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Home / Equine Research Bank / Vet Radiol Ultrasound / Bilateral thoracic radiographs increase lesion detection in ...
Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association2022; 63(5); 518-529; doi: 10.1111/vru.13088

Bilateral thoracic radiographs increase lesion detection in horses with pneumonia or pulmonary neoplasia but do not bring any additional benefit for inflammatory or diffuse pulmonary disease.

Abstract: Published studies describing the effects of bilateral radiographic projections on the detection of equine pulmonary lesions are currently lacking. The objectives of this retrospective, single center, observational study were to compare unilateral and bilateral thoracic radiographic projections for the detection of pulmonary lesions in a group of horses. Based on their clinical diagnosis, 167 adults and foals with bilateral thoracic radiographs were classified as having pneumonia (n = 88), inflammatory or diffuse pulmonary disease (n = 72), and pulmonary masses (n = 7). After an initial interrater repeatability test, right-to-left and left-to-right projections were anonymized and independently interpreted by a radiologist blinded to the clinical diagnosis. Scores were attributed for each pattern/lesion (alveolar, interstitial, bronchial, nodules/masses, cavitary lesions) and each quadrant. Agreement between scores from each projection was evaluated with Bland-Altman plots. Lesions identified on one side but not on the contralateral projection were considered discordant. There was no preferential lateralization of pulmonary lesions. The prevalence of discordance was 14.4%, 9.0%, and 4.2% for alveolar pattern, nodules/masses, and cavitary lesions, respectively. Up to nine horses (10.2%) with pneumonia could have been misdiagnosed. A pulmonary mass would have been missed in one case. For inflammatory or diffuse disease, discordance was slight, and the addition of contralateral projections had no impact on radiographic interpretation. In conclusion, in horses with pneumonia or neoplasia, bilateral projections, or adding at least one contralateral caudoventral view, increased the probability of identifying pulmonary lesions. In horses with inflammatory or diffuse disease, bilateral thoracic radiography provided no additional benefit.
© 2022 American College of Veterinary Radiology.
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Publication Date: 2022-04-11 PubMed ID: 35404508DOI: 10.1111/vru.13088Google Scholar: Lookup
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  • Journal Article
  • Observational Study
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research focuses on the effectiveness of bilateral thoracic radiographs in detecting pulmonary lesions in horses. The findings suggest that this method is especially beneficial in identifying issues in horses with pneumonia or pulmonary neoplasia but doesn’t offer any extra advantage when it comes to diagnosing inflammatory or diffuse pulmonary disease.

Study Details and Methodology

  • The study was a retrospective, observational analysis carried out at a single center.
  • The purpose was to compare the effectiveness of unilateral (one-sided) and bilateral (two-sided) thoracic radiographic projections in detecting pulmonary (lung-related) lesions in horses.
  • A total of 167 adult horses and foals, who had undergone bilateral thoracic radiographs, were categorized based on their clinical diagnoses into pneumonia (88 horses), inflammatory or diffuse pulmonary disease (72 horses), and pulmonary masses (7 horses).
  • The radiographs’ interpretations were anonymized and carried out by a radiologist blinded to the clinical diagnoses of the horses. The projections from right-to-left and left-to-right were reviewed independently.
  • The study assigned scores for each pattern or lesion (alveolar, interstitial, bronchial, nodules/masses, cavitary lesions) and each quadrant of the lungs.
  • To evaluate the agreement between scores from each projection, Bland-Altman plots were used.

Findings

  • The findings revealed no preferential lateralization or side bias of pulmonary lesions in horses.
  • The discrepancies between the projections on either side were 14.4% for alveolar pattern, 9.0% for nodules/masses, and 4.2% for cavitary lesions.
  • Up to nine horses (10.2% of the sample) with pneumonia could have been incorrectly diagnosed if only one side was examined. A pulmonary mass could have been missed in one instance.
  • In the case of inflammatory or diffuse disease, there was very little discrepancy and the inclusion of projections from the opposite side had no significant impact on interpretation.

Conclusions

  • For horses with pneumonia or neoplasia, bilateral projections increased the odds of identifying lung lesions. This highlighted the importance of examining both sides, or at least including one contralateral caudoventral view, in the radiographic process.
  • In horses with inflammatory or diffuse disease, employing bilateral thoracic radiography offered no additional benefits. This could offer guidance to veterinarians on when to use the more resource-intensive bilateral approach while diagnosing specific pulmonary conditions.

Cite This Article

APA
Malek G, Leclere M, Masseau I, Zur Linden A, Beauchamp G, Finck C. (2022). Bilateral thoracic radiographs increase lesion detection in horses with pneumonia or pulmonary neoplasia but do not bring any additional benefit for inflammatory or diffuse pulmonary disease. Vet Radiol Ultrasound, 63(5), 518-529. https://doi.org/10.1111/vru.13088

Publication

Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
ISSN: 1740-8261
NlmUniqueID: 9209635
Country: England
Language: English
Volume: 63
Issue: 5
Pages: 518-529

Researcher Affiliations

Malek, Gwladys
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Q, Canada.
Leclere, Mathilde
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Q, Canada.
Masseau, Isabelle
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Q, Canada.
Zur Linden, Alex
  • Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Beauchamp, Guy
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Q, Canada.
Finck, Cyrielle
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Q, Canada.

MeSH Terms

  • Animals
  • Horse Diseases / pathology
  • Horses
  • Lung / pathology
  • Lung Diseases / veterinary
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / veterinary
  • Pneumonia / diagnostic imaging
  • Pneumonia / veterinary
  • Radiography, Thoracic / veterinary
  • Retrospective Studies

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