diagnosis of spontaneous canine hyperadrenocorticism: 2012 ACVIM consensus statement (small animal). J Vet Intern Med 2013; 27:1292-304. [PMID: 24112317 DOI: 10.1111/jvim.12192] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 07/05/2013] [Accepted: 08/06/2013] [Indexed: 11/28/2022] Open
Abstract
This report offers a consensus opinion on the diagnosis of spontaneous canine hyperadrenocorticism. The possibility that a patient has hyperadrenocorticism is based on the history and physical examination. Endocrine tests should be performed only when clinical signs consistent with HAC are present. None of the biochemical screening or differentiating tests for hyperadrenocorticism are perfect. Imaging can also play a role. Awareness of hyperadrenocorticism has heightened over time. Thus, case presentation is more subtle. Due to the changes in manifestations as well as test technology the Panel believes that references ranges should be reestablished. The role of cortisol precursors and sex hormones in causing a syndrome of occult hyperadrenocorticism remains unclear.
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Affiliation(s)
- E N Behrend
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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33
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Shanaman MM, Schwarz T, Gal A, O'Brien RT. Comparison between survey radiography, B-mode ultrasonography, contrast-enhanced ultrasonography and contrast-enhanced multi-detector computed tomography findings in dogs with acute abdominal signs. Vet Radiol Ultrasound 2013; 54:591-604. [PMID: 23919809 DOI: 10.1111/vru.12079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/18/2013] [Indexed: 12/14/2022] Open
Abstract
Contrast-enhanced multi-detector computed tomography (CE-MDCT) is used routinely in evaluating human patients with acute abdominal symptoms. Contrast-enhanced ultrasound (CEUS) continues to be in its infancy as it relates to evaluation of the acute abdomen. The purpose of this study was to compare survey radiography, B-mode ultrasound, CEUS, and CE-MDCT findings in canine patients presenting with acute abdominal signs; with a focus on the ability to differentiate surgical from non-surgical conditions. Nineteen dogs were prospectively enrolled. Inclusion required a clinical diagnosis of acute abdominal signs and confirmed surgical or non-surgical causes for the clinical signs. Agreement for the majority of recorded imaging features was at least moderate. There was poor agreement in the identification of pneumoperitoneum and in the comparison of pancreatic lesion dimensions for B-mode vs. CEUS. The CT feature of fat stranding was detected in cases including, but not limited to, gastric neoplasia with perforation, pancreatitis, and small intestinal foreign body. Ultrasound underestimated the size and number of specific lesions when compared with CE-MDCT. Contrast-enhanced ultrasound was successful in detecting bowel and pancreatic perfusion deficits that CE-MDCT failed to identify. Accuracy for differentiation of surgical vs. non-surgical conditions was high for all modalities; 100%, 94%, and 94% for CE-MDCT, ultrasonography and survey radiography respectively. Findings indicated that CE-MDCT is an accurate screening test for differentiating surgical from non-surgical acute abdominal conditions in dogs. Focused CEUS following CE-MDCT or B-mode ultrasonography may be beneficial for identifying potentially significant hypoperfused lesions.
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Affiliation(s)
- Miriam M Shanaman
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, 61802
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34
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Carotenuto AM, Borghi L, Paltrinieri S, Giordano A, Moretti P, Giancamillo MD. Serum biochemical response to contrast media administration in anaesthetised dogs. Vet Rec 2013; 172:101. [DOI: 10.1136/vr.100867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A. M. Carotenuto
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - L. Borghi
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - S. Paltrinieri
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - A. Giordano
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - P. Moretti
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
| | - M. Di Giancamillo
- Facoltà di Medicina Veterinaria; Università degli Studi di Milano; Via Celoria 10 20133 Milano Italy
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35
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Shanaman MM, Hartman SK, O'Brien RT. Feasibility for using dual-phase contrast-enhanced multi-detector helical computed tomography to evaluate awake and sedated dogs with acute abdominal signs. Vet Radiol Ultrasound 2012; 53:605-12. [PMID: 22995037 DOI: 10.1111/j.1740-8261.2012.01973.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 07/18/2012] [Indexed: 11/29/2022] Open
Abstract
Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. Contrast-enhanced multi-detector computed tomography (CT) is the current modality of choice for evaluating acute abdominal pain in people. We hypothesized that contrast-enhanced multi-detector CT would be a feasible and safe technique for use in awake and lightly sedated dogs with acute abdominal signs. Eighteen client-owned dogs were enrolled, all presenting with acute abdominal signs. Dogs were scanned using a dual-phase protocol that included precontrast, arterial, and portal venous phases. Eight dogs were scanned awake and ten were given light sedation as chosen by the primary care clinician. Two observers who were unaware of clinical findings and sedation status scored image quality for each scan by consensus opinion. Mean serum creatinine in the sedated group was higher than in the awake group but was within the normal reference range. Other laboratory and physiologic measures did not differ between awake and sedated groups. No IV contrast-related adverse reactions were seen. Median scan time for all patients was less than 10 min. Sixteen of 18 contrast-enhanced multi-detector CT scans were scored fair to excellent in diagnostic quality, with no statistical difference in diagnostic quality for awake vs. sedated patients. Causes for two poor quality diagnostic scans included severe beam hardening from previously administered barium contrast agent and severe motion artifacts. We conclude that dual-phase contrast-enhanced multi-detector CT is a feasible and safe technique for evaluating awake and minimally sedated dogs presenting with acute abdominal signs.
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Affiliation(s)
- Miriam M Shanaman
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802, USA
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36
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Hoey S, Drees R, Hetzel S. EVALUATION OF THE GASTROINTESTINAL TRACT IN DOGS USING COMPUTED TOMOGRAPHY. Vet Radiol Ultrasound 2012; 54:25-30. [DOI: 10.1111/j.1740-8261.2012.01969.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 06/20/2012] [Indexed: 01/03/2023] Open
Affiliation(s)
- Seamus Hoey
- Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI; 53707
| | - Randi Drees
- Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI; 53707
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics; School of Medicine and Public Health; Clinical Sciences Center, University of Wisconsin-Madison; Madison; WI; 53792
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37
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Guillaumot PJ, Heripret D, Bouvy BM, Christiaens G, Poujade A, Delverdier M, Poncet C. 49-month survival following caval venectomy without nephrectomy in a dog with a pheochromocytoma. J Am Anim Hosp Assoc 2012; 48:352-8. [PMID: 22843823 DOI: 10.5326/jaaha-ms-5788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An 11 yr old spayed female Labrador retriever was diagnosed with a right adrenal tumor. At surgery, adhesions to the right kidney were dissected, allowing the right kidney to be preserved. The tumor showed extensive invasion into the suprarenal vena cava. It was felt that thrombus removal via venotomy could not be performed. Instead, the vena cava was ligated caudal to the liver and cranial to the right renal vein. The neoplastic gland was then excised en bloc together with the portion of the invaded caudal vena cava. Hind limb edema had developed preoperatively and increased transiently in the first days postoperatively. The animal was discharged 6 days postoperatively with no other clinical disorders, and hind limb edema resolved over time. Histopathology identified a pheochromocytoma. The dog died 49 mo later. A neoplastic thrombus of the vena cava may require venotomy to allow thrombus removal. Occasionally, removal of the thrombus by venotomy may prove impossible. In such a situation, en bloc removal of the concerned portion of the vena cava may be performed with a good long-term outcome provided that gradual occlusion of the vena cava by the thrombus has allowed time for collateral circulation to develop.
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Affiliation(s)
- Pierre J Guillaumot
- Centre Hospitalier Vétérinaire Frégis, Service de Chirurgie, Arcueil, France.
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38
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Fields EL, Robertson ID, Brown JC. Optimization of contrast-enhanced multidetector abdominal computed tomography in sedated canine patients. Vet Radiol Ultrasound 2012; 53:507-12. [PMID: 22612282 DOI: 10.1111/j.1740-8261.2012.01950.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 04/09/2012] [Indexed: 11/27/2022] Open
Abstract
A major disadvantage of computed tomography for abdominal screening in dogs has been the need for general anesthesia to prevent motion artifacts. With multidetector helical CT, it is possible to decrease examination time, allowing patients to be scanned under sedation. It is also desirable to decrease tube loading to prolong x-ray tube life. To develop a protocol that will allow for examination of sedated patients with minimal image artifacts, milliamperage (mA) and helical pitch were varied, providing 16 experimental scan protocols. A standard clinical protocol was also tested, providing 17 protocols for evaluation. These protocols were tested, using a standard CT phantom, canine tissues in a water bath, and a canine cadaver. The cadaver images were scored semiquantitatively by three reviewers to determine the protocol with the best combination of speed and minimal image artifact. The optimized protocol was then applied to 27 sedated canine patients of three body weight categories. The images obtained were compared to the standard protocol by two reviewers for presence of motion, streak, and quantum mottle artifacts. There was significantly more streak artifact noted by one observer using the optimized study protocol, but no significant difference in any other category. Scanning under sedation was well tolerated in all patients, and sedated CT examination is a promising tool for screening abdominal disease in dogs.
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Affiliation(s)
- Erica L Fields
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
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Davis MK, Schochet RA, Wrigley R. ULTRASONOGRAPHIC IDENTIFICATION OF VASCULAR INVASION BY ADRENAL TUMORS IN DOGS. Vet Radiol Ultrasound 2012; 53:442-5. [DOI: 10.1111/j.1740-8261.2011.01911.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 11/15/2011] [Indexed: 11/28/2022] Open
Affiliation(s)
- Mary K. Davis
- From the Veterinary Cancer Group; Culver City; CA; 90232
| | | | - Robert Wrigley
- Colorado State University Veterinary Teaching Hospital; Ft. Collins; CO; 80526
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40
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Rodríguez Piñeiro MI, de Fornel-Thibaud P, Benchekroun G, Garnier F, Maurey-Guenec C, Delisle F, Rosenberg D. Use of computed tomography adrenal gland measurement for differentiating ACTH dependence from ACTH independence in 64 dogs with hyperadenocorticism. J Vet Intern Med 2011; 25:1066-74. [PMID: 21848965 DOI: 10.1111/j.1939-1676.2011.0773.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The measurement of adrenal gland size on computed tomography (CT) scan has been proposed for the etiological diagnosis of hyperadrenocorticism (HAC) in dogs. Symmetric adrenal glands are considered to provide evidence for ACTH-dependent hyperadrenocorticism (ADHAC), whereas asymmetry suggests ACTH-independent hyperadrenocorticism (AIHAC). However, there are currently no validated criteria for such differentiation. OBJECTIVE The aim of this retrospective study was to compare various adrenal CT scan measurements and the derived ratios in ADHAC and AIHAC cases, and to validate criteria for distinguishing between these conditions in a large cohort of dogs. ANIMALS Sixty-four dogs with HAC (46 ADHAC, 18 AIHAC). METHODS Dogs with confirmed HAC and unequivocal characterization of its origin were included. Linear measurements of adrenal glands were made on both cross-sectional and reformatted images. RESULTS An overlap was systematically observed between the AIHAC and ADHAC groups for all measurements tested. Overlaps also were observed for ratios tested. For the maximum adrenal diameter ratio derived from reformatted images (rADR), only 1/18 AIHAC dogs had a rADR within the range for ADHAC. For a threshold of 2.08, the 95% confidence intervals for estimated sensitivity and specificity extended from 0.815 to 1.000 and from 0.885 to 0.999, respectively, for AIHAC diagnosis. CONCLUSION AND CLINICAL IMPORTANCE Measurements from cross-sectional or reformatted CT scans are of little use for determining the origin of HAC. However, rADR appears to distinguish accurately between ADHAC and AIHAC, with a rADR > 2.08 highly suggestive of AIHAC.
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Affiliation(s)
- M I Rodríguez Piñeiro
- Internal Medicine Unit, National Veterinary School of Alfort, Maisons-Alfort, France
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Lee KJ, Kishimoto M, Shimizu J, Kobayashi Y, Matsumoto K, Sasaki N, Ishii M, Inokuma H, Iwasaki T, Miyake YI, Yamada K. Use of contrast-enhanced CT in the diagnosis of abscesses in cattle. J Vet Med Sci 2010; 73:113-5. [PMID: 20736515 DOI: 10.1292/jvms.10-0233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We report here the non-contrast and contrast-enhanced computed tomography performed in two calves with brain abscess and multiple pulmonary abscesses with pharyngeal abscess, respectively. Contrast-enhanced computed tomography was useful in the diagnosis of these diseases in both calves. The diseases were confirmed by histopathological examination.
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Affiliation(s)
- Ki-Ja Lee
- The United Graduate School of Veterinary Sciences, Gifu University, Gifu, Japan
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