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Equine veterinary journal2005; 37(6); 541-545; doi: 10.2746/042516405775314899

Radiographic scoring lacks predictive value in inflammatory airway disease.

Abstract: Diagnosis of inflammatory airway disease (IAD) currently rests upon the results of bronchoalveolar lavage (BAL) cytology, lung function testing and histamine bronchoprovocation (HBP), none of which provides direct information about structural change in the lung. Objective: That thoracic radiography might better portray structural change in the lungs and therefore offer a good clinical assessment of IAD. Methods: A radiographic scoring system was developed to assess the extent of bronchial and interstitial pattern on thoracic radiographs in the dorsocaudal, dorsocranial and caudoventral regions in 16 control horses and 33 horses with IAD. Mean scores were compared to ascertain whether thoracic radiographs could distinguish between the 2 groups. In order to determine whether independent observers reliably scored radiographs similarly, an inter-rater reliability score was employed for each radiographic observation. Correlations between radiographic scores, BAL cytology, lung function testing using the forced oscillatory technique and HBP were examined. Results: Inter-rater reliability was only moderate. Radiographic scoring demonstrated no differences between the 2 groups. There were no correlations among BAL cytology, lung function testing, HBP and radiographic scores. Conclusions: Thoracic radiographs are a low-yield diagnostic modality in horses with a clinical history compatible with IAD. In the absence of clinical evidence of more extensive, infectious disease, thoracic radiographs neither refine nor improve diagnosis of IAD, but increase diagnostic costs.
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Publication Date: 2005-11-22 PubMed ID: 16295932DOI: 10.2746/042516405775314899Google Scholar: Lookup
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  • Journal Article

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.

This research explores the efficacy of using thoracic radiographs as a diagnostic tool for inflammatory airway disease (IAD) in horses, concluding that it does not provide reliable results or improvements in the diagnosis process and instead only increases costs.

Research Objective

The objective of this research was to assess if thoracic radiographs could provide a more detailed picture of structural changes in the lungs of horses and thus serve as an improved clinical assessment tool for IAD.

Research Method

  • The researchers designed a scoring system for evaluating the bronchial and interstitial patterns visible on thoracic radiographs. This scoring system was applied to images from 16 control horses and 33 horses diagnosed with IAD.
  • The regions surveyed in the images were dorsocaudal, dorsocranial, and caudoventral.
  • The mean scores for both groups were compared to determine if the radiographic scores could distinguish between horses with IAD and the control group.
  • Inter-rater reliability scores were used to see if different observers scored the radiographs similarly.
  • Further, the researchers compared the correlations between radiographic scores, bronchoalveolar lavage (BAL) cytology, lung function testing, and histamine bronchoprovocation (HBP).

Research Results

  • The reliability of scores between different observers was found to be only moderate, i.e., not highly reliable.
  • Comparison of radiographic scoring did not reveal any significant differences between horses with IAD and control horses.
  • There were no discernable correlations between the parameters evaluated – BAL cytology, lung function testing, HBP, and radiographic scores.

Research Conclusion

Based on the results, the researchers concluded that thoracic radiographs are of low diagnostic value for IAD in horses. In cases where horses show clinical signs compatible with IAD but no evidence of more extensive infectious diseases, using thoracic radiographs neither improves nor refines the diagnosis. Instead, it adds to the diagnostic costs unnecessarily.

Cite This Article

APA
Mazan MR, Vin R, Hoffman AM. (2005). Radiographic scoring lacks predictive value in inflammatory airway disease. Equine Vet J, 37(6), 541-545. https://doi.org/10.2746/042516405775314899

Publication

Equine veterinary journal
ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 37
Issue: 6
Pages: 541-545

Researcher Affiliations

Mazan, M R
  • Lung Function Laboratory, Tufts University School of Veterinary Medicine, 200 Westboro Road, North Grafton, Massachusetts 01536, USA.
Vin, R
    Hoffman, A M

      MeSH Terms

      • Animals
      • Bronchoalveolar Lavage Fluid / cytology
      • Case-Control Studies
      • Forced Expiratory Flow Rates
      • Horse Diseases / diagnosis
      • Horse Diseases / diagnostic imaging
      • Horses
      • Lung / diagnostic imaging
      • Predictive Value of Tests
      • Radiography, Thoracic / economics
      • Radiography, Thoracic / methods
      • Radiography, Thoracic / veterinary
      • Respiratory Function Tests / veterinary
      • Respiratory Tract Diseases / diagnosis
      • Respiratory Tract Diseases / diagnostic imaging
      • Respiratory Tract Diseases / veterinary
      • Sensitivity and Specificity

      Citations

      This article has been cited 15 times.
      1. Hepworth-Warren KL, Nelson N, Dembek KA, Young KAS. Comparison of thoracic ultrasonography and thoracic radiography between healthy adult horses and horses with bacterial pneumonia using a novel, objective ultrasonographic scoring system. Front Vet Sci 2022;9:991634.
        doi: 10.3389/fvets.2022.991634pubmed: 36311667google scholar: lookup
      2. Lo Feudo CM, Stucchi L, Alberti E, Stancari G, Conturba B, Zucca E, Ferrucci F. The Role of Thoracic Ultrasonography and Airway Endoscopy in the Diagnosis of Equine Asthma and Exercise-Induced Pulmonary Hemorrhage. Vet Sci 2021 Nov 15;8(11).
        doi: 10.3390/vetsci8110276pubmed: 34822649google scholar: lookup
      3. Dixon CE, Bedenice D, Mazan MR. Comparison of Flowmetric Plethysmography and Forced Oscillatory Mechanics to Measure Airway Hyperresponsiveness in Horses. Front Vet Sci 2020;7:511023.
        doi: 10.3389/fvets.2020.511023pubmed: 33693040google scholar: lookup
      4. Couetil L, Cardwell JM, Leguillette R, Mazan M, Richard E, Bienzle D, Bullone M, Gerber V, Ivester K, Lavoie JP, Martin J, Moran G, Niedźwiedź A, Pusterla N, Swiderski C. Equine Asthma: Current Understanding and Future Directions. Front Vet Sci 2020;7:450.
        doi: 10.3389/fvets.2020.00450pubmed: 32903600google scholar: lookup
      5. Arencibia A, Corbera JA, Ramírez G, Díaz-Bertrana ML, Pitti L, Morales M, Jaber JR. Anatomical Assessment of the Thorax in the Neonatal Foal Using Computed Tomography Angiography, Sectional Anatomy, and Gross Dissections. Animals (Basel) 2020 Jun 17;10(6).
        doi: 10.3390/ani10061045pubmed: 32560487google scholar: lookup
      6. Barton AK, Schulze T, Doherr MG, Gehlen H. Influence of bronchoalveolar lavage on thoracic radiography in the horse. J Vet Sci 2018 Jul 31;19(4):563-569.
        doi: 10.4142/jvs.2018.19.4.563pubmed: 29486534google scholar: lookup
      7. Barton AK, Wirth C, Bondzio A, Einspanier R, Gehlen H. Are pulmonary hemostasis and fibrinolysis out of balance in equine chronic pneumopathies?. J Vet Sci 2017 Sep 30;18(3):349-357.
        doi: 10.4142/jvs.2017.18.3.349pubmed: 28057902google scholar: lookup
      8. Barton AK, Pelli A, Rieger M, Gehlen H. Procalcitonin as a biomarker in equine chronic pneumopathies. BMC Vet Res 2016 Dec 9;12(1):281.
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      9. Couëtil LL, Cardwell JM, Gerber V, Lavoie JP, Léguillette R, Richard EA. Inflammatory Airway Disease of Horses--Revised Consensus Statement. J Vet Intern Med 2016 Mar-Apr;30(2):503-15.
        doi: 10.1111/jvim.13824pubmed: 26806374google scholar: lookup
      10. Barton AK, Shety T, Bondzio A, Einspanier R, Gehlen H. Metalloproteinases and Their Tissue Inhibitors in Comparison between Different Chronic Pneumopathies in the Horse. Mediators Inflamm 2015;2015:569512.
        doi: 10.1155/2015/569512pubmed: 26770019google scholar: lookup
      11. Savitske BJ, Dulli RJ, Paul NC, Washburn KE. Transtracheal Wash Fluid Collection and Analysis in Healthy Goats. J Vet Intern Med 2025 Sep-Oct;39(5):e70211.
        doi: 10.1111/jvim.70211pubmed: 40958735google scholar: lookup
      12. Lendl L, Barton AK. Equine Asthma Diagnostics: Review of Influencing Factors and Difficulties in Diagnosing Subclinical Disease. Animals (Basel) 2024 Dec 4;14(23).
        doi: 10.3390/ani14233504pubmed: 39682469google scholar: lookup
      13. Meiseberg LK, Delarocque J, de Buhr N, Ohnesorge B. Clinical variability of equine asthma phenotypes and analysis of diagnostic steps in phenotype differentiation. Acta Vet Scand 2024 Sep 18;66(1):51.
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      14. Simões J, Tilley P. Decision Making in Severe Equine Asthma-Diagnosis and Monitoring. Animals (Basel) 2023 Dec 16;13(24).
        doi: 10.3390/ani13243872pubmed: 38136909google scholar: lookup
      15. Robins TJ, Bedenice D, Mazan M. A Longitudinal Analysis of Equine Asthma Presentation and Response to Treatment Using Lung Function Testing and BAL Cytology Analysis in Combination with Owner Perception. Animals (Basel) 2023 Nov 1;13(21).
        doi: 10.3390/ani13213387pubmed: 37958142google scholar: lookup
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