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Simon H, Hecht S, Fazio C, Sun X. Magnetic resonance imaging subtraction vs. pre- and post-contrast 3D gradient recalled echo fat suppressed imaging for evaluation of the canine and feline brain. Front Vet Sci 2024; 11:1346617. [PMID: 38322167 PMCID: PMC10844400 DOI: 10.3389/fvets.2024.1346617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/11/2024] [Indexed: 02/08/2024] Open
Abstract
Subtraction magnetic resonance imaging (MRI) has been reported to increase accuracy in the diagnosis of meningeal and inflammatory brain diseases in small animals. 3D T1W gradient recalled echo (GRE) techniques have been proposed as a suitable alternative to conventional spin echo sequences in imaging the canine brain. The aim of this study was to compare subtraction images and paired pre- and post-contrast 3D T1W GRE fat suppressed (FS) images in canine and feline MRI studies using clinical diagnosis as the gold standard. Paired pre- and post-contrast T1W 3D FS GRE images and individual subtraction images of 100 small animal patients were randomized and independently evaluated by 2 blinded observers. Diagnosis categories were "normal," "inflammatory," "neoplastic," and "other." Clinical diagnosis was made in the same categories and served as the gold standard. Image interpretation results were compared to the clinical diagnosis. Interobserver agreement was determined. Clinically, 41 studies were categorized as "normal," 18 as "inflammatory," 28 as "neoplastic," and 13 as "other." The agreement of the pre- and post-contrast GRE images with the gold standard was significantly higher than that of the subtraction images (k = 0.7491 vs. k = 0.5924; p = 0.0075). The largest sources of error were misinterpretation of "other" as "normal" and "normal" as "inflammatory." There was no significant difference between the two observers (p = 0.8820). Based on this study, subtraction images do not provide an advantage to paired pre- and post-contrast FS GRE images when evaluating the canine and feline brain.
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Affiliation(s)
- Heather Simon
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Constance Fazio
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee, Knoxville, TN, United States
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Johnson KA, Sutherland-Smith J, Oura TJ, Sato AF, Barton B. Rapid brain MRI protocols result in comparable differential diagnoses versus a full brain protocol in most canine and feline cases. Vet Radiol Ultrasound 2023; 64:86-94. [PMID: 35969218 DOI: 10.1111/vru.13134] [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: 11/30/2021] [Revised: 05/09/2022] [Accepted: 05/20/2022] [Indexed: 01/26/2023] Open
Abstract
Evaluation of brain disease in veterinary patients uses a wide variety of MRI sequences. A shortened protocol that maintains consistency of interpretation would reduce radiologist reporting time, patient anesthetic time, and client cost. The aims of this retrospective, methods comparison, observer agreement study were to evaluate whether abbreviated MRI protocols alter differential diagnoses and recommendations compared to our institution's standard protocol; evaluate interobserver agreement on standard brain MRIs; and assess whether differential diagnoses change after postcontrast images. Normal and pathologic canine and feline brain MRIs were retrieved from hospital archives. Three protocols were created from each: a 5-sequence noncontrast enhanced Fast Brain Protocol 1 (FBP1); a 6-sequence contrast-enhanced Fast Brain Protocol 2 (FBP2); and an 11-sequence standard brain protocol (SBP). Three blinded veterinary radiologists interpreted FBP images for 98 cases (1 reader/case) and SBP images for 20 cases (3 readers/case). A fourth observer compared these interpretations to the original MRI reports (OMR). Overall agreement between FBPs and OMR was good (k = 0.75) and comparable to interobserver agreement for multiple reviews of SBP cases. Postcontrast images substantially altered conclusions in 17/97 cases (17.5%), as well as improved interobserver agreement compared to noncontrast studies. The conclusions reached with shortened brain protocols were comparable to those of a full brain study. The findings supported the use of a 6-sequence brain MRI protocol (sagittal T2-weighted [T2w] TSE; transverse T2w turbo spin echo fluid-attenuated inversion recovery, T2*-weighted gradient recalled echo, T1-weighted spin echo, and diffusion weighted imaging/apparent diffusion coefficient; and postcontrast transverse T1-weighted spin echo) for dogs and cats with suspected intracranial disease.
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Affiliation(s)
- Kelsey A Johnson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, Massachusetts, USA
| | - James Sutherland-Smith
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, Massachusetts, USA
| | - Trisha J Oura
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, Massachusetts, USA
| | - Amy F Sato
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, Massachusetts, USA
| | - Bruce Barton
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation St, Worcester, Massachusetts, USA
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Drexlin JC, Schweizer D, Stein VM. [Diagnostics in epilepsy - potential of magnetic resonance imaging]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2021; 49:29-42. [PMID: 33588463 DOI: 10.1055/a-1322-9439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Epilepsy is a common neurologic disease frequently encountered by small animal practitioners. The disease comprises a multiplicity of clinical presentations and etiologies and often necessitates a comprehensive as well as cost-intensive diagnostic workup. This is mandatory in order to be able to diagnose or exclude a metabolic cause of the seizures and to distinguish between idiopathic and structural epilepsy. The examination by means of magnetic resonance imaging (MRI) represents a central component of the diagnostic workup, which in turn has essential effects on treatment and prognosis. In order to achieve standardized examination and comparable results, it is of utmost importance to use defined MRI protocols. Accordingly, communication and interaction between clinical institutions may be facilitated and as of yet undetected structural changes might be recorded in future MRI techniques. This review article sets particularly emphasis on the definition and classification of epilepsy as well as its diagnostic imaging procedures and refers to statistics and specialists' recommendations for the diagnostic workup in dogs.
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Affiliation(s)
- Jana C Drexlin
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Daniela Schweizer
- Abteilung für Klinische Radiologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Veronika M Stein
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
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Everest SJ, Schwarz T, Walker D, Eatwell K, Marioni‐Henry K. Clinical and imaging features of suspected pituitary apoplexy in a domestic rat. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Stephen James Everest
- Hospital for Small AnimalsThe University of Edinburgh Royal Dick School of Veterinary StudiesRoslinMidlothianUK
- Companion Animal HospitalUniversity of Guelph Ontario Veterinary CollegeGuelphOntarioCanada
| | - Tobias Schwarz
- Hospital for Small AnimalsThe University of Edinburgh Royal Dick School of Veterinary StudiesRoslinMidlothianUK
| | - David Walker
- Hospital for Small AnimalsThe University of Edinburgh Royal Dick School of Veterinary StudiesRoslinMidlothianUK
| | - Kevin Eatwell
- Hospital for Small AnimalsThe University of Edinburgh Royal Dick School of Veterinary StudiesRoslinMidlothianUK
| | - Katia Marioni‐Henry
- Hospital for Small AnimalsThe University of Edinburgh Royal Dick School of Veterinary StudiesRoslinMidlothianUK
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Kohler RJ, Arnold SA, Eck DJ, Thomson CB, Hunt MA, Pluhar GE. Incidence of and risk factors for major complications or death in dogs undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. J Am Vet Med Assoc 2019; 253:1594-1603. [PMID: 30668253 DOI: 10.2460/javma.253.12.1594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine incidence of and risk factors for major complications occurring in dogs within 30 days after cytoreductive surgery performed by a single pair of surgeons for treatment of suspected primary intracranial masses. DESIGN Retrospective cohort study. ANIMALS 160 client-owned dogs that underwent cytoreductive surgery for treatment of suspected primary intracranial masses between January 2009 and December 2015 at a veterinary teaching hospital. PROCEDURES Medical records were retrospectively reviewed for complications occurring within 30 days after surgery. Data (eg, signalment, clinical signs, previous treatments, preoperative neurologic examination findings, neuroanatomical location, time from onset of clinical signs to surgery, surgical approach, and histopathologic diagnosis) were analyzed for associations with death and with development of major complications other than death. RESULTS 21 (13.1%) dogs died (11 during hospitalization and 10 after discharge) and 30 (18.8%) developed major complications other than death during the first 30 days after surgery. Dogs with abnormal preoperative neurologic examination findings were more likely to develop complications or die. Dogs undergoing a suboccipital approach were more likely to die. The most common postoperative complications other than death were seizures (n = 18 [11.3%]), worsening of neurologic status (6 [3.8%]), and aspiration pneumonia (6 [3.8%]). CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study provided valuable information on predisposing factors, odds of major complications or death, and incidences of major complications or death in dogs during the first 30 days after undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. Careful case selection may help improve outcomes and minimize complications.
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Oliveira M, McConnell JF, Maddox TW, Sanchez-Masian D, Gonçalves R. Agreement between transverse T2-weighted and three-dimensional constructive interference in steady state sequences in the evaluation of spinal cord disease in dogs. Vet Rec 2018. [PMID: 29540556 DOI: 10.1136/vr.104583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The constructive interference in steady state (CISS) sequence has been widely used in human neuroimaging. It has been shown to be advantageous in the evaluation of intra-axial and extra-axial cystic abnormalities, arteriovenous and dysraphic malformations and disturbances of cerebrospinal fluid circulation. To assess the utility of this technique in small animals, interpretations based on this sequence were compared with those based on T2-weighted (T2W) sequences in 145 dogs that underwent MRI of the spine for suspected spinal cord disease. Two sets of images (T2W and CISS) were reviewed separately by three observers in random order and intraobserver and interobserver agreements between both sequences were evaluated for several categorical variables. The overall agreement between T2W and CISS sequences was good. The highest agreement was observed for lesion diagnosis (0.739<k<0.928), treatment recommendation (0.715<k<0.833) and degree of spinal cord compression (0.772<k<0.952). The agreement for intramedullary intensity change (0.192<k<0.332) was lower compared with the other variables. Lesions that were predominantly characterised by focal hyperintense parenchymal changes on T2W were in some instances undetected on the CISS sequence while lesions consistent with spinal arachnoid diverticula on CISS sequences were occasionally missed on T2W. CISS enabled demonstration that lesions were directly affecting associated spinal nerves in some cases where T2W sequence was equivocal. Although CISS does not replace standard spin echo sequences, the results support inclusion of this sequence in small animal spinal MRI studies when subarachnoid diverticula or spinal nerve compression is suspected.
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Affiliation(s)
- Maria Oliveira
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - James Fraser McConnell
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Thomas W Maddox
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Daniel Sanchez-Masian
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Rita Gonçalves
- Institute of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Neston, UK
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Masciarelli AE, Griffin JF, Fosgate GT, Hecht S, Mankin JM, Holmes SP, Platt SR, Kent M, Pancotto TE, Chen AV, Levine JM. Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog. Vet Radiol Ultrasound 2017; 58:444-453. [DOI: 10.1111/vru.12501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 12/11/2016] [Accepted: 01/16/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Amanda E. Masciarelli
- Departments of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - John F. Griffin
- Departments of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - Geoffrey T. Fosgate
- The Department of Production Animal Studies; University of Pretoria; Pretoria South Africa
| | - Silke Hecht
- The Department of Small Animal Clinical Sciences; University of Tennessee College of Veterinary Medicine; Knoxville TN 37996
| | - Joseph M. Mankin
- Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; TX 77843
| | - Shannon P. Holmes
- The Departments of Veterinary Biosciences and Diagnostic Imaging; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Simon R. Platt
- Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Marc Kent
- Small Animal Medicine and Surgery; University of Georgia College of Veterinary Medicine; Athens GA 30602
| | - Theresa E. Pancotto
- The Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24061
| | - Annie V. Chen
- The Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman WA 99164
| | - Jonathan M. Levine
- The Department of Production Animal Studies; University of Pretoria; Pretoria South Africa
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Carrera I, Richter H, Beckmann K, Meier D, Dennler M, Kircher PR. Evaluation of intracranial neoplasia and noninfectious meningoencephalitis in dogs by use of short echo time, single voxel proton magnetic resonance spectroscopy at 3.0 Tesla. Am J Vet Res 2016; 77:452-62. [DOI: 10.2460/ajvr.77.5.452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Stadler KL, Ober CP, Feeney DA, Jessen CR. Multivoxel proton magnetic resonance spectroscopy of inflammatory and neoplastic lesions of the canine brain at 3.0 T. Am J Vet Res 2014; 75:982-9. [DOI: 10.2460/ajvr.75.11.982] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Dickinson P. Advances in diagnostic and treatment modalities for intracranial tumors. J Vet Intern Med 2014; 28:1165-85. [PMID: 24814688 PMCID: PMC4857954 DOI: 10.1111/jvim.12370] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 02/24/2014] [Accepted: 03/25/2014] [Indexed: 12/23/2022] Open
Abstract
Intracranial neoplasia is a common clinical condition in domestic companion animals, particularly in dogs. Application of advances in standard diagnostic and therapeutic modalities together with a broad interest in the development of novel translational therapeutic strategies in dogs has resulted in clinically relevant improvements in outcome for many canine patients. This review highlights the status of current diagnostic and therapeutic approaches to intracranial neoplasia and areas of novel treatment currently in development.
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Affiliation(s)
- P.J. Dickinson
- Department of Surgical and Radiological SciencesSchool of Veterinary MedicineUniversity of California DavisDavisCA
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Young BD, Fosgate GT, Holmes SP, Wolff CA, Chen-Allen AV, Kent M, Platt SR, Savage MY, Schatzberg SJ, Levine JM. Evaluation of standard magnetic resonance characteristics used to differentiate neoplastic, inflammatory, and vascular brain lesions in dogs. Vet Radiol Ultrasound 2014; 55:399-406. [PMID: 24467341 DOI: 10.1111/vru.12137] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/25/2013] [Indexed: 12/01/2022] Open
Abstract
Magnetic resonance (MR) imaging characteristics are commonly used to help predict intracranial disease categories in dogs, however, few large studies have objectively evaluated these characteristics. The purpose of this retrospective study was to evaluate MR characteristics that have been used to differentiate neoplastic, inflammatory, and vascular intracranial diseases in a large, multi-institutional population of dogs. Medical records from three veterinary teaching hospitals were searched over a 6-year period for dogs that had diagnostic quality brain MR scans and histologically confirmed intracranial disease. Three examiners who were unaware of histologic diagnosis independently evaluated 19 MR lesion characteristics totaling 57 possible responses. A total of 75 dogs with histologically confirmed intracranial disease were included in analyses: 51 with neoplasia, 18 with inflammatory disease, and six with cerebrovascular disease. Only strong contrast enhancement was more common in neoplasia than other disease categories. A multivariable statistical model suggested that extra-axial origin, T2-FLAIR mixed intensity, and defined lesion margins were also predictive of neoplasia. Meningeal enhancement, irregular lesion shape, and multifocal location distinguished inflammatory diseases from the other disease categories. No MR characteristics distinguished vascular lesions and these appeared most similar to neoplasia. These results differed from a previous report describing seven MR characteristics that were predictive of neoplasia in dogs and cats. Findings from the current study indicated that the high performance of MR for diagnosing canine intracranial diseases might be due to evaluator recognition of combinations of MR characteristics vs. relying on any one MR characteristic alone.
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Affiliation(s)
- Benjamin D Young
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
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